Cerebral Palsy - Baclofen Pump Installation Surgery

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Hello, I am an occupational therapist and work with cerebral palsy kids .Recently one of our patients underwent surgery for baclofen pump installation.I want to know how useful it is in such cases. My patient is a dystonic patient and is 10yrs old.Have there been any surgeries of this kind in India recently and if yes then how successful have they been?What is the success rate of this pump?
Answer
Baclofen is a drug produced as a muscle relaxant. It has been used to relieve the stiffness caused by spasticity. However, when it was taken orally it was found to have many side-effects, including lethargy and loss of balance. Intrathecal Baclofen Therapy (ITB). The system is also known as Continuous By Intrathecal Baclofen Infusion (CIBI,)Baclofen is delivered directly into the spinal fluid by a pump that is implanted under the skin of the abdomen in an operation that lasts about two hours. By putting the Baclofen directly into the spinal fluid, the drug can act as a muscle relaxant and reduce spasticity in the lower limbs without the side-effects associated with the oral administration of the drug. The most common side-effects of the Baclofen when delivered by pump include loose muscles, drowsiness, nausea, headache and dizziness. However, these are usually temporary and manageable by adjusting the dose.The pump itself needs to be refilled every few months and this is accomplished by inserting a needle through the skin into the pump. Potential risks include those associated with the pump. For example, the tube may move, kink or break or part of the pump may fail to work. It is important that this treatment is accompanied by therapy. This can involve intensive physio and occupational therapy in the first few weeks after the operation. Therapy may continue for several months. The cost of therapy is expensive and that is the major deterrent of the surgery in India. Back to All Questions

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