Functional outcome of intrathecal baclofen administration for severe spasticity.
OBJECTIVE
To estimate the functional benefit in patients with severe spasticity treated with intrathecal baclofen infusion through an implantable pump and to stress the need for functional assessment of these patients with a functional scale.


METHODS
Between 1999 and 2003, 22 patients with a long history of severe and disabling pharmaceutically intractable spasticity, underwent implantation of a pump for continuous intrathecal baclofen infusion. The patients were subdivided into two categories according to the aetiology of spasticity: 15 had Multiple Sclerosis and seven had suffered a Spinal Cord Injury at different levels (from C4 to T11). Clinical status was assessed with the Ashworth and Penn spasm scales. Functional benefits were evaluated with the Barthel index score and pain relief with a self-reported visual analogue pain scale.


RESULTS
Postoperatively, all patients presented improvement in spasticity, reduction of spasm frequency, significant improvement in functional status, enhancement of life comfort and reduction of pain.


CONCLUSIONS
Reduction of spasticity and spasms achieved with intrathecally delivered baclofen, leads to functional improvement and pain relief.
Boviatsis
Efstathios J
EJ
Department of Neurosurgery, Evangelismos General Hospital, University of Athens Medical School, 61 Ipsilantou Street, Kolonaki, Athens 11521, Greece. eboviats@med.uoa.gr
Kouyialis
Andreas T
AT
Korfias
Stefanos
S
Sakas
Damianos E
DE
D000203:Activities of Daily Living; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D020127:Recovery of Function; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D001418:Baclofen