title: Unusual placement of intrathecal baclofen pumps: report of two cases.
abstract: Intrathecal baclofen delivery via implantable pump represents an important modality for symptomatic relief in patients with chronic spasticity. Pumps are routinely implanted subcutaneously in the anterior abdominal wall. We describe two unusual cases where skin-related complications necessitated revision surgery in order to relocate the pump to alternative sites. The first patient was an international power canoeist, whose strenuous exercise programme interfered with his pump's original siting. The second patient was a cachectic university student with a history of cerebral palsy, who maintained low body mass despite attempted weight gain. The relocation of these two intrathecal devices to the medial compartment of the right thigh and right iliac fossa, respectively, is described.
authors.affiliation: The Medical School, University College London, Gower Street, London, WC1E 6BT, UK. oliver.devine@gmail.com.
authors.forename: Oliver
authors.initials: O
authors.lastname: Devine
authors.affiliation: Hull Royal Infirmary, Anlaby Rd, Kingston upon Hull, HU3 2JZ, UK. andyharborne@doctors.org.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Harborne
authors.affiliation: Department of Neurosurgery, Queen Elizabeth Medical Centre, Birmingham, B15 2TH, UK. williamlo@doctors.org.uk.
authors.forename: William B
authors.initials: WB
authors.lastname: Lo
authors.affiliation: Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK. weinberg@doctors.org.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weinberg
authors.affiliation: Department of Rehabilitation and Musculoskeletal Medicine, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK. mahesh.ciras@uhns.nhs.uk.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Ciras
authors.affiliation: Department of Neurosurgery, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK. rupert.price@uhns.nhs.uk.
authors.forename: Rupert
authors.initials: R
authors.lastname: Price
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy*; D012086:Reoperation / Q000379:methods*
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: Baclofen; Cerebral palsy; Intrathecal baclofen; Intrathecal device; Spastic diplegia; Spasticity