Intrathecal Baclofen (ITB) Therapy and Management

For patients with movement disorders like spasticity or dystonia, Children’s offers intrathecal baclofen therapy and management. We use the medication baclofen to manage these disorders that are often associated with cerebral palsy and brain injury. This type of therapy uses a pump and catheter system to deliver baclofen to the spine, which can be more effective than baclofen taken orally. Our physiatrists assess and identify potential patients that could benefit from ITB pump therapy. The decision to use this treatment will be made based on the patient’s level of spasticity or dystonia and previous response to other types of therapy.

The goals of intrathecal baclofen therapy are to:

  • Decrease spasticity or dystonia 
  • Improve comfort and range of motion 
  • Prevent or limit contractures 
  • Improve functional independence 
  • Minimize oral medications 
  • Improve the ease of care provided by caregivers

To evaluate effectiveness and identify the potential benefits of intrathecal baclofen pump therapy, our doctors evaluate patients in one of two ways:

  • A patient may be evaluated with a one-time intrathecal baclofen injection. If the patient shows improvement, they may meet with a neurosurgeon to coordinate a pump implant.

or

  • A patient may be evaluated using a several day baclofen infusion, which occurs through a catheter implanted by our neurosurgeons. If the result of the catheter implant is successful, neurosurgery will implant an Intrathecal Baclofen Pump. The implant usually occurs three to four days after the catheter is placed.

Our physiatrists work very closely with neurosurgery as the patient transitions to rehabilitation. After implantation, the pump must be refilled anywhere from every three weeks to six months, depending on the dosage. Children’s performs this refill procedure in the office without sedation. Because baclofen withdrawal can be serious, it is necessary that parents keep all baclofen pump refill appointments.