Intrathecal baclofen in tetraplegia of spinal origin: efficacy for upper extremity hypertonia.
METHODS
Retrospective analysis.


OBJECTIVE
To evaluate the efficacy of intrathecal baclofen (ITB) for upper extremity spastic hypertonia in tetraplegia of spinal origin.


METHODS
University of Alabama at Birmingham hospital.


METHODS
The medical records of 14 individuals with tetraplegia of spinal origin who underwent intrathecal baclofen pump placement were reviewed. The effects of intrathecal baclofen on spasm frequency, deep tendon reflexes, and tone (Ashworth scale) were assessed for the upper and lower extremities for a 1-year follow-up period.


RESULTS
There were statistically significant declines in upper extremity spasm scores (1.8 points, P=0.012), reflex scores (1.4 points, P<0.0001) and Ashworth scores (0.6 points, P<0.0001) for the 1-year follow-up period. For the lower extremities, all decreases were significant (P<0.0001). There was also a statistically significant (P<0.0001) increase in intrathecal baclofen dosage requirements during the 1-year follow-up period to maintain the reductions in spasm frequency, reflexes and tone.


CONCLUSIONS
Intrathecal baclofen is a safe and effective intervention for treating upper extremity hypertonia of spinal origin. In addition, the level of intrathecal catheter placement is felt to be of importance.
Burns
A S
AS
Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Meythaler
J M
JM
D000328:Adult; D001132:Arm / Q000502:physiology; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D011782:Quadriplegia / Q000150:complications*; D012018:Reflex / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen