Baclofen Pump - Information and Specialists

Baclofen is a medication that doctors use to treat the symptoms of severe spasticity. Patients can take the medication orally, which works very well for most people.

However, some patients experience the following side effects:

• Dizziness
• Nausea
• Drowsiness or
• Muscle weakness

In such cases, a baclofen pump is often used.

Spasticity is muscle stiffness accompanied by pain, spasms, immobility, deformities, or abnormal reflexes. It occurs in the spinal cord or brain and can significantly impair the quality of life of those affected.

People with spasticity suffer from a pathological increase in muscle tone @ Marcos /AdobeStock

If the patient takes baclofen orally, most of the medication remains in the bloodstream. Even at high doses, only a small amount reaches the cerebrospinal fluid, which is the drug’s target site.

With the help of a baclofen pump, the medication is delivered directly into the cerebrospinal fluid. Neurologists use an ITB system to administer it precisely where it is needed. This allows for a lower dose, improves efficacy, and reduces side effects.

A baclofen pump delivers a specific dose of intrathecal baclofen into the cerebrospinal fluid space (intrathecal space). A surgeon implants the pump under the skin in the abdomen. The surgeon then connects it to a catheter (a thin, flexible tube).

The surgeon then routes this catheter to the cerebrospinal fluid space, where the tube delivers the medication regularly and in precise doses.

The surgery is usually performed under general anesthesia and takes the surgeon about an hour. Afterward, neurologists program the system to adjust the dosage so that no unwanted side effects occur.

Doctors must then replace or replenish the medication approximately every six months. This is done via a virtually painless injection into the abdominal skin, beneath which the pump is located.

In addition, the pump can emit various alarms.

These include:

• Emergency alarm: For malfunctions that doctors must resolve immediately
• Refill alarm: Indicates that doctors need to refill the baclofen pump
• Pump replacement alarm
• Double-beep alarm: Sounds before the pump is finally shut down

In some patients, the medication baclofen may cause the following side effects:

• Dizziness
• Headaches
• Vomiting
• Drowsiness or
• Muscle weakness

But the surgery itself also carries various risks, such as:

• Nerve damage
• Headaches
• Hematomas or
• infections

However, these occur very rarely. In addition, there may also be system-related risks. For example, under certain circumstances, the baclofen pump may become dislodged, or the catheter may tear, leak, or kink. This results in impaired pump function.

This, in turn, leads to a withdrawal of the medication, and the symptoms of spasticity reappear. However, system-related risks are also extremely rare.

Not every patient is a suitable candidate for treatment with a baclofen pump. This form of therapy is effective only for spasticity in the legs, not in the arms.

If patients suffer from connective-tissue muscle contractures, a baclofen pump is not effective. When connective tissue contractures occur, the muscles are transformed into very hard cords. This causes the legs to become immobile and stiff. However, physical therapy prevents this in most cases.

Before surgery, doctors simulate the pump in a test by injecting the medication into the cerebrospinal fluid space. This allows them to determine whether the patient responds well to the treatment.

Afterward, the treating physician examines and monitors the patient. Only after a positive baclofen test does the physician recommend the use of a pump. Patients should expect a one-week hospital stay for this procedure. Health insurance companies typically cover the costs of the therapy.

Physical therapy keeps the affected muscles and joints mobile @ n.tati.m /AdobeStock

About two weeks after the surgery, you can have the stitches removed. The treating physician will also check the wound.

A postoperative follow-up appointment takes place after about six weeks. The doctor conducts further checkups during regular pump refills.

Intrathecal baclofen therapy is appropriate when the patient does not respond to standard therapy (physical therapy). Baclofen therapy has been approved for adults suffering from severe spasticity since 1985.

For children aged six and older, this form of therapy has been available since 1995. The baclofen pump helps reduce unwanted side effects because the dosage is lower.

In addition, the pump delivers the medication in a consistent amount of active ingredient. This largely eliminates fluctuations in the drug’s effect.

The pump delivers the drug baclofen directly into the cerebrospinal fluid. This helps patients regain the ability to lie down, sit, walk, or stand more easily.