Best Practices for Intrathecal Baclofen Therapy: Patient Selection

Saulino, Michael; Ivanhoe, Cindy B.; McGuire, John R.; Ridley, Barbara; Shilt, Jeffrey S.; Boster, Aaron

doi:10.1111/ner.12447

Cited by 64 publications

(43 citation statements)

References 42 publications

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“…In their 2016 Best Practices for Intrathecal Baclofen Therapy series, Boster, Saulino et al (1)(2)(3)(4) provide an overview of this important therapy-and consensus-based recommendations on patient selection, screening tests, troubleshooting, and dosing. The location of the catheter tip of intrathecal baclofen (ITB) pumps for severe upper extremity or generalized spasticity, however, has not been clearly elucidated.…”

Section: Placement Of Baclofen Pump Catheter Tip For Upper Extremity mentioning

confidence: 99%

Placement of Baclofen Pump Catheter Tip for Upper Extremity Spasticity Management

Chang

Ehsan

2018

Neuromodulation: Technology at the Neural Interface

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Section: Placement Of Baclofen Pump Catheter Tip For Upper Extremity mentioning

confidence: 99%

Placement of Baclofen Pump Catheter Tip for Upper Extremity Spasticity Management

Chang

Ehsan

2018

Neuromodulation: Technology at the Neural Interface

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Section: Scs For Spasticity: Review Of the Literaturementioning

confidence: 99%

“…Conversely, drug titration is usually more complicated and associated with increased risk relative to an adjustment in the SCS power setting. Detailed contemporary assessments of its implementation in the treatment of spasticity have been presented recently in an important series of best-practices papers in ITB (41)(42)(43)(44)(45). The earliest mention of SCS for spasticity dates to 1973 when Cook and Weinstein reported unexpected improvements in spasticity in a patient with MS who was trialing SCS for pain (46).…”

Section: Scs For Spasticity: Review Of the Literaturementioning

confidence: 99%

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Nagel

Wilson

Johnson

et al. 2017

Neuromodulation: Technology at the Neural Interface

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“…Saulino et al advocated that the best practice for intrathecal baclofen pumps was patient selection. 14 The limitation of the present study was based on its retrospective nature. However, we were able to In the early period, from 2000 to 2003, when there were only two patients with intrathecal baclofen pumps, the average interval for a medical staff to refill a baclofen pump was 38.1 days.…”

Section: Discussionmentioning

confidence: 92%

Blessing or burden? Long‐term maintenance, complications and clinical outcome of intrathecal baclofen pumps

Chan

et al. 2018

Surgical Practice

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AimThe intrathecal baclofen pump is an effective treatment for spasticity. However, long‐term results have reported patients’ dissatisfaction and perception of disability. Potential causes include a frequent need for baclofen pump refill and risks of complications. The aim of the present study was to evaluate the long‐term maintenance, complications and clinical outcome of intrathecal baclofen pumps.Patients and MethodsWe conducted a 16‐year retrospective cohort study of patients with spasticity treated with an intrathecal baclofen pump at a university hospital from 2000 to 2016. The primary outcome was the rate of infection per puncture for baclofen pump refill. Secondary outcomes included the incidence of other complications, such as running out of baclofen causing symptomatic withdrawal symptoms, pump mechanical failure, pump battery end of life and the need for pump replacement. The clinical outcome was assessed by the Modified Ashworth Scale (mAS).ResultsIn total, 340 follow‐up episodes with pump refill procedures were recorded. The average interval between each pump refill was 57.3 days (±15.4 days). The average duration of admission for each pump refill was 4 h and 49 min (from 2 h 23 min to 10 h). There were two events with established infection after puncture for the refill, giving rise to an infection rate per puncture of 0.6 percent (2/340).For the long‐term clinical outcome, at an average follow‐up period of 7.6 years, the postoperative mAS for spasticity was 2.0 ± 0.756, which was significantly better than the preoperative mAS at 3.75 ± 0.462 (P = 0.001).ConclusionLong‐term aftercare with baclofen pump refill was safe, with an infection rate of 0.6 per cent per puncture for each refill. Long‐term intrathecal baclofen pump was effective in the treatment of spasticity with persistent significant improvement in the spasticity scale.

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Best Practices for Intrathecal Baclofen Therapy: Patient Selection

Cited by 64 publications

References 42 publications

Placement of Baclofen Pump Catheter Tip for Upper Extremity Spasticity Management

Placement of Baclofen Pump Catheter Tip for Upper Extremity Spasticity Management

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Blessing or burden? Long‐term maintenance, complications and clinical outcome of intrathecal baclofen pumps

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