Description: Baclofen pills are often used to treat spasticity. In this form, however, the amount required to decrease spasticity often causes sleepiness. An intrathecal baclofen pump delivers the baclofen directly into the fluid around the spinal cord. A battery-operated pump the size of a hockey puck is placed (implanted) under the skin on the person’s trunk. The pump is connected to a small tube that delivers baclofen to the area around the spinal cord. Both are implanted during surgery. Everything is under the skin; on some people, the pump can be felt under the skin on the abdomen. The pump works by a small computer that is programmed by the doctor. This way of delivering the baclofen decreases spasticity without drowsiness. The pump needs to be refilled regularly. For some people, the pump is refilled every two months. Others may go as long as six months between baclofen pump refills.
Who may benefit: Intrathecal baclofen pumps work best for people with CP over the age of four who have either spasticity or dystonia in many muscles. It may be considered when other treatments have not helped and the person, family and medical team agree that there are goals the person could achieve with the pump that would otherwise continue to be a struggle. Because the pump needs to be refilled often, both the person and the family or caretaker must be willing and able to come to frequent clinic appointments.
How it is done: Once the goals for the pump are identified, the person participates in a trial to see if the baclofen decreases his or her spasticity or dystonia. This is done in the hospital. An injection of the drug is given into the spinal space. A doctor and therapist evaluate to see if the spasticity changes. If the spasticity is a lot less after the injection, the person, family and medical team discuss implanting a pump. The person goes home and returns to the hospital at another time to have the surgery to put in the pump. He or she is in the hospital for four or five days. To get the dose of drug that helps the most, frequent clinic visits are needed during the first six months after a pump is implanted. After that, the person comes back every eight to twelve weeks for the pump to be refilled with more baclofen.