Intrathecal baclofen therapy in children with severe spasticity: Outcome and complications |
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Authors: | Matthias Walter Stefan Altermatt Claudia Furrer Andreas Meyer-Heim |
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Affiliation: | 1. Neuro-Urology, Spinal Cord Injury Centre &2. Research, University of Zurich, Balgrist University HospitalZurichSwitzerland;3. Paediatric Surgery, University Children’s Hospital ZurichZurichSwitzerland;4. Rehabilitation Centre, University Children’s Hospital ZurichAffoltern am AlbisSwitzerland |
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Abstract: | Objective: To investigate clinical efficacy and incidence of complications regarding intrathecal baclofen (ITB) therapy in children.Methods: Retrospective medical chart review of 15 paediatric patients with congenital brain injuries who underwent ITB implantation for treatment of severe spasticity between 2003 and 2009.Results: Compared to the preoperative state, ITB therapy significantly reduced spasticity of lower limbs with corresponding decrease of the modified Ashworth scale (p?0.05), while baclofen dosage increased (p?=?0.001). Cobb angle of patients with scoliosis prior to ITB therapy (n?=?8) increased significantly (p?0.05) during follow-up. Overall, 10 complications (nine device related and one accidental) were found in six patients (40%), mostly emerging within the first three years after implantation.Conclusion: Intrathecal baclofen is an effective therapy option for paediatric patients to significantly reduce spasticity of lower limbs. The high incidence of complications implicates the need for a close monitoring of the patients especially in the early post-operative period. |
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Keywords: | Cerebral palsy congenital brain injury paediatric |
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