Procedure- and device-related complications of intrathecal baclofen administration for management of adult muscle hypertonia: a review.

Abstract

BACKGROUND:

Intrathecal baclofen (ITB) effectively reduces muscle hypertonia; however, associated complications influence its utility and acceptance.

OBJECTIVE:

To systematically review the literature on procedure- and device-related complications associated with ITB infusion therapy for adult muscle hypertonia of spinal or cerebral origin.

METHODS:

The authors searched the PubMed database for full-length articles published in English that reported ITB-associated complications in adults. Of 147 articles retrieved, 32 full-length manuscripts and 10 case reports were reviewed in detail.

RESULTS:

Overall, 558 complications were reported after 1362 pump implants (0.41 per implant).

METHOD:

s for characterizing complications varied greatly between studies, as did complication rates, ranging from 0 to 2.24 per implant. Of the 558 complications, 148 (27%) were related to surgical procedures, 39 (7%) to pump problems, and 369 (66%) to catheter malfunctions. The overall complication rate was higher for studies that followed patients for more than 18 months on average (mean 0.56/implant) versus studies with shorter follow-up (0.23/implant, P < .05). Although correlation between the number of implants and the number of complications was significant (r = .58), the goodness of linear fit was poor because of clusters with varied complication rates.

CONCLUSIONS:

Catheter problems are relatively common and more frequent than pump or surgical procedure complications after ITB pump implantation. Higher complication rates should be expected in centers that follow patients for a longer period of time. Standardized data collection and complication-reporting procedures along with appropriate training should be implemented in centers offering ITB treatment for management of muscle hypertonia.

• Authors: Ivana Stetkarova, Stuart A Yablon, Markus Kofler, Dobrivoje S Stokic
• Journal: Neurorehabilitation and neural repair (Neurorehabil Neural Repair) Vol. 24 Issue 7 Pg. 609-19 (Sep 2010) ISSN: 1552-6844 [Electronic] United States
• PMID: 20233964 (Publication Type: Journal Article, Review)

Chemical References

• Baclofen

Topics

• Adult
• Baclofen (administration & dosage, adverse effects)
• Humans
• Infusion Pumps, Implantable (adverse effects, standards)
• Injections, Spinal (adverse effects, instrumentation, methods)
• Muscle Hypertonia (drug therapy, physiopathology)
• Postoperative Complications (epidemiology, prevention & control)