Intrathecal baclofen therapy

Abstract

Intrathecal baclofen (ITB) therapy is a good therapeutic, evidence-based option and effective treatment for spasticity in children with cerebral palsy. It has also been used in children with dystonic cerebral palsy. ITB results in decreased spasticity, with the lower extremities more relieved than the upper extremities, fewer spasms, improvement in ankle clonus and increased range of motion and improved ambulation in children with spastic diplegia. As well, ITB therapy can help in reducing contractures, improving functional abilities and facilitating patient care by parents and caregivers. ITB therapy involves the surgical implantation of a programmable pump in the abdomen with a catheter tracking into the spinal subarachnoid space and the baclofen venting into the cerebrospinal fluid. There can be surgical complications, as well as complications related to the patient’s medical condition, to the hardware implanted and to the medication. Despite this, the overall perceptions of ITB therapy have been found to be positive with most parents or caregivers satisfied and would go through the process again if needed for their child.