Tags

Type your tag names separated by a space and hit enter

Outcomes of posterior spinal fusion and instrumentation in patients with continuous intrathecal baclofen infusion pumps.
Spine (Phila Pa 1976). 2008 Feb 15; 33(4):E94-9.S

Abstract

STUDY DESIGN

In this retrospective study, 20 spastic quadriplegic cerebral palsy (CP) patients with baclofen pumps, who underwent spinal fusion and instrumentation for neuromuscular scoliosis, were matched for weight, age, and type of fusion with patients without pumps.

OBJECTIVE

The objective of this study is to determine the rate of complications, adverse outcomes, and curve correction after spinal fusion in patients with CP and baclofen pumps compared with similar patients without pumps.

SUMMARY OF BACKGROUND DATA

CP patients treated with continuous intrathecal baclofen (ITB) can develop neuromuscular scoliosis and may require spinal fusion with instrumentation. ITB pumps may increase complications with this procedure.

METHODS

Medical records were examined, and preoperative risks, intraoperative complications, postoperative complications, and pump-specific complications were documented. Cobb angles were measured throughout the treatment to determine surgical correction.

RESULTS

Pump patients more frequently required reoperation (9 vs. 4, P = 0.039) and rehospitalization (8 vs. 2, P = 0.008). There was a trend toward more wound infections in pump patients (5 vs. 0, P = 0.063). Nine pump patients (45%) had a pump-related complication; 5 of these patients required pump removal or revision. Complications included durotomy, tubing problems, and deep spinal infection. Average surgical correction in pump patients was 42% (81 degrees -48 degrees) versus 50% (81 degrees -39 degrees) in nonpump patients, with no significant difference between pairs (P = 0.11).

CONCLUSION

CP patients with baclofen pumps who underwent spinal fusion had more complications compared with similar patients without pumps. There was no significant difference in surgical correction between matched pairs. Physicians and families should be aware of the increased risks of reoperation and rehospitalization after spinal fusion in the presence of baclofen pumps.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA. sugiyama@med.umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18277862

Citation

Caird, Michelle S., et al. "Outcomes of Posterior Spinal Fusion and Instrumentation in Patients With Continuous Intrathecal Baclofen Infusion Pumps." Spine, vol. 33, no. 4, 2008, pp. E94-9.
Caird MS, Palanca AA, Garton H, et al. Outcomes of posterior spinal fusion and instrumentation in patients with continuous intrathecal baclofen infusion pumps. Spine. 2008;33(4):E94-9.
Caird, M. S., Palanca, A. A., Garton, H., Hensinger, R. N., Ayyangar, R. N., Drongowski, A., & Farley, F. A. (2008). Outcomes of posterior spinal fusion and instrumentation in patients with continuous intrathecal baclofen infusion pumps. Spine, 33(4), E94-9. https://doi.org/10.1097/BRS.0b013e3181642aae
Caird MS, et al. Outcomes of Posterior Spinal Fusion and Instrumentation in Patients With Continuous Intrathecal Baclofen Infusion Pumps. Spine. 2008 Feb 15;33(4):E94-9. PubMed PMID: 18277862.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of posterior spinal fusion and instrumentation in patients with continuous intrathecal baclofen infusion pumps. AU - Caird,Michelle S, AU - Palanca,Ariel A, AU - Garton,Hugh, AU - Hensinger,Robert N, AU - Ayyangar,Rita N, AU - Drongowski,Amy, AU - Farley,Frances A, PY - 2008/2/19/pubmed PY - 2008/5/15/medline PY - 2008/2/19/entrez SP - E94 EP - 9 JF - Spine JO - Spine VL - 33 IS - 4 N2 - STUDY DESIGN: In this retrospective study, 20 spastic quadriplegic cerebral palsy (CP) patients with baclofen pumps, who underwent spinal fusion and instrumentation for neuromuscular scoliosis, were matched for weight, age, and type of fusion with patients without pumps. OBJECTIVE: The objective of this study is to determine the rate of complications, adverse outcomes, and curve correction after spinal fusion in patients with CP and baclofen pumps compared with similar patients without pumps. SUMMARY OF BACKGROUND DATA: CP patients treated with continuous intrathecal baclofen (ITB) can develop neuromuscular scoliosis and may require spinal fusion with instrumentation. ITB pumps may increase complications with this procedure. METHODS: Medical records were examined, and preoperative risks, intraoperative complications, postoperative complications, and pump-specific complications were documented. Cobb angles were measured throughout the treatment to determine surgical correction. RESULTS: Pump patients more frequently required reoperation (9 vs. 4, P = 0.039) and rehospitalization (8 vs. 2, P = 0.008). There was a trend toward more wound infections in pump patients (5 vs. 0, P = 0.063). Nine pump patients (45%) had a pump-related complication; 5 of these patients required pump removal or revision. Complications included durotomy, tubing problems, and deep spinal infection. Average surgical correction in pump patients was 42% (81 degrees -48 degrees) versus 50% (81 degrees -39 degrees) in nonpump patients, with no significant difference between pairs (P = 0.11). CONCLUSION: CP patients with baclofen pumps who underwent spinal fusion had more complications compared with similar patients without pumps. There was no significant difference in surgical correction between matched pairs. Physicians and families should be aware of the increased risks of reoperation and rehospitalization after spinal fusion in the presence of baclofen pumps. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/18277862/Outcomes_of_posterior_spinal_fusion_and_instrumentation_in_patients_with_continuous_intrathecal_baclofen_infusion_pumps_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3181642aae DB - PRIME DP - Unbound Medicine ER -