Article

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.

Langue : ANGLAIS