Cervical catheter placement for intrathecal baclofen test dose: is it safe?

Muquit, Samiul; Ughratdar, Ismail; Ingale, Harshal; Vloeberghs, Michael

doi:10.1007/s00381-012-1711-2

Cited by 4 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In total, 121 patients with a tip at or above vertebral level T1 were included. Risk of bias was moderate in 5 ( 15 , 23 , 40 – 42 ), serious in 6 ( 15 , 25 , 31 , 36 – 38 , 43 ) and critical in 2 ( 24 , 39 ) studies ( Appendix 1 and Appendix 2 ). Risk of bias of the study of McCall & MacDonald was evaluated for 2 different outcomes: it was moderate for Ashworth and serious for complications ( 15 ).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding efficacy, only 9 studies described effects on spasticity ( 15 , 24 , 25 , 31 , 36 – 38 , 40 , 41 ). Three studies concerned cervical ITB in patients with dystonia ( 23 , 41 , 42 ) and one study focused on surgical aspects of cervical catheter placement, rather than the effect on spasticity ( 39 ). Six studies evaluated effects on UE function ( 23 , 24 , 36 , 37 , 41 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review

Jacobs¹,

Maas²,

Brusse-Keizer³

et al. 2021

J Rehabil Med

View full text Add to dashboard Cite

Objective To evaluate the effectiveness and safety of intrathecal baclofen treatment of spasticity, administered via a cervical catheter tip. Design A review of PubMed and the Cochrane Library up to September 2020. No restriction in study design. Two reviewers independently evaluated eligibility, extracted data and evaluated risk of bias. Studies were included in which patients were treated with intrathecal baclofen for spasticity, with the catheter tip at or above the first thoracic level, independent of diagnosis and age. Results Thirteen studies were eligible, with a moderate to critical risk of bias. Improvement in spasticity was seen only in the upper extremity in 6% of subjects, only in the lower extremity in 2%, in both upper and lower extremities in 50% and without specification of location in 41%. Upper extremity function improved in 88% of cases. Neither drug-related (1%) nor technical (21%) complications occurred more often than in lower placement of the tip. Effects on respiratory function and sleep apnoea were not investigated. Conclusion Cervically administered intrathecal baclofen seems to improve upper extremity spasticity and function, without causing more complications than thoracolumbar intrathecal baclofen. However, the mainly drug-related complications have not been thoroughly investigated and the available literature is of poor methodological quality. Further research is needed to confirm the efficacy and safety of this procedure. LAY ABSTRACT Spasticity is a common complication in central neurological disorders. It can lead to discomfort and functional limitations. To reduce spasticity, administration of baclofen via a catheter into the spinal canal has been used successfully for several years. However, this treatment often has limited effects on the upper limbs. The catheter tip is often situated in the thoracolumbar region. This review suggests that baclofen treatment via a cervically located catheter tip reduces spasticity of both arms and legs. Also, arm function improved in patients with a cervical catheter tip. Neither drug-related nor technical complications occurred more often than in lower placement of the cervical catheter tip. Few studies were found on this subject, and the available literature is of poor quality. Therefore, more research is needed to confirm the positive effect of this procedure on spasticity of the arms and to monitor for complications.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review

Jacobs¹,

Maas²,

Brusse-Keizer³

et al. 2021

J Rehabil Med

View full text Add to dashboard Cite

show abstract

Intrathecal baclofen for treating spasticity in children with cerebral palsy

Hasnat

Rice

2015

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

There is some limited short-term evidence that intrathecal baclofen is an effective therapy for reducing spasticity in children with cerebral palsy. The effect of intrathecal baclofen on long-term spasticity outcomes is less certain.The validity of the evidence for the effectiveness of intrathecal baclofen in treating spasticity in children with cerebral palsy from the studies in the review is constrained by the small sample sizes of the studies and methodological issues in some studies.Spasticity is a impairment in the domain of body structure and function. Consideration must also be given to the broader context in determining whether intrathecal baclofen therapy is effective. The aim of therapy may be, for example, to improve gross motor function, to increase participation at a social role level, to improve comfort, to improve the ease of care by others or to improve the overall quality of life of the individual. Intrathecal baclofen may improve gross motor function in children with cerebral palsy, but more reliable evidence is needed to determine this.There is some evidence that intrathecal baclofen improves ease of care and the comfort and quality of life of the individuals receiving it, but again small sample sizes and methodological issues in the studies mean that these results should be interpreted with caution.Further evidence of the effectiveness of intrathecal baclofen for treating spasticity, increasing gross motor function and improving comfort, ease of care and quality of life is needed from other investigators in order to validate these results.The short duration of the controlled studies included in this review did not allow for the exploration of questions regarding whether the subsequent need for orthopaedic surgery in children receiving intrathecal baclofen therapy is altered, or the safety and the economic implications of intrathecal baclofen treatment when long-term therapy is administered via an implanted device. Controlled studies are not the most appropriate study design to address these questions, cohort studies may be more appropriate.

show abstract

Lumbar translaminar fenestration for insertion of intrathecal baclofen catheter: a novel technique

2017

View full text Add to dashboard Cite

Intrathecal baclofen has long been known to be an efficacious treatment of spasticity in children with cerebral palsy. Test bolus administration is often necessary to ensure patients will benefit from this treatment. The introduction of a intrathecal catheter for test bolus administration can prove challenging in a subset of this population, particularly those who have received surgery with postoperative spinal fusion masses. We outline a novel technique of inserting a spinal catheter for test bolus administration in a patient with a postoperative fusion mass whereby a fenestration is created through the lamina using an osteotomy needle.

show abstract

Cervical catheter placement for intrathecal baclofen test dose: is it safe?

Abstract: Our experience shows that low cervical catheter insertion for administration of a test dose of intrathecal baclofen and feasible and safe to perform via the method described.

Cited by 4 publications

References 8 publications

Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review

Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review

Intrathecal baclofen for treating spasticity in children with cerebral palsy

Lumbar translaminar fenestration for insertion of intrathecal baclofen catheter: a novel technique

Contact Info

Product

Resources

About