Retraction of an intrathecal baclofen infusion catheter following suprapubic cystotomy: a case report.
BACKGROUND
Intrathecal baclofen, administered via a Baclofen pump, is used for patients with spasticity. We report here a case of intrathecal catheter retraction following surgery.


METHODS
A male patient with adrenoleukodystrophy and a baclofen pump implant was admitted to the urology department with bladder stones. A transurethral cystolithotripsy and a suprapubic cystotomy were performed. Following surgery there was no adequate spasm control. Plain abdominal X-ray showed complete retraction of the catheter out of the intrathecal space.


CONCLUSIONS
Intrathecal catheter retraction after surgery has been reported in a few cases. The retraction in this case did not seem to be due to the suprapubic cystotomy itself, but was more likely due to the positioning of the patient for cystoscopy and surgery, combined with possible loosening of the anchoring of the catheter.


CONCLUSIONS
Specific attention should be paid to the positioning of patients before surgery in order to avoid intrathecal baclofen catheter withdrawal.
Martens
Frank M J
FM
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. F.Martens@uro.umcn.nl
Somford
Diederik M
DM
van Kuppevelt
Dirk H J M
DH
van den Burg
Monica J M
MJ
Heesakkers
John P F A
JP
D000326:Adrenoleukodystrophy / Q000188:drug therapy; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D053715:Cystotomy; D004868:Equipment Failure; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011187:Posture; D001744:Urinary Bladder Calculi / Q000601:surgery
D009125:Muscle Relaxants, Central; D001418:Baclofen