Intrathecal Baclofen therapy for refractory spasticity: a case series

World Neurosurg. 2024 May 9:S1878-8750(24)00762-9. doi: 10.1016/j.wneu.2024.05.009. Online ahead of print.

Abstract

Background: Management of refractory spasticity symptoms remains a challenging task for clinicians. ITB therapy has emerged as a promising option for treating this condition. This study evaluates the effectiveness of ITB therapy in managing refractory spasticity symptoms.

Materials and methods: A retrospective chart review was conducted on 34 patients with refractory spasticity symptoms who underwent ITB therapy at a single institution. The patients' demographics, clinical characteristics, and dosages were recorded. The primary outcome measures were the reduction in pain, improvement in mobility, decrease in spasm frequency, and alleviation of spasticity.

Results: ITB therapy successfully reduced pain, improved mobility, decreased spasm frequency, and alleviated spasticity. The mean daily administered dose was 245μg (range: 88-510μg, SD:104). However, it was observed that the appropriate dosage of ITB therapy was patient-specific and time-sensitive. Moreover, side effects were observed when an incorrect dose was administered.

Conclusion: Intrathecal baclofen therapy is an effective and safe option for managing refractory spasticity symptoms. However, the appropriate dosage should be individualized and monitored closely to avoid side effects. This study highlights the importance of carefully considering the potential risks and benefits of ITB therapy for each patient.

Keywords: baclofen; intrathecal; pain; refractory; spasticity.