FAQs on Baclofen Pumps for Spinal Cord Injury in Colorado

 

An intrathecal baclofen pump is a medical device used to treat severe spasticity and pain. The catheter is inserted into the dura, which surrounds the spinal cord. A pump implanted under the skin delivers baclofen to the intrathecal space.

What is the purpose of a baclofen intrathecal pump?

Patients with chronic, severe pain, and who have not responded to other treatments, may benefit from intrathecal baclofen administration. The pump device delivers small amounts of medication into the spinal cord region, which allows the patient to stop or decrease use of oral medications. In addition, the implanted device delivers medication around the clock, and eliminates the need for breakthrough pain medicines.

Does the baclofen pump work for spinal cord injury?

In a study of 62 people with severe spasticity of the spinal cord, researchers evaluated the use of intrathecal baclofen via a pain pump. The patients’ spasticity scores and costs were analyzed before and after pump implant. The spasm frequency scores were found to decrease from a mean of 3.6 to 0.5. In addition, activities of sleep, daily, and skin integrity improved, and some patients were pain-free. The researchers concluded that intrathecal baclofen was safe, cost-efficient, and effective for spasticity and pain in people with spinal cord injury.

What conditions are treated with intrathecal baclofen?

Conditions that respond to intrathecal delivery of baclofen are:

  • Complex regional pain syndrome
  • Cancer pain
  • Spinal cord injury
  • Multiple sclerosis
  • Failed back surgery syndrome

How long does the procedure take?

The procedure to insert intrathecal pump is done in two stages. During the first stage, the catheter is placed into the space around the spinal cord, and a single injection is made to screen for side effects and check for effectiveness. If the trial goes good, the permanent device is surgically placed under the skin. The trial takes around 1 hour, and the implantation surgery takes approximately 2 hours. This includes preparation and recovery time, as well as the actual procedure.

Does the intrathecal pump procedure hurt?

Most pain management specialists give you a local anesthetic, which numbs the skin and deeper tissues to eliminate pain. In addition, you are given a sedative (twilight anesthesia), which makes you not aware of what is going on. The needle used to numb your skin does not hurt, but you may feel a slight pinching sensation when the medication is instilled. General anesthesia is sometimes used to implant the pump, so you will have no memory of the surgery and not experience any pain.

How is the intrathecal pain pump procedure performed?

When you arrive to the surgical center, a nurse has you sign a consent form and change into a gown. Then, the nurse places an IV line in your arm and attaches monitoring devices to your finger and arm. Once you are positioned face-down on the table, the nurse administers sedative, and the doctor numbs the skin near your spine. To insert the tubing, a special needle is guided into the space around the spinal cord using real-time x-ray. During the final implant procedure, a tiny incision is made over the abdomen, and the device is placed under the skin. The tubing is threaded from the device to that tubing previously placed during the trial period. After the pump is set and working, the incision is closed with sutures.

Resources

Ordi JI, Fischer E, Adamski E, & Spatz EL (2006). Chronic intrathecal delivery of baclofen by a programmable pump for the treatment of severe spasticity. Journal of Neurosurg, 85(3), 452-457.