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Complications of intrathecal baclofen pumps in children: experience from a tertiary care center.
Pediatr Neurosurg 2013; 49(3):138-44PN

Abstract

BACKGROUND/AIMS

Intrathecal baclofen (ITB) therapy is useful in treating spasticity and dystonia but it has many complications, more so in children. The main aim of the study was to look at the complications of ITB pumps in children with the goal of future prevention.

METHODS

Charts of all patients ≤21 years with an ITB pump, implanted by a single pediatric neurosurgeon, at a single center, between 1996 and 2011 were reviewed retrospectively. Data regarding an ITB test trial were also recorded.

RESULTS

During 1996-2011, 119 children (mean age 13.2 years) underwent ITB pump placement; 84% had spastic quadriplegic cerebral palsy. The gross motor function classification system level was ≥4 for most. The pump was removed in 5 (4.2%) patients due to inefficacy. The mean follow-up was 38 months. Mechanical complications requiring pump and/or catheter revision occurred in 19.3% and infections in an additional 21.8%. Seven patients (6%) had meningitis. No complication was noted after 72 months of initial pump insertion, even after pump reinsertion.

CONCLUSION

There is a need for better infection control as well as better pump, catheter and surgical technology to lower the complications of ITB pumps in children.

Authors+Show Affiliations

Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24577095

Citation

Ghosh, Debabrata, et al. "Complications of Intrathecal Baclofen Pumps in Children: Experience From a Tertiary Care Center." Pediatric Neurosurgery, vol. 49, no. 3, 2013, pp. 138-44.
Ghosh D, Mainali G, Khera J, et al. Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatr Neurosurg. 2013;49(3):138-44.
Ghosh, D., Mainali, G., Khera, J., & Luciano, M. (2013). Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatric Neurosurgery, 49(3), pp. 138-44. doi:10.1159/000358307.
Ghosh D, et al. Complications of Intrathecal Baclofen Pumps in Children: Experience From a Tertiary Care Center. Pediatr Neurosurg. 2013;49(3):138-44. PubMed PMID: 24577095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. AU - Ghosh,Debabrata, AU - Mainali,Gayatra, AU - Khera,Jena, AU - Luciano,Mark, Y1 - 2014/02/21/ PY - 2013/08/22/received PY - 2014/01/02/accepted PY - 2014/3/1/entrez PY - 2014/3/1/pubmed PY - 2015/2/24/medline SP - 138 EP - 44 JF - Pediatric neurosurgery JO - Pediatr Neurosurg VL - 49 IS - 3 N2 - BACKGROUND/AIMS: Intrathecal baclofen (ITB) therapy is useful in treating spasticity and dystonia but it has many complications, more so in children. The main aim of the study was to look at the complications of ITB pumps in children with the goal of future prevention. METHODS: Charts of all patients ≤21 years with an ITB pump, implanted by a single pediatric neurosurgeon, at a single center, between 1996 and 2011 were reviewed retrospectively. Data regarding an ITB test trial were also recorded. RESULTS: During 1996-2011, 119 children (mean age 13.2 years) underwent ITB pump placement; 84% had spastic quadriplegic cerebral palsy. The gross motor function classification system level was ≥4 for most. The pump was removed in 5 (4.2%) patients due to inefficacy. The mean follow-up was 38 months. Mechanical complications requiring pump and/or catheter revision occurred in 19.3% and infections in an additional 21.8%. Seven patients (6%) had meningitis. No complication was noted after 72 months of initial pump insertion, even after pump reinsertion. CONCLUSION: There is a need for better infection control as well as better pump, catheter and surgical technology to lower the complications of ITB pumps in children. SN - 1423-0305 UR - https://www.unboundmedicine.com/medline/citation/24577095/Complications_of_intrathecal_baclofen_pumps_in_children:_experience_from_a_tertiary_care_center_ L2 - https://www.karger.com?DOI=10.1159/000358307 DB - PRIME DP - Unbound Medicine ER -