Spasticity Management
Baclofen Pump Therapy
contributed by Joanne S. Janas, M.D. and William R. Boydston, M.D., Ph.D.
Baclofen is a drug used to relax muscles. Large doses of baclofen taken by mouth
can produce unacceptable sedation.
The baclofen pump delivers the drug only to the nerves controlling the child's
muscles. The pump is a mechanical device surgically implanted on the abdominal
wall. The pump is connected to a small tube implanted in the spinal canal. The
pump delivers a specific amount of baclofen to the nerves in the spinal cord.
The dosage can be adjusted non-surgically by a neurologist.
Before surgical implantation at Children's Healthcare of Atlanta, patients undergo
a drug trial to evaluate the potential effectiveness of the pump. The child is
admitted to the hospital where baclofen is injected through a spinal needle. A
neurologist and physical therapist evaluate the child both before and after the
injection. If the drug treatment is successful, surgical pump placement is recommended.
While baclofen is very effective in reducing overall tone and spasticity, the
tone reduction is not specific. All muscles will have reduced tone. When a child's
muscles are so stiff that the child is difficult to position and care for, the
baclofen pump is very useful. It may also be beneficial in improving the child's
upper extremity function by increasing the child's range of independent motion.