Intrathecal baclofen therapy in children with severe spasticity: Outcome and complications

Abstract

Objective: To investigate clinical efficacy and incidence of complications regarding intrathecal baclofen (ITB) therapy in children.

Methods: Retrospective medical chart review of 15 paediatric patients with congenital brain injuries who underwent ITB implantation for treatment of severe spasticity between 2003 and 2009.

Results: Compared to the preoperative state, ITB therapy significantly reduced spasticity of lower limbs with corresponding decrease of the modified Ashworth scale (p < 0.05), while baclofen dosage increased (p = 0.001). Cobb angle of patients with scoliosis prior to ITB therapy (n = 8) increased significantly (p < 0.05) during follow-up. Overall, 10 complications (nine device related and one accidental) were found in six patients (40%), mostly emerging within the first three years after implantation.

Conclusion: Intrathecal baclofen is an effective therapy option for paediatric patients to significantly reduce spasticity of lower limbs. The high incidence of complications implicates the need for a close monitoring of the patients especially in the early post-operative period.

• Cerebral palsy
• congenital brain injury
• paediatric

Acknowledgements

The authors thank all children and their families who participated in our programme. Additionally Matthias Walter would like to thank Susanne Fluri, Elisabeth Klauser, Sandra Leuteritz, Deborah Bergmann, Lorenzo Tanadini, John Kramer, and in particular Catherine Jutzeler.