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Long Term Intrathecal Baclofen Therapy in Patients with Intractable Spasticity

Published online by Cambridge University Press:  18 September 2015

W.J. Becker ,
C.J. Harris ,
M.L. Long ,
D.P. Ablett ,
G.M. Klein  and
D.A. DeForge
W.J. Becker*
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
C.J. Harris
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
M.L. Long
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
D.P. Ablett
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
G.M. Klein
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
D.A. DeForge
Affiliation:
University of Calgary and the Calgary General Hospital, Calgary
*
Calgary General Hospital, M6-012, 841 Centre Avenue E., Calgary, Alberta, Canada T2E 0A1.
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Abstract

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Background

Severe spasticity unresponsive to oral drugs may respond satisfactorily to baclofen delivered intrathecally.

Methods

Intrathecal 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.

Results

Patients 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.

Conclusions

IB 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.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 3 , August 1995 , pp. 208 - 217
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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