Tags

Type your tag names separated by a space and hit enter

Long-term follow-up for lumbar intrathecal baclofen catheters placed using the paraspinal subfascial technique.
J Neurosurg Pediatr 2016; 17(3):357-60JN

Abstract

OBJECT Intrathecal baclofen (ITB) is a valuable therapeutic option for patients with spasticity and dystonia. The techniques that place an ITB pump catheter into the subcutaneous fat of a lumbar incision are well described. Because patients who require ITB often have low body fat content, they may be predisposed to catheter-related complications. The senior author used a novel technique to place the catheter in a paraspinal subfascial fashion, and the short-term results were previously published. That study demonstrated no development of hardware erosions, catheter migrations, or CSF leaks within an average follow-up of 5 months. This study followed up on those initial findings by looking at the long-term outcomes since this technique was introduced.

METHODS

Using the institutional review board-approved protocol, the electronic medical records were reviewed retrospectively for all patients who underwent paraspinal subfascial catheter placement by the senior author. Patients received follow-up with the surgeon at 2 weeks postoperatively and were followed routinely by their physiatrist thereafter.

RESULTS

Of the 43 patients identified as having undergone surgery by the senior author using the paraspinal subfascial technique between July 2010 and February 2014, 12 patients (27.9%) required reoperation. There were 5 patients (11.6%) who had complications related to the catheter or lumbar incision. No hardware erosions or CSF leaks were identified. These patients received a median follow-up of 3.0 years, with 30 of 43 patients receiving follow-up over 2.0 years.

CONCLUSION

This follow-up study suggests that the technique of paraspinal subfascial catheter placement translates to long-term decreases in CSF leakage and complications from erosion, infection, and also catheter malfunctions. It does not seem to affect the overall rate of complications.

Authors+Show Affiliations

Department of Neurosurgery, New York University Langone Medical Center, New York, New York.Department of Neurosurgery, New York University Langone Medical Center, New York, New York.Department of Neurosurgery, New York University Langone Medical Center, New York, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26588457

Citation

Thakur, Saumitra K., et al. "Long-term Follow-up for Lumbar Intrathecal Baclofen Catheters Placed Using the Paraspinal Subfascial Technique." Journal of Neurosurgery. Pediatrics, vol. 17, no. 3, 2016, pp. 357-60.
Thakur SK, Rubin BA, Harter DH. Long-term follow-up for lumbar intrathecal baclofen catheters placed using the paraspinal subfascial technique. J Neurosurg Pediatr. 2016;17(3):357-60.
Thakur, S. K., Rubin, B. A., & Harter, D. H. (2016). Long-term follow-up for lumbar intrathecal baclofen catheters placed using the paraspinal subfascial technique. Journal of Neurosurgery. Pediatrics, 17(3), pp. 357-60. doi:10.3171/2015.7.PEDS15137.
Thakur SK, Rubin BA, Harter DH. Long-term Follow-up for Lumbar Intrathecal Baclofen Catheters Placed Using the Paraspinal Subfascial Technique. J Neurosurg Pediatr. 2016;17(3):357-60. PubMed PMID: 26588457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up for lumbar intrathecal baclofen catheters placed using the paraspinal subfascial technique. AU - Thakur,Saumitra K, AU - Rubin,Benjamin A, AU - Harter,David H, Y1 - 2015/11/20/ PY - 2015/11/21/entrez PY - 2015/11/21/pubmed PY - 2016/7/9/medline KW - BMI = body mass index KW - CP = cerebral palsy KW - IRB = institutional review board KW - ITB KW - ITB = intrathecal baclofen KW - catheter placement KW - intrathecal baclofen KW - paraspinal KW - subfascial KW - technique SP - 357 EP - 60 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 17 IS - 3 N2 - OBJECT Intrathecal baclofen (ITB) is a valuable therapeutic option for patients with spasticity and dystonia. The techniques that place an ITB pump catheter into the subcutaneous fat of a lumbar incision are well described. Because patients who require ITB often have low body fat content, they may be predisposed to catheter-related complications. The senior author used a novel technique to place the catheter in a paraspinal subfascial fashion, and the short-term results were previously published. That study demonstrated no development of hardware erosions, catheter migrations, or CSF leaks within an average follow-up of 5 months. This study followed up on those initial findings by looking at the long-term outcomes since this technique was introduced. METHODS Using the institutional review board-approved protocol, the electronic medical records were reviewed retrospectively for all patients who underwent paraspinal subfascial catheter placement by the senior author. Patients received follow-up with the surgeon at 2 weeks postoperatively and were followed routinely by their physiatrist thereafter. RESULTS Of the 43 patients identified as having undergone surgery by the senior author using the paraspinal subfascial technique between July 2010 and February 2014, 12 patients (27.9%) required reoperation. There were 5 patients (11.6%) who had complications related to the catheter or lumbar incision. No hardware erosions or CSF leaks were identified. These patients received a median follow-up of 3.0 years, with 30 of 43 patients receiving follow-up over 2.0 years. CONCLUSION This follow-up study suggests that the technique of paraspinal subfascial catheter placement translates to long-term decreases in CSF leakage and complications from erosion, infection, and also catheter malfunctions. It does not seem to affect the overall rate of complications. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/26588457/Long_term_follow_up_for_lumbar_intrathecal_baclofen_catheters_placed_using_the_paraspinal_subfascial_technique_ L2 - https://thejns.org/doi/10.3171/2015.7.PEDS15137 DB - PRIME DP - Unbound Medicine ER -