Faculty Collaboration Database

Low Rate of Intrathecal Baclofen Pump Catheter-Related Complications: Long-Term Study in Over 100 Adult Patients Associated With Reinforced Catheter. Neuromodulation 2021 Oct;24(7):1176-1180

Date

05/12/2021

Pubmed ID

33974333

DOI

10.1111/ner.13412

Scopus ID

2-s2.0-85105424850 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVES: Intrathecal baclofen (ITB) is a cost-effective therapy for patients with severe spasticity. The most common complications are catheter-related complications (CRCs) including kinking/occlusion, blockage, migration, fracture, disconnection, and CSF leak. Our objective was to determine the CRC rate in a large cohort of adults with newly implanted ITB pump systems with polymer reinforced silicone catheters.

MATERIALS AND METHODS: This is a retrospective study of a prospectively maintained database consisting of patients who had undergone implantation of ITB pump systems with Ascenda (Medtronic, Minneapolis) catheters from 2013 to 2020. Over this seven-year period, 141 patients underwent ITB pump system implantations; 126 of which had a minimum of one-year follow-up.

RESULTS: The 126 patients with a minimum of one year follow-up (average 43 month; range 12-89), had an average age of 51 years (63% male). Severe spasticity was due to spinal cord injury (38%), traumatic brain injury (15%), cerebral palsy (13%), multiple sclerosis (11%), stroke (10%), and other (13%). Nine (7.1%) CRCs occurred in 7 (5.6%) patients (median 6 mo. post-implant): 5 intrathecal catheter occlusions (range 3-52 months post-implant), two fractures in one patient (6 months), one disconnection at the catheter pump interface (2 months), and one due to kinking at 84 months No migrations occurred.

CONCLUSIONS: Reported CRCs have been high for ITB pump systems. Ours is the first large cohort, long-term study of CRCs related to reinforced catheters; additionally, our low CRC rate compares favorably to previously published data. Thus, implantation of reinforced catheters may be associated with a low CRC rate.

Author List

Feller CN, Awad AJ, Nelson MES, Ketchum N, Pahapill PA

Authors

Mary Elizabeth S. Nelson-Biersach DNP, NP Assistant Professor Outpatient in the Physical Medicine and Rehabilitation department at Medical College of Wisconsin
Peter A. Pahapill MD, PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Baclofen
Catheters
Female
Humans
Infusion Pumps, Implantable
Injections, Spinal
Male
Middle Aged
Muscle Relaxants, Central
Muscle Spasticity
Retrospective Studies