An Intrathecal Baclofen Pump placement procedure typically lasts two hours or so, in which the pump is filled with medication before it is placed in the body. Once positioned, the pump delivers a very low and continuous dose of Baclofen. After the patient comes out of anesthesia, the doctors collaborate with the patient to determine an appropriate dosage to reduce their spasticity effectively.
 
Patients may experience some relief immediately after the surgery, though it may take weeks or months to steadily increase the dose to a functional level. After implantation, you will have frequent visits with your doctor to do this; it may take up to eight hours to feel more relief after the dose has been increased. Doctors regulate dosage amount and timing through an external programming system.

Intrathecal Baclofen (ITB) therapy is primarily used for spasticity seen in neurological conditions. Spasticity is a movement disorder characterized by the body’s muscles’ uncontrollable contraction and subsequent stiffness. It could also include spasmodic movements and clonus, repetitive, involuntary movements. This is believed to be caused by an improper balance of inhibitory (stopping) and excitatory (inducing) chemical signals in the nervous system, resulting in the misfire of muscle contraction.
 
Conditions causing moderate to severe spasticity include multiple sclerosis (MS), cerebral palsy, stroke, brain, or spinal cord injury, and more. If a patient diagnosed with multiple sclerosis or a spinal injury is interested in ITB therapy, they must first have tried oral Baclofen and saw no improvement. If a patient has had a brain injury and suffers from spasticity, they must wait a full year after their injury occurred to receive ITB therapy. Though conservative (non-surgical) treatments should first be tried and failed, this treatment is highly effective.

Typically, the procedure to place an intrathecal Baclofen pump is done under general anesthesia and on an outpatient basis. However, some patients may need a brief stay in the health center. The surgery is quite fast as it is completed in one to two hours, from preparation to post-operative recovery.
 
In the placement procedure, a surgeon will make a small incision on the side of the abdomen, in which the 3-inch SynchroMed II pump disc is inserted. A small flexible tube called a catheter is connected to this pump and runs to the spinal cord. The end of this catheter is placed in the dural sac, a surrounding layer of the spine in which cerebrospinal fluid flows, which acts to cushion the vulnerable spinal cord. The skeletal muscle relaxant medication, Baclofen, is then released from the pump to be absorbed by the spinal nerves, effectively decreasing spasticity. The specific chemical effect this drug has on the body is not well studied, and the reason it works is not entirely known. However, it has been theorized that Baclofen increases inhibitory signaling to the muscles, reducing involuntary tightening. Doctors then use an external program to prescribe a specific dose to be released at certain time intervals.
 
After the procedure, this low initial dose will be slowly raised until you feel effective relief. Doses administered by the pump will be much lower than those taken orally. This is because the medication is delivered directly to the spine and is not lost elsewhere as the body absorbs it, as you would see in gastrointestinal absorption with pills. While side effects may still occur with an intrathecal baclofen pump, they are less likely and less severe than oral medications, again due to a lower dose necessary to see good results.
 
At Ramos Center for Innovation and Functional Pain Medicine, we are fully dedicated to minimizing your pain with various traditional and non-traditional methods. Our highly skilled team of physicians, coupled with our state-of-the-art technological treatments, can provide many benefits for you and help you go back to an optimal quality of life. So please, reach out to us by phone, or feel free to book an appointment online. We are currently accepting new patients at all eight of our locations and are eager to hear from you. We serve patients from Bradenton FL, Sarasota FL, Venice FL, Englewood FL, Cortez FL, Palmetto FL, Laurel FL, Memphis FL, Port Charlotte FL, and Dunedin FL.

Spasticity is a motor disorder characterized by tight or stiff muscles that may interfere with voluntary muscle movements and is a problem for many patients with multiple sclerosis (MS), spinal cord injury (SCI), cerebral palsy (CP), and acquired brain injury (ABI). Increased tone and spasm reduces mobility and independence, and interferes with activities of daily living, continence and sleep patterns.

Intrathecal drug delivery is a targeted route of drug distribution, designed to reduce cancer pain and minimize intolerable side effects. Studies show Intrathecal Pumps are a cost-effective treatment option that improves quality of life for patients with over 3 months of survival time. Patients can trial pumps prior to implantation and if necessary, is easily removable.

Pumps can be programmable or nonprogrammable. Using an external programmer, a physician can make adjustments in the dose, rate and timing. The pump reservoir can be refilled approximately every 2-3 months by percutaneous injection. The pump is taken out and replaced at the end of the battery’s life span (approximately 5-7 years).

Candidates for intrathecal baclofen infusion are patients with spasticity who have intractable spasticity uncontrolled by drug therapy or who experience intolerable side effects to oral baclofen.

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