Intrathecal baclofen for severe spasticity: A meta-analysis

Creedon, Steven D.; Dijkers, Marcel; Hinderer, Steven R.

doi:10.1007/bf02766064

Cited by 27 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reintroduction of ITB is usually successful but most cases reported in the literature do not include long-term follow-up period and the effect could only be transitory. 34,38 In our one patient, the efficiency of ITB was observed for at least 4 years after re-introduction.…”

Section: Long-term Intrathecal Baclofenmentioning

confidence: 57%

“…Most studies 34 have an average follow-up period of less than 2 years, with the exception of the work by Lazorthes 25 with a mean follow-up of 4 years in a series of 40 patients. This long follow-up was necessary to evaluate the cumulated rate of incidents and side effects that a patient offered life-long ITB would probably encounter.…”

Section: Long-term Intrathecal Baclofenmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients

et al. 2004

View full text Add to dashboard Cite

Study design: Case series of a consecutive sample. Retrospective audit. Objective: To analyze the long-term safety and efficacy of intrathecal baclofen (ITB), and technical incidents. Setting: Neurosurgical and Physical Medicine Departments of two university hospitals in western France. Methods: The medical records of 40 patients who underwent ITB pump placement for the treatment of severe chronic spasticity were reviewed. Patients were eligible independently of the origin of the spasticity (spinal cord origin 33, brain damage 8). They underwent a final assessment with clinical examination and questionnaire in 2001. Ashworth scale scores were assessed, patient satisfaction was rated on a visual analog scale (VAS), functional independence before and after treatment was classified as bed-ridden, wheelchair dependant or ambulant, and the frequency and nature of complications were noted. Results: The average follow-up period was of 4 years. The average Ashworth score at the final assessment was 1.870.6. Average patients satisfaction was 7.4/1072.21 on VAS. In all, 85% would have undergone the procedure again if they had to make the decision. In 85% of the cases the ambulation status was unchanged. Technical incidents occured at least once in 37% of the patients (due to the catheter in 58% and to the pump in 42%). They included catheter disconnections (4), migration (4), kinks (3), obstruction (3), development of fibrosis (3), disconnection of pump reservoir (2), porosity of pump membrane (2), unexplained pump dysfunction (4) leakage, and subcutaneous collection (5). Severe pharmacological side effects requiring transfer to intensive care unit occured in 12% of cases, 80% of which were directly related to pump refill procedures. Conclusion: ITB remained effective in the long term and patients were satisfied. Nevertheless, complications were frequent, involving mainly the catheters, which would require further technical improvements.

show abstract

Section: Long-term Intrathecal Baclofenmentioning

confidence: 57%

Section: Long-term Intrathecal Baclofenmentioning

confidence: 99%

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients

et al. 2004

View full text Add to dashboard Cite

show abstract

“…2,3 Meanwhile, a series of studies has shown the effectiveness of continuous intrathecal therapy for both spinal or cerebral spasticity [3][4][5][6][7][8] and chronic pain. 9 The inadequate efficacy and intolerable side effects of oral and transdermal pharmacotherapy for the relief of symptoms in a considerable proportion of patients have led to the increased popularity of intrathecal therapies over the past two decades.…”

Section: Introductionmentioning

confidence: 99%

Device-related complications of long-term intrathecal drug therapy via implanted pumps

et al. 2008

View full text Add to dashboard Cite

Study Design: Case series. Objectives: To evaluate the risk of pump-and catheter-related complications of intrathecal drug delivery systems. Setting: Tertiary care center in Switzerland. Methods:The medical records of all in-and out-patient adults treated at our institution during a 12-year period were reviewed. All patients that had received intrathecal drug therapy via an implanted pump were invited to a structured interview. Results: One hundred patients, representing therapy with 175 implanted pumps and 132 intrathecal catheters over 552 years, participated in the study. During the observation period, 217 surgical procedures (including 100 primary pump implants) and 5863 pump refills were performed. The annual rate for complications requiring surgical measures was 10.5%, with 35% being pump related and 65% being catheter related. The incidence of infections in our patients was 0.7% per year; all infections appeared during the first 3 months after implantation of the first pump. Conclusions: Complication rates of the patients treated in our center, where we have long-term experience with the indication, implantation and continuous care of patients with intrathecal infusion systems, are in the lowest ranges when compared with other published studies. We consider intrathecal testing before implantation, standardized perioperative procedures and consequent long-term care of the patients in a specialized outpatient clinic to be essential factors for the avoidance of complications.

show abstract

“…A Cochrane review, last updated in June 2001, identified 23 placebo-controlled trials on antispasticity agents for MS 8 and Creedon and colleagues carried out a meta-analysis of intrathecal baclofen in 1997. 9 This took the form of a meta-analysis of English language trials of published studies on intrathecal baclofen prior to June 1996 and covered 27 studies including 162 patients with MS. There were also various reviews of single antispasticity agents in non-MS conditions which have been referred to in the discussion.…”

mentioning

confidence: 99%

Treatments for spasticity and pain in multiple sclerosis: a systematic review

Beard

Hunn²,

Wight³

2003

Health Technol Assess

236

131

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents, York Publishing Services by:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS and public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please contact York Publishing Services at the address above. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to York Publishing Distribution and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.ncchta.org/htacd.htm). Or contact York Publishing Services (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTATreatments for spasticity and pain in multiple sclerosis: a systematic review NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.The research reported in this monograph was commissioned by the HTA Programme and funded as project number 99/05/03. Technology assessment reports are completed in a limited time to inform decisions in key areas by bringing together evidence on the use of the technology concerned.The views expressed in this publication are those of the authors and not necessarily those of the HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for any recommendations made by the authors. HTA Programme Director:Professor Kent Woods Series Editors:Professor Andrew Stevens, Dr Ken Stein, Professor John Gabbay, Dr Ruairidh Milne, Dr Chris Hyde and Dr Rob Riemsma Managing Editors:Sally Bailey and ...

show abstract

Intrathecal baclofen for severe spasticity: A meta-analysis

Cited by 27 publications

References 34 publications

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients

Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients

Device-related complications of long-term intrathecal drug therapy via implanted pumps

Treatments for spasticity and pain in multiple sclerosis: a systematic review

Contact Info

Product

Resources

About