What is the Intrathecal Baclofen Pump?
A programmable pump implanted in the abdomen delivers liquid baclofen directly to the spinal fluid via a thin catheter. By bypassing the blood-brain barrier, the drug reaches its target directly. This approach requires only 1/100th of the oral dose for the same therapeutic effect, providing more consistent and precise drug delivery than oral baclofen.
Conditions Treated
The Intrathecal Baclofen Pump is indicated for patients with severe, disabling spasticity that has not responded adequately to oral medications:
- Severe spasticity from spinal cord injury
- Cerebral palsy with debilitating spasticity
- Multiple sclerosis-related spasticity
- Traumatic brain injury spasticity
- Stroke-related spasticity
- Hereditary spastic paraplegia
Advantages Over Oral Baclofen
Intrathecal delivery offers significant advantages over traditional oral baclofen therapy:
- Only 1/100th the oral dose needed for equivalent effect
- Dramatically fewer systemic side effects (drowsiness, confusion, dizziness)
- More precise and consistent drug delivery
- Adjustable dosing throughout the day
- Better quality of life and functional outcomes
The ITB Screening Trial
Before permanent implantation, a screening trial is conducted to determine whether the patient will benefit from intrathecal baclofen therapy:
- A lumbar puncture is performed to deliver a test dose of intrathecal baclofen.
- The patient is monitored closely for 4-6 hours following the injection.
- Spasticity reduction is measured using the Ashworth Scale.
- If significant improvement is observed, the patient is considered a candidate for permanent pump implantation.
The Implantation Procedure
The surgical implantation is performed under general anesthesia and involves several key steps:
- The pump (approximately the size of a hockey puck) is placed in a surgically created pocket in the abdominal wall.
- A thin catheter is threaded into the intrathecal (spinal fluid) space.
- The pump is programmed to deliver a patient-specific dose of baclofen.
- Hospital stay is typically 3-5 days for monitoring and initial dose adjustment.
Pump Management
Ongoing management of the ITB pump is straightforward and designed for long-term patient convenience:
- Refills: Every 1-6 months via a simple office visit. A needle is inserted through the skin into the pump reservoir to refill the baclofen medication.
- Dose adjustments: Made via an external programmer at clinic visits. The pump can deliver different doses at different times of day to match the patient's activity patterns.
- Battery replacement: Required every 5-7 years via minor surgery.
- MRI compatibility: Regular MRI-compatible models are available.
NuRaX ITB Program
The NuRaX Intrathecal Baclofen Pump program provides end-to-end care for patients with severe spasticity:
- Comprehensive spasticity assessment by our multidisciplinary team
- Supervised screening trial with close monitoring
- Expert surgical implantation by experienced neurosurgeons
- Ongoing pump management, refills, and dose optimization
- Coordination with rehabilitation team for best functional outcomes