title: Intrathecal baclofen therapy--how we do it.
abstract: Intrathecal baclofen has become an invaluable tool to treat spasticity of various etiologies. Children who benefit from intrathecal baclofen are often significantly underweight due to underlying disease pathology, and they lack adequate soft-tissue mass to effectively provide cover to the pump. Thus, in this population, subfascial implantation is favored over the subcutaneous technique in view of the high frequency of wound dehiscence and subsequent explantation of the pump associated with the latter method.   The authors describe and review their unit's adapted subfascial implantation technique that has been performed over a period of 10 years in 182 children. This technique provides better tissue coverage for the pump and has resulted in lowering the risk of complications as compared with the subcutaneous technique.
authors.affiliation: Department of Pediatric Neurosurgery, University of Nottingham, University Park, UK.
authors.forename: Amr
authors.initials: A
authors.lastname: Ammar
authors.forename: Ismail
authors.initials: I
authors.lastname: Ughratdar
authors.forename: Gnanamurthy
authors.initials: G
authors.lastname: Sivakumar
authors.forename: Michael H
authors.initials: MH
authors.lastname: Vloeberghs
mesh_terms: D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015918:Infusion Pumps, Implantable; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy*; D013116:Spinal Cord; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen