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. 2023 Jan 23;5(4):CASE22472.
doi: 10.3171/CASE22472. Print 2023 Jan 23.

Recurrent abdominal dislodgement of intrathecal pump and utility of infraclavicular site for patients with elevated body mass index: illustrative case

Kristin Buxton  1 , Ann Morgan  1 , Weston T Northam  2 , Scellig S D Stone  2
Affiliations

Recurrent abdominal dislodgement of intrathecal pump and utility of infraclavicular site for patients with elevated body mass index: illustrative case

Kristin Buxton et al. J Neurosurg Case Lessons. .

Abstract

Background: Intrathecal baclofen, delivered via implanted pump, has been used to manage spasticity for approximately 40 years. The device is typically subcutaneously or subfascially implanted in the abdominal wall. There are very few cases reported of the pump being implanted in other locations.

Observations: This case describes the complicated course of a patient presenting with multiple episodes of catheter malfunction related to pump flipping in the abdominal pocket. The patient was successfully treated with repositioning of the pump into the infraclavicular fossa.

Lessons: Infraclavicular placement of the implanted pump allowed for a more secure pocket base for this patient and less strain applied to the pump, minimizing the risk of disruption of pump positioning and interruption of drug delivery.

Keywords: baclofen; infraclavicular; intrathecal; pump.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1.
FIG. 1.
Catheter is noted to be tightly coiled with a kink in the tubing.
FIG. 2.
FIG. 2.
Catheter with significant coiling indicating excessive flipping of the pump in the pocket.
See this image and copyright information in PMC

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