Turkish Journal of Physical Medicine and Rehabilitation 2013 , Vol 59 , Num 4
Intrathecal Baclofen Therapy in Patients With Traumatic Spinal Cord Injury
Ümüt Güzelküçük 1 ,İltekin Duman 2 ,Bilge Yılmaz 3 ,Arif Kenan Tan 4
1 Gülhane Askeri Tıp Akademisi, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye
2 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, TSK Rehabilitasyon ve Bakım Merkezi, Ankara, Türkiye
3 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye
4 GATA Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
DOI : 10.4274/tftr.90582

Objective: To evaluate the results of intrathehal baclofen (ITB) therapy in 15 patients with traumatic spinal cord injury (SCI).

 

Materials and Methods: Medical records of 15 patients with SCI receiving ITB were evaluated retrospectively. Degree of spasticity before and after ITB, time interval between SCI and ITB, follow-up period after ITB, first effective dose of baclofen, current dose of baclofen and the complications after ITB were obtained.

 

Results: Eight (53%) patients had tetraplegia and seven (47%) patients had paraplegia. The mean follow-up period after ITB was 57.43±36.89 months. According to the modified Ashworth scale (MAS) mean spasticities were 3.47±0.51 before ITB and 1.50±0.51 after ITB. The difference between the mean degree of spasticity before and after ITB was significant (p=0.001). The mean first effective dose of baclofen was 174.33±92.25 μg/d. The mean current dose of baclofen was 240.42±125.19 μg/d. The differences in the mean first baclofen doses and current baclofen doses were significant between complete and incomplete patients (p=0.012; p=0.018, respectively). Complications developed in nine ( 60%) patients.

 

Conclusion: ITB is an effective treatment in traumatic SCI patients with severe spasticity, however, some medical and pump system complications might develop.

Keywords : Intrathecal baclofen pump, spasticity, spinal cord injury