title: Respiratory Function Under Intrathecal Baclofen Therapy in Patients With Spastic Tetraplegia.
abstract: OBJECTIVE
  Intrathecal baclofen (ITB) therapy is an effective treatment for patients with severe spasticity. However, the effect of ITB therapy on respiratory function has not been reported in detail. In this study we quantitatively analyzed the effects of ITB on the respiratory function of patients with spastic tetraplegia.
  
  
  METHODS
  We retrospectively reviewed 23 patients who were administrated ITB therapy from January 2009 to December 2012. Six of these 23 patients, who had spastic tetraplegia and were able to undergo spirometric testing, were included this study. The spasticity derived from cervical spinal cord injury in four patients and cerebral palsy (CP) in two patients. Patients' Ashworth Scale scores and spirometer measurements obtained before and 1-6 months after the start of ITB therapy were evaluated and compared.
  
  
  RESULTS
  Before ITB therapy, %FVC of all six patients was below 80%, and a restrictive respiratory disorder was diagnosed in five patients and a combined respiratory disorder in one patient. Ashworth Scale scores for both the lower and upper extremities improved significantly with ITB therapy. Forced vital capacity (FVC), %FVC, and forced expiratory volume at one sec also improved significantly with ITB therapy.
  
  
  CONCLUSIONS
  Respiratory disorders were indeed present in our SCI and CP patients with spastic tetraplegia, and the respiratory function of these patients improved with ITB therapy. Our results suggest that ITB therapy is safe and efficacious in patients with spastic tetraplegia and respiratory dysfunction.
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kishima
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Takufumi
authors.initials: T
authors.lastname: Yanagisawa
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.|Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Oshino
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.|Department of Neurosurgery, Otemae Hospital, Osaka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Maruo
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.|Department of Neurosurgery, Osaka General Medical Center, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tani
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Hui Ming
authors.initials: HM
authors.lastname: Khoo
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.|Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hosomi
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hirata
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D011782:Quadriplegia / Q000150:complications* / Q000188:drug therapy; D012120:Respiration Disorders / Q000188:drug therapy* / Q000209:etiology*; D012189:Retrospective Studies; D013147:Spirometry; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: Cerebral palsy; intrathecal baclofen; respiratory function; spastic tetraplegia; spinal cord injury