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. 2012:2012:575168.
doi: 10.5402/2012/575168. Epub 2012 Mar 24.

Complications of intrathecal baclofen pump: prevention and cure

Yasser Awaad  1 , Tamer Rizk, Iram Siddiqui, Norbert Roosen, Kelly McIntosh, G Michael Waines
Affiliations

Complications of intrathecal baclofen pump: prevention and cure

Yasser Awaad et al. ISRN Neurol. 2012.

Abstract

Increasingly, spasticity is managed with surgically implanted Intrathecal Baclofen pumps. Intrathecal Baclofen pump revision surgery unrelated to programmable pump end-of-life is not uncommon, requiring special attention during pre-, intra-, and postoperative management. We aimed to identify and describe complications of Intrathecal Baclofen pump as well as to report avoidance and management of complications. Methods and Materials. Through 2002-2006, at the department of neurosurgery, Henry Ford and Oakwood Health Systems, Intrathecal Baclofen pumps were implanted in 44 patients: 24 children versus 20 adults; 30 "primary-implant-patients"; 14 "revision-only patients". We evaluated reasons for revision surgeries and diagnostic workup requirements. Results. Eight primary-implant-patients required 14 revisions and 7 of revision-only patients needed 13 procedures. Seven patients with slowly increasing baclofen-resistant spasticity had either (i) unsuspected pump-catheter connector defects, (ii) an X-ray-documented pump-catheter connector defect, (iii) X-ray-demonstrated fractured catheter with intrathecal fragment. Implant infections occurred in 4 cases. Scintigraphy revealed occult CSF leakage N=1 and intrinsic pump failure N=1. Conclusion. Intrathecal Baclofen pumps, although very gratifying, have a high, technique-related complication incidence during implant life. Meticulous technique, high clinical suspicion, appropriate workup, and timely surgical management can reduce surgical complications of Intrathecal Baclofen pump implantation.

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Figures

Figure 1
Figure 1
Tear at metal connector to pump within protective silicone covering.
Figure 2
Figure 2
perforating tear at metal connector to pump with protrusion of connector.
Figure 3
Figure 3
Removal of old catheter with extensive catheter tract obliteration. No specific CSF tract was found. (ABD: Abdominal, ANT: anterior, IMMED: immediately after dye administration, LAT: lateral, POST: posterior, RT: right).
See this image and copyright information in PMC

References

    1. Purves D, Augustine GJ, Fitzpatrick D, Hall WC, LaMantia A-S, McNamara JO, et al., editors. Neuroscience . 3rd edition. Sunderland, Mass, USA: Sinauer Publishers; 2004. Upper motor neuron control of the brainstem and spinal cord; pp. 414–415. .
    1. Purves D, Augustine GJ, Fitzpatrick D, Hall WC, LaMantia A-S, McNamara JO, et al., editors. Neuroscience . 3rd edition. Sunderland, Mass, USA: Sinauer Publishers; 2004. Lower motor neuron circuits and motor control; pp. 379–381. .
    1. Penn RD, Kroin JS. Intrathecal baclofen alleviates spinal cord spasticity. Lancet . 1984;1(8385):p. 1078. . - PubMed
    1. Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW. Classification and definition of disorders causing hypertonia in childhood. Pediatrics . 2003;111(1):e89–e97. . - PubMed
    1. Ivanhoe CB, Reistetter TA. Spasticity: the misunderstood part of the upper motor neuron syndrome. American Journal of Physical Medicine and Rehabilitation . 2004;83(10, supplement):S3–S9. . - PubMed

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