Intrathecal Baclofen Pump for Spasticity Treatment
Overview
Rady Children’s offers Intrathecal Baclofen Pump therapy for the treatment and management of spasticity in cerebral palsy patients. An Intrathecal Baclofen (ITB) pump is a specialized medical device used to effectively treat spasticity, particularly in patients for whom oral baclofen pills aren’t sufficient or cause undesirable side effects like drowsiness. Unlike oral medications, an ITB pump delivers medication directly to the spinal fluid, significantly reducing spasticity without causing drowsiness.
How the ITB Pump Works
The ITB pump is a small, battery-operated device (about the size of a hockey puck) implanted under the skin in the trunk area. It delivers medication directly around the spinal cord through a thin catheter. The dosage is adjustable and refilled every three to six months.
Benefits of ITB Pump
- Reduced spasticity without drowsiness.
- Tailored dosing (higher at night, lower during the day) to improve daily function.
- Enhanced mobility and comfort, particularly beneficial for individuals with cerebral palsy.
- Optimal dosage typically achieved within six months.
- Increased quality of life and ease in performing daily activities.
Risks and Side Effects
Like any surgical procedure, ITB pump implantation has risks, including:
- Spinal fluid leakage (potentially requiring bed rest or additional surgery)
- Infection (such as meningitis)
- Catheter issues (e.g., kinking)
Possible medication side effects, generally mild and manageable through dosage adjustments, include:
- Constipation
- Dizziness
- Drowsiness
- Seizure activity (rare)
The Baclofen Trial
Before pump implantation, a baclofen trial determines if ITB therapy will effectively reduce your spasticity. During this trial:
- Sedation is used in children; adults receive local anesthetic.
- Baclofen is injected into the spinal area; peak effectiveness occurs within a few hours.
- Your spasticity levels before and after injection are compared.
- You may feel unusually floppy temporarily, which indicates responsiveness to treatment.
Preparing for ITB Implantation
If your baclofen trial is successful, further preparations include:
- Gait Study (if you walk): Measures baseline mobility and energy use. Electrodes track muscle and joint movement.
- Goal-setting meeting with the Cerebral Palsy team to discuss lifestyle and body-image considerations.
Surgery and Recovery
- Implantation requires a short hospital stay.
- Post-surgery bed rest for 24 hours to reduce the risk of headaches.
- Gradual mobilization under supervision before discharge.
Follow-up Care
- Regular visits (every 1-2 weeks initially) to monitor healing and adjust dosage.
- Keeping a spasticity diary helps optimize dosage adjustments.
- Regular pump refills at scheduled clinic visits are essential.
Contact your healthcare provider at Rady Children’s Hospital to discuss further questions or concerns about ITB pump therapy.