Catheter migration after implantation of an intrathecal baclofen infusion pump for severe spasticity: A case report

Tung Chou Li, Mei Hsiu Chen, Jing Shan Huang, Jun Yeen Chan, Yaun Kai Liu, Ming Hong Chen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

We report a case of intrathecal baclofen infusion pump implantation complicated by migration of the catheter tip. A 55-year-old man required an intrathecal baclofen infusion for severe spasticity 4 years after a cervical spinal cord injury with incomplete tetraparesis. Twelve months after initial implantation of the device, the patient began to experience a recurrence of trunk tightness and spasticity. Subsequent X-ray and computed tomography evaluations of the catheter system revealed pooling of contrast medium outside of the intrathecal distribution in the lumbar subcutaneous region of the back and therefore migration of the pump catheter tip. At surgical revision, emphasis was placed on minimizing the length of catheter outside of the spine and securing the catheter in the supraspinous fascia with a right-angled anchor. The distance between the anchors and the entry point of the catheter into the supraspinous fascia was also reduced to prevent slipping when the patient bends forward. After surgery, the patient's spasticity improved and, 1 year later, he has experienced no further complications during follow-up, requiring an average baclofen dose of 150 μg/day. Here, we describe several surgical methods intended to secure the intrathecal catheter and prevent catheter migration. Other complications related to catheter failure are also highlighted.

Original languageEnglish
Pages (from-to)492-497
Number of pages6
JournalKaohsiung Journal of Medical Sciences
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 2008
Externally publishedYes

Keywords

  • Baclofen
  • Baclofen withdrawal syndrome
  • Infusion pump
  • Intrathecal
  • Spasticity
  • Spinal cord injury

ASJC Scopus subject areas

  • Medicine(all)

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