Intrathecal Baclofen Therapy
What is Intrathecal Baclofen Therapy?
Intrathecal Baclofen Therapy (ITB) treats severe spasticity, a condition where injury or illness disrupts nerve signals to muscles and causes stiffness and difficulty in moving the arms, legs and other parts of the body. ITB delivers baclofen directly into the fluid surrounding the spinal cord, enabling patients to be more independent and allowing them to better perform activities of daily living.
How Does it Work?
ITB Therapy works by injecting the medication baclofen via a catheter directly into the cerebrospinal fluid surrounding the spinal cord. The catheter connects to an infusion pump implanted under the skin of the abdomen.
Because the delivery of drug is direct to the site of action, patients achieve relaxation with very small doses – as little as 1/100th of the typical oral dose. This increases effectiveness and helps reduce undesirable side effects such as drowsiness and weakness common with oral antispastic medications.
How is the Procedure Performed?
To get started, patients have a one-day screening test to determine if they are a candidate for ITB therapy. Patients receive a small dose of intrathecal baclofen to test response to the medication. Patients who experience relaxed muscles with the test dose are potential candidates for ITB therapy. After consulting with their health care professionals, those who are candidates are then scheduled to receive a drug infusion system.
Patients are scheduled for surgery to implant the pump, working with their physicians to determine the position for optimal comfort. After surgery, patients may have some pain for a few days, but once the incision is healed, the pump site requires no special care. Patients are able to resume their daily activities.
Patients need to work closely with their health care professionals to make sure they are receiving the proper dosage based on their level of activity and need. Most patients benefit from physical therapy after the pump is inserted to get the most benefit from the treatment. The pump has an alarm to indicate when it needs to be refilled. The refill is a simple out-patient procedure, performed by a health care professional who is knowledgeable about the pump.
What are the Key Benefits?
- Spasticity greatly reduced
- Lower doses than would be needed with oral medication, reducing side effects
- Increased function and independence
- Consistent, automatic administration of baclofen without having to remember to take oral doses
- Dosages can be varied throughout the day and custom tailored to meet individual needs
- Non-invasive changing of doses and refilling medication
What are the Risks and Side Effects of ITB Therapy?
- Loose muscles, sleepiness, headaches and dizziness
- Problems with the pump or catheter may result in return to or increase in spasticity
- Infection leading to need for surgical removal of the pump or catheter (this is unusual)
Why Alta Bates Summit Medical Center?
Established in 1996, the Alta Bates Summit ITB Program is one of the largest in the state and is a recognized Center of Excellence for this therapy. The therapy is offered under the auspices of the Rehabilitation Department, ensuring a coordinated, multidisciplinary approach to Spasticity Management.