Cervical catheter placement for intrathecal baclofen test dose: is it safe?
BACKGROUND
Intrathecal baclofen testing is usually performed via a catheter inserted at the lumbar spine. However, in patients with scoliosis, the distorted anatomy and bone fusion from corrective spinal surgery obviates access at the lumbar spine.


METHODS
We report a method for inserting the intrathecal catheter via a posterior cervical approach and discuss our outcome. We describe our experience in 20 patients in whom intrathecal baclofen test catheter was inserted at the lower cervical spine. Data was collected prospectively.


CONCLUSIONS
The procedure was successful in all 20 patients. There were no complications as a result of surgery or from baclofen test dose administration via a cervical catheter. Of the 20 patients, 15 went on to have baclofen pump implantation via a cervical catheter. In one patient, subsequent pump implantation procedure was unsuccessful due to presence of extradural scar tissue. In the remaining four patients pump implantation was declined due impending corrective spinal surgery or social reasons.


CONCLUSIONS
Our experience shows that low cervical catheter insertion for administration of a test dose of intrathecal baclofen and feasible and safe to perform via the method described.
Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK. samiulm@aol.com
Samiul
S
Muquit
Ismail
I
Ughratdar
Harshal
H
Ingale
Michael
M
Vloeberghs
D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage*; D020739:Brain Diseases, Metabolic, Inborn / Q000150:complications / Q000188:drug therapy; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D002921:Cicatrix; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D012600:Scoliosis / Q000601:surgery
D009125:Muscle Relaxants, Central; D001418:Baclofen