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Getting the Therapy
A baclofen pump is a surgically implanted device that delivers medication exactly where your spinal cord needs it. If you pass a standard screening test and don't respond to oral baclofen, the pump can be implanted in a 2-hour procedure, followed by a short hospital stay.
Your doctor will consider many factors including your symptoms, goals, body mass, and results of a screening test.
With ITB therapy, a variety of healthcare providers will work together to help manage your severe spasticity caused by spinal cord injury or spinal cord disease.
Your doctor will consider many important factors to decide if ITB therapy is right for you.
You may be a candidate for ITB therapy if you:
In addition, healthcare professionals may use the following criteria to determine if you are a candidate for a baclofen pump:
A standard screening test determines if ITB therapy may work for you. During the test, you’ll be screened with a small dose of the drug baclofen injected into the intrathecal space (where fluid flows around the spinal cord).
In clinical studies during the screening test, baclofen reduced spasticity in 97% of people with severe spasticity due to multiple sclerosis or spinal cord injury .1
If your doctor determines you are a candidate for a baclofen pump, you will need to make the final decision about whether to pursue the therapy.
Here are some suggestions to help you decide if a baclofen pump is right for you:
Before you meet with your doctor, think about what you hope to learn. Prepare questions, and be ready to provide information about your medical history.
You’ll work with a variety of healthcare professionals to determine your suitability for ITB therapy. They’ll thoroughly evaluate your condition to find the most appropriate treatment options. To get the best results, it’s important to actively participate in discussions and decision-making related to your care.
Your healthcare team for severe spasticity treatment with a baclofen pump may be a combination of the following:
Surgery to implant a baclofen pump takes approximately 1 to 2 hours from start to finish, depending on individual surgical techniques. Your doctor will be able to answer any questions you may have about the specifics of your procedure.
Your surgery to receive a baclofen pump may require a brief hospital stay, or it may be done on an outpatient basis. Before the procedure, you and your doctor will decide where to position the pump for your comfort.
Typically, the surgery is performed under general anaesthesia, but you may discuss alternatives with your doctor. During surgery, the pump will be placed just under the skin of your lower abdomen.
The pump will be connected to a thin, flexible silicone tube called a catheter. The catheter is threaded beneath the skin into the intrathecal space (around the spinal cord), into which it will deliver the medication.
After surgery, you may feel some discomfort and tenderness at the pump and catheter sites. Your doctor may prescribe medication to relieve any pain caused by surgery and antibiotics to prevent infection. Tell your doctor if you notice any swelling, pain, or redness on or near your incision.
Depending on your doctor's preference, the pump may be filled during or after surgery. However, some doctors recommend a short waiting period to allow you to recover from surgery and get adjusted to the pump.
You'll begin receiving treatment as soon as the pump is filled with medication and the medication travels through the catheter to the intrathecal space. You may feel effects from the medication soon after delivery, or it may take a while for you to experience benefits. It may take several weeks or months to reach your optimal dose.
A baclofen pump (ITB therapy) can be helpful to people with severe spasticity.
Potential surgical complications may include:
ITB therapy drug side effects are usually temporary and may be managed by adjusting dosage.
The most common side effects include:
Please follow your doctor's instructions closely because a sudden stop of intrathecal baclofen therapy can result in serious illness (baclofen withdrawal symptoms), such as:
It's important to keep your scheduled refill visits so you don’t run out of medication (baclofen) and to understand the early symptoms of baclofen withdrawal, which include:
Once the infusion system is implanted, possible device complications may include:
Penn RD, Intrathecal Baclofen for Spasticity of Spinal Origin: Seven Years of Experience. J Neurosurg, 1992, 77: 236-240.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.