Abstract

Increasingly, spasticity is managed with surgically implanted Intrathecal Baclofen pumps. Intrathecal Baclofen pump revision surgery unrelated to programmable pump end-of-life is not uncommon, requiring special attention during pre-, intra-, and post-operative management. We aimed to identify and describe complications of Intrathecal Baclofen pump as well as to report avoidance and management of complications.

Methods and Materials: Through 2007- 2010, at the department of neurosurgery, King Fahad Medical City, Intrathecal Baclofen pumps were implanted in 43 patients; 21 children versus 22 adults; 14 revision surgeries were performed in 10 patients. We evaluated reasons for revision surgeries and diagnostic work-up requirements.

Results: Ten out of 43 primary-implant-patients required 14 revisions; 8 patients had only 1 revision procedure while 2 patients had multiple revision procedures. Complications ranged between: Implant infections in 8 cases; 1 paternal cause, 3 post dehiscence, 1 post rejection, 1 post trauma, 1 post hematoma and 1 pure infection. CSF leakage in one case.

Conclusions: Intrathecal Baclofen pumps, although very gratifying, have a high, technique-related complication incidence during implant life. Meticulous technique, high clinical suspicion, appropriate work-up, and timely surgical management can reduce surgical complications of Intrathecal Baclofen pump implantation.