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Intrathecal baclofen therapy for severe spasticity: analysis on a series of 112 consecutive patients and future prospectives.
Clin Neurol Neurosurg 2012; 114(4):321-5CN

Abstract

OBJECTIVE

Intrathecal baclofen therapy (ITB) is a well-known treatment for spasticity. Despite this fact, several topics have to be still discussed: new indications and screening tools, appropriate surgical timing and complicance avoidance.

METHODS

A total of 112 consecutive patients all with a severe, progressive and refractory to medical therapy spasticity from different causes were treated using ITB, after a bolus test. Every patient was assessed by means of Modified Ashworth Scale (MAS), Penn spasm frequency scale (SFS) and Visual Analog Scale for pain. Since available, a Gait analysis was also performed.

RESULTS

There were 63 males (56%) and 49 females (44%). Seventy-four (66%) had a quadriparesis, 34 (30.4%) had a paraparesis and 4 (3.6%) were hemiplegic. Among these patients 77 (68.7%) were non ambulatory, while 35 (31.3%) were ambulatory. These patients suffered from spasticity due to many different diseases. Mean follow-up was 55 months. The mean Modified Ashworth score decreased from 4.5±0.5 preoperatively to 1.2±0.4 on chronic intrathecal baclofen. Daily baclofen dose varied between 23 and 500 mcg. Drug-induced complications and catheter related problems occurred, respectively in 7 (6.3%) and 10 patients (8.9%).

CONCLUSIONS

Although ITB is a well known and good treatment option in the management of severe spasticity, because of the different goals and subgroups of patients treated, a variety of techniques are needed to evaluate the benefits of this therapy. New indications, effects of ITB on central nervous system and cognitive functions needs yet to be fully clarified.

Authors+Show Affiliations

Department of Neurosurgery, Second University of Naples SUN, Naples, Italy. massimo.natale@unina2.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22104692

Citation

Natale, M, et al. "Intrathecal Baclofen Therapy for Severe Spasticity: Analysis On a Series of 112 Consecutive Patients and Future Prospectives." Clinical Neurology and Neurosurgery, vol. 114, no. 4, 2012, pp. 321-5.
Natale M, Mirone G, Rotondo M, et al. Intrathecal baclofen therapy for severe spasticity: analysis on a series of 112 consecutive patients and future prospectives. Clin Neurol Neurosurg. 2012;114(4):321-5.
Natale, M., Mirone, G., Rotondo, M., & Moraci, A. (2012). Intrathecal baclofen therapy for severe spasticity: analysis on a series of 112 consecutive patients and future prospectives. Clinical Neurology and Neurosurgery, 114(4), pp. 321-5. doi:10.1016/j.clineuro.2011.10.046.
Natale M, et al. Intrathecal Baclofen Therapy for Severe Spasticity: Analysis On a Series of 112 Consecutive Patients and Future Prospectives. Clin Neurol Neurosurg. 2012;114(4):321-5. PubMed PMID: 22104692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal baclofen therapy for severe spasticity: analysis on a series of 112 consecutive patients and future prospectives. AU - Natale,M, AU - Mirone,G, AU - Rotondo,M, AU - Moraci,A, Y1 - 2011/11/21/ PY - 2011/01/22/received PY - 2011/10/27/revised PY - 2011/10/30/accepted PY - 2011/11/23/entrez PY - 2011/11/23/pubmed PY - 2012/7/31/medline SP - 321 EP - 5 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 114 IS - 4 N2 - OBJECTIVE: Intrathecal baclofen therapy (ITB) is a well-known treatment for spasticity. Despite this fact, several topics have to be still discussed: new indications and screening tools, appropriate surgical timing and complicance avoidance. METHODS: A total of 112 consecutive patients all with a severe, progressive and refractory to medical therapy spasticity from different causes were treated using ITB, after a bolus test. Every patient was assessed by means of Modified Ashworth Scale (MAS), Penn spasm frequency scale (SFS) and Visual Analog Scale for pain. Since available, a Gait analysis was also performed. RESULTS: There were 63 males (56%) and 49 females (44%). Seventy-four (66%) had a quadriparesis, 34 (30.4%) had a paraparesis and 4 (3.6%) were hemiplegic. Among these patients 77 (68.7%) were non ambulatory, while 35 (31.3%) were ambulatory. These patients suffered from spasticity due to many different diseases. Mean follow-up was 55 months. The mean Modified Ashworth score decreased from 4.5±0.5 preoperatively to 1.2±0.4 on chronic intrathecal baclofen. Daily baclofen dose varied between 23 and 500 mcg. Drug-induced complications and catheter related problems occurred, respectively in 7 (6.3%) and 10 patients (8.9%). CONCLUSIONS: Although ITB is a well known and good treatment option in the management of severe spasticity, because of the different goals and subgroups of patients treated, a variety of techniques are needed to evaluate the benefits of this therapy. New indications, effects of ITB on central nervous system and cognitive functions needs yet to be fully clarified. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/22104692/Intrathecal_baclofen_therapy_for_severe_spasticity:_analysis_on_a_series_of_112_consecutive_patients_and_future_prospectives_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(11)00364-7 DB - PRIME DP - Unbound Medicine ER -