Intrathecal antispastic drug application with implantable pumps: results of a 10 year follow-up study.
Since 1986, more than 300 patients received an intrathecal baclofen (ITB) pump for the treatment of severe spasticity. Chronic ITB administration is a safe and effective method, which significantly decreases pathologically exaggerated muscle tone and improves the quality of life in most patients. This therapy is indicated in severe spasticity of cerebral or spinal origin that is unresponsive to oral antispastic medications. It is also useful in patients who may experience intolerable side effects when they receive orally effective baclofen doses. The therapeutic dose required to treat spasticity of cerebral origin is about three times higher than in spasticity of spinal origin. In carefully selected patients who suffer from spasticity, pump implantation is a cost-effective treatment which improves their quality of life. In our series with a follow-up period of 10 years, the ITB dose remained constant and no development of tolerance was observed in most patients. Destructive procedures such as myelotomy are no longer performed in our department in order to treat spasticity.
Koulousakis
A
A
Department of Neurosurgery, Cologne University, Cologne, Germany.
Kuchta
J
J
D001418:Baclofen / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002526:Cerebellar Diseases / Q000150:complications; D004305:Dose-Response Relationship, Drug; D004333:Drug Administration Routes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications
D009125:Muscle Relaxants, Central; D001418:Baclofen