Amparo Saenz1, Miguel Grijalba2, Juan Pablo Mengide2, Romina Argañaraz2, Fernando Ford3, Beatriz Mantese2. 1. Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, ZC, Argentina. amparo_saenz@hotmail.com. 2. Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, ZC, Argentina. 3. Division of Kinesiology, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.
Abstract
PURPOSE: This study aims to describe a new baclofen pump implantation technique with pre-brainstem catheter placement and to demonstrate the benefits that this procedure has in treating spasticity and dystonia. METHODS: We described a new technique to place a baclofen pump catheter anterior to the brainstem. To illustrate the technique, we presented five patients with both spasticity and dystonia in whom conventional treatment was not effective. They each received a baclofen pump with a pre-brainstem catheter. We evaluated the results using the Ashworth scale for spasticity, the Barry-Albright scale for dystonia, and the PedsQL for quality of life assessment. Each patient was evaluated before a surgery and after 6 months of follow-up. RESULTS: There were statistically significant differences in all the physical examination evaluated areas using the Barry-Albright and modified Ashworth scales between the preoperative and the postoperative period. The same applies to the results of the PedsQL quality of life scale. CONCLUSION: We presented an innovative baclofen pump implantation technique with pre-brainstem catheter placement that could be a therapeutic alternative in patients with dystonia and spastic quadriparesis for whom conventional therapy is not effective.
PURPOSE: This study aims to describe a new baclofen pump implantation technique with pre-brainstem catheter placement and to demonstrate the benefits that this procedure has in treating spasticity and dystonia. METHODS: We described a new technique to place a baclofen pump catheter anterior to the brainstem. To illustrate the technique, we presented five patients with both spasticity and dystonia in whom conventional treatment was not effective. They each received a baclofen pump with a pre-brainstem catheter. We evaluated the results using the Ashworth scale for spasticity, the Barry-Albright scale for dystonia, and the PedsQL for quality of life assessment. Each patient was evaluated before a surgery and after 6 months of follow-up. RESULTS: There were statistically significant differences in all the physical examination evaluated areas using the Barry-Albright and modified Ashworth scales between the preoperative and the postoperative period. The same applies to the results of the PedsQL quality of life scale. CONCLUSION: We presented an innovative baclofen pump implantation technique with pre-brainstem catheter placement that could be a therapeutic alternative in patients with dystonia and spastic quadriparesis for whom conventional therapy is not effective.
Entities:
Keywords:
Baclofen; Baclofen pump; Cerebral palsy; Dystonia; Movement disorders; Spasticity
Authors: A Camacho-Salas; C R Pallás-Alonso; J de la Cruz-Bértolo; R Simón-de Las Heras; F Mateos-Beato Journal: Rev Neurol Date: 2007 Oct 16-31 Impact factor: 0.870
Authors: J R Coffey; D Cahill; W Steers; T S Park; J Ordia; J Meythaler; R Herman; A G Shetter; R Levy; B Gill Journal: J Neurosurg Date: 1993-02 Impact factor: 5.115