title: [Utility of Intraoperative Catheter Myelography during Intrathecal Baclofen Pump Implantation:Report of 2 Cases].
abstract: We report two patients in whom the intrathecal baclofen(ITB)catheter was located in the subdural space, although we had confirmed good outflow of spinal fluid from the spinal catheter. Patient 1 was a woman in her 30s with spastic quadriplegia due to subarachnoid hemorrhage. An ITB pump was implanted, and a good outflow of spinal fluid from the spinal catheter was observed during the surgery. Postoperatively, her spasticity did not improve. Catheter myelography revealed that the spinal catheter was located in the subdural space. Using intraoperative catheter myelography, we corrected the position of the catheter. Patient 2 was a man in his 20s diagnosed with adrenoleukodystrophy. An ITB therapy was performed to improve his spastic gait. Intraoperative catheter myelography showed that the spinal catheter was located in the subdural space, although there was good outflow of spinal fluid from the catheter. Our experience suggests that the outflow of spinal fluid alone should not be used to determine the location of the spinal catheter. Intraoperative catheter myelography is useful for the correct placement of the spinal catheter in the subarachnoid space.
authors.affiliation: Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Takamiya
authors.forename: Toru
authors.initials: T
authors.lastname: Sasamori
authors.forename: Shuji
authors.initials: S
authors.lastname: Hamauchi
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Seki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kano
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yabe
authors.forename: Hidenao
authors.initials: H
authors.lastname: Sasaki
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D000328:Adult; D001418:Baclofen / Q000627:therapeutic use*; D002404:Catheterization; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007430:Intraoperative Care; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology; D009192:Myelography; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D001418:Baclofen