AOCPMR 2024 Mid-Year Meeting-Intrathecal Baclofen Pump (ITB)

Video Transcription

Video Summary

Dr. Mike Green, a pediatric rehabilitation physician, discusses intrathecal baclofen (ITB) pumps used to manage spasticity from central nervous system lesions such as cerebral palsy, brain/spinal cord injuries, and genetic disorders. Spasticity involves involuntary muscle tightness affecting movement and function. Treatments range from physical therapy and oral medications, to orthopedic and neurosurgical interventions. ITB pumps deliver baclofen directly into the spinal fluid, targeting GABA-B receptors to reduce spasticity more effectively than oral pills, with fewer systemic side effects and better dose control.<br /><br />Candidates for ITB pumps typically have moderate to severe, systemic spasticity impacting function or caregiving. The pump, implanted surgically, allows programmable, continuous or timed dosing tailored to daily activities. Advantages include improved tone control and reduced medication side effects; disadvantages involve surgical risks, pump-related complications, and need for lifelong management.<br /><br />Potential complications include infection, overdose, and withdrawal, all requiring prompt recognition and treatment to avoid serious outcomes like seizures or death. Maintenance includes regular pump refills every 4-6 months and pump replacement every seven years. Selection involves multidisciplinary evaluation of goals, family support, and logistics. Dr. Green emphasizes thorough education on risks, monitoring, and careful dose titration to balance improved function with risks, ensuring better quality of life for patients with spasticity.

Keywords

osteoporosis

women over 50

early detection

neurologic diseases

muscular diseases

bone density testing

FRAX tool

bisphosphonates

patient education

intrathecal baclofen pump

spasticity management

pediatric rehabilitation

central nervous system lesions

cerebral palsy treatment

baclofen delivery

neuromuscular disorders

pump complications