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


Walter, Matthias; Altermatt, Stefan; Furrer, Claudia; Meyer-Heim, Andreas (2014). Intrathecal baclofen therapy in children with severe spasticity: Outcome and complications. Developmental Neurorehabilitation, 17(6):368-374.

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.

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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2014
Deposited On:12 Sep 2013 11:01
Last Modified:05 Apr 2016 16:57
Publisher:Informa Healthcare
ISSN:1751-8423
Publisher DOI:https://doi.org/10.3109/17518423.2013.827256
PubMed ID:23977869

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