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Case Reports
. 2023 Sep;165(9):2707-2710.
doi: 10.1007/s00701-023-05718-z. Epub 2023 Jul 21.

Unique form of catheter malconnection following intrathecal baclofen surgery for spinal cord injury: a case report

Raoul J Koopmans  1 , Carel G M Meskers  2   3 , Vincent de Groot  2   3 , K Mariam Slot  4
Affiliations
Case Reports

Unique form of catheter malconnection following intrathecal baclofen surgery for spinal cord injury: a case report

Raoul J Koopmans et al. Acta Neurochir (Wien). 2023 Sep.

Abstract

This case report concerns a patient suffering from traumatic spinal cord injury with severe spasticity treated with intrathecal baclofen therapy. After revision surgery for a confirmed catheter obstruction, progressive spasticity reappeared. Diagnostics demonstrated signs of catheter fracture or disconnection adjacent to the pump. During revision surgery, the silicone layer surrounding the sutureless pump connector was shown to be curled up, revealing the cause of dysfunction. As far as we know, this form of malconnection has not been reported before. Therefore, surgeons must be aware of this complication and additional inspection of the silicone connector prior to definite connection is advised.

Keywords: Case report; Disconnection; Dysfunction; Intrathecal baclofen (ITB); Malfunction; Spinal cord injury (SCI).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Intrathecal contrast after catheter access port contrast injection on CT (blue arrow)
Fig. 2
Fig. 2
Edema (blue arrow) and suspected fluid collection on CT
Fig. 3
Fig. 3
Medtronic Ascenda catheter system
Fig. 4
Fig. 4
Incorrect alignment of the sutureless pump connector
Fig. 5
Fig. 5
Curled up silicone layer surrounding the sutureless pump connector (left) and normal silicone layer surrounding the sutureless pump connector (right)
See this image and copyright information in PMC

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