Orthopedic surgery in children with intrathecal baclofen pumps.
OBJECTIVE
Children with cerebral palsy often have severe spasticity leading to deformity that requires multiple orthopedic surgeries. Intrathecal baclofen pump implantation effectively decreases severe spasticity. The objective of this study was to determine whether children who have a baclofen pump implanted at a young age have fewer orthopedic surgeries than those who have a baclofen pump implanted at later ages.


METHODS
In this retrospective study of 310 children, we compared occurrence of surgery in relation to having or not having the baclofen pump, by using survival analysis with surgery as the outcome, presence of baclofen pump as the exposure of interest, modeled as a time-dependent variable, and age as the time scale.


RESULTS
There was no significant effect of pump placement on overall surgery frequency. Analyses by type of surgery showed that those without a pump in place had a 64% lower hazard of scoliosis surgery.


CONCLUSIONS
No evidence was found to indicate that children who have a baclofen pump implanted at a young age have fewer orthopedic surgeries than those who have a baclofen pump implanted at later ages.
Utah Neuro Rehabilitation, Salt Lake City, UT, USA.
Judith L
JL
Gooch
University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Molly
M
McFadden
Primary Children's Medical Center, Salt Lake City, UT, USA.
Wende
W
Oberg
D000293:Adolescent; D000367:Age Factors; D001418:Baclofen / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015918:Infusion Pumps, Implantable / Q000706:statistics & numerical data*; D008297:Male; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D009985:Orthopedics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
D009125:Muscle Relaxants, Central; D001418:Baclofen
Intrathecal baclofen; cerebral palsy; orthopedic surgery; spasticity