title: Rapid progression of scoliosis following insertion of intrathecal baclofen pump.
abstract: Placement of an intrathecal baclofen pump is a common treatment of spasticity in cerebral palsy patients. Though effective, the hardware is prone to malfunction, and multiple revisions are often necessary. Additional complications have also been described, including infection and drug toxicity or withdrawal. The authors report another complication of intrathecal baclofen therapy: accelerated progression of scoliosis after pump insertion. A retrospective chart review was performed on four patients who showed accelerated scoliotic progression after intrathecal baclofen pump insertion for treatment of spasticity. Cobb angles were measured from preoperative and postoperative radiographs to determine the rate of scoliotic degeneration both before and after pump insertion. Although there may not be a direct correlation between intrathecal baclofen and scoliosis, the authors consider the issue important enough to warrant discussion with any patient considering intrathecal baclofen.
authors.affiliation: Department of Neurological Surgery, University of Wisconsin Hospital & Clinics, Madison, 53792, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Sansone
authors.forename: David
authors.initials: D
authors.lastname: Mann
authors.forename: Kenneth
authors.initials: K
authors.lastname: Noonan
authors.forename: Deborah
authors.initials: D
authors.lastname: Mcleish
authors.forename: Michael
authors.initials: M
authors.lastname: Ward
authors.forename: Bermans J
authors.initials: BJ
authors.lastname: Iskandar
mesh_terms: D000328:Adult; D001418:Baclofen / Q000009:adverse effects* / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D009125:Muscle Relaxants, Central / Q000009:adverse effects* / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012600:Scoliosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012720:Severity of Illness Index
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen