scholarly journals Long Term Intrathecal Baclofen Therapy in Patients with Intractable Spasticity

1995 ◽  
Vol 22 (3) ◽  
pp. 208-217 ◽  
Author(s):  
W.J. Becker ◽  
C.J. Harris ◽  
M.L. Long ◽  
D.P. Ablett ◽  
G.M. Klein ◽  
...  
Keyword(s):  
Cervical Spinal Cord ◽  
Cost Effective ◽  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Skin Breakdown ◽  
Severe Spasticity ◽  
Cord Injury ◽  
At Home

AbstractBackgroundSevere spasticity unresponsive to oral drugs may respond satisfactorily to baclofen delivered intrathecally.MethodsIntrathecal baclofen (IB) therapy delivered by means of implanted infusion pumps was used for nine patients with severe spasticity. Six patients had multiple sclerosis, two cervical spinal cord injury, and one head injury. All were non-ambulatory.ResultsPatients showed improvement in many areas, including ability to transfer, seating, pain control, personal care, and liability to skin breakdown. Before IB therapy, only three of the nine patients were able to live at home in the community and six were institutionalized. At the end of our follow-up period, only one patient remained institutionalized, three lived in group homes and five lived at home in the community. In the year preceding pump implantation, the nine patients spent a total of 755 days in acute care hospitals. In the year following onset of IB therapy, they spent only 259 days in hospital.ConclusionsIB therapy can improve patient quality of life and can be cost-effective in carefully selected patients with severe spasticity and disability. The drug delivery catheter is that part of the therapeutic system most vulnerable to failure. Because of the varied expertise required to manage these patients effectively, and the potential for a variety of complications, it is essential that an IB program is supported by a well-organized multi-disciplinary medical team.

scholarly journals The dosage and administration of long-term intrathecal baclofen therapy for severe spasticity of spinal origin

Spinal Cord ◽  
2018 ◽  
Vol 56 (10) ◽  
pp. 996-999
Author(s):  
Osamu Kawano ◽  
Muneaki Masuda ◽  
Tsuneaki Takao ◽  
Hiroaki Sakai ◽  
Yuichiro Morishita ◽  
...  
Keyword(s):  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Severe Spasticity

393 LONG TERM FOLLOW-UP AFTER CONTINUOUS INTRATHECAL BACLOFEN THERAPY FOR SEVERE SPASTICITY

2010 ◽  
Vol 4 (S1) ◽  
pp. 112-112
Author(s):  
E. Anastasiou ◽  
A. Tzortzopoulou ◽  
A. Alexandropoulou ◽  
K. Rizos ◽  
A. Karakosta ◽  
...  
Keyword(s):  
Intrathecal Baclofen ◽  
Intrathecal Baclofen Therapy ◽  
Severe Spasticity ◽  
Long Term Follow Up

scholarly journals Continuous intrathecal baclofen delivery in severely disabling spasticity

2018 ◽  
Vol 75 (11) ◽  
pp. 1076-1082 ◽  
Author(s):  
Hakan Simsek ◽  
Emre Zorlu ◽  
Omer Bakal ◽  
Selim Akarsu ◽  
Senol Güney
Keyword(s):  
Neurological Disorders ◽  
Intrathecal Baclofen ◽  
Percutaneous Technique ◽  
Physical Treatment ◽  
Severe Spasticity ◽  
Cord Injury ◽  
Clinical Conditions ◽  
Pump Implantation

Background/Aim. Spasticity is the consequence of several clinical conditions including cerebral palsy, brain injury, spinal cord injury, multiple sclerosis, aneurysm bleeding, and some other neurological disorders. The aim of this study was to determine the efficacy of intrathecal baclofen (ITB) treatment in medically intractable severely disabling spasticity and present the challenges encountered during pump implantation surgery on these patients. Methods. The patients who underwent intrathecal baclofen pump implantation surgery between the years 2012 and 2015 with minimum follow-up of six months were recruited from the clinic archives. Twenty two patients with severe spasticity who had Modified Asworth Spasticity Scale (MASS) score of 3 or 4 were enrolled in our series. Eight of twenty-two patients were at pediatric age and they all were non-ambulant before surgery. Results. All of the patients underwent programmable intrathecal baclofen pump implantation surgery. Catheters were placed via percutaneous technique into to the subarachnoid space in 18 patients while, we had to perform partial hemi-laminectomy in order to place the catheters in 4 patients. All the patients improved significantly and 5 began using upper extremities and 3 adults became ambulant following physical therapy. Mean of the MASS scores improved from 3.59 to 1.32 (p < 0.001). Conclusion. The ITB therapy obviously increased quality of life and functional outcome in patients with disabling spasticity. As a result, physical treatment was more useful for these patients. Although some spinal abnormalities due to spasticity may necessitate partial hemilaminectomy to implant the pump, patients with intractable spasticity should be given the chance of intrathecal baclofen treatment at the earliest period of their lifetime disability.

scholarly journals Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord ◽  
2021 ◽  
Author(s):  
Florian Möller ◽  
Rüdiger Rupp ◽  
Norbert Weidner ◽  
Christoph Gutenbrunner ◽  
Yorck B. Kalke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Independence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cord Injury ◽  
Over Time

Abstract Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

INTRATHECAL BACLOFEN PUMP FOR SPASTIC HYPERTONIA FOLLOWING PENETRATING BRAIN INJURY

2021 ◽  
pp. 76-78
Author(s):  
Anand Sharma ◽  
Yashbir Dewan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Intrathecal Baclofen ◽  
Gunshot Injury ◽  
Review Of Literature ◽  
Penetrating Brain Injury ◽  
Severe Spasticity ◽  
Cord Injury

Management of severe spasticity following penetrating brain injury is often a difcult problem. Orally administered medications generally offer limited benets. Intrathecally administered baclofen has been shown to be effective in patients with spasticity caused by spinal cord injury and stroke, however, the effectiveness of ITB for spasticity related to penetrating brain injury is not well established. We reported two cases of spastic hypertonia following gunshot injury to brain with brief review of literature upon role of intrathecal baclofen pump (ITB) in cortical spastic hypertonia

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