Review article

Intrathecal Delivery of Baclofen As Functional Treatment of Severe Spasticity

Klemen GRABLJEVEC ; University Rehabilitation Institute »Soča«, Spasticity treatment Unit, Ljubljana, Slovenia
Katja GROLEGER SRŠEN ; University Rehabilitation Institute »Soča«, Spasticity treatment Unit, Ljubljana, Slovenia
Nataša PUZIĆ ; University Rehabilitation Institute »Soča«, Spasticity treatment Unit, Ljubljana, Slovenia

Abstract

In some patients severe spasticity of cerebral or spinal origin cannot be
treated successfully with conventional oral medication or physical modalities.
Intrathecal baclofen therapy with implanted pump has represented effective
treatment from mid-80’s. Baclofen (Lioresal) is a muscle relaxant and a potent
GABA agonist that acts via GABAb receptors at the posterior columns of spinal
cord level, to inhibit the release of excitatory neurotransmitters by inhibiting
calcium ions influx into presynaptic terminals. This direct binding on spinal
cord receptors leads to higher efficiency compared to peroral therapy in which
baclofen does not pass the brain-blood barrier. The article overviews indications
and contraindications for intrathecal baclofen therapy, selection and preparation
of patients for surgery, the surgical procedure of pump implantation, long term
follow-up with pump refill procedure and possible complications of intratecal
baclofen therapy. The experiences of the Center for spasticity treatment at the
University Rehabilitation Institute in Ljubljana are described.

Keywords

spasticity; intrathecal baclofen therapy

Hrčak ID:

163474

URI

https://hrcak.srce.hr/163474

Publication date:

3.4.2016.

Article data in other languages: croatian

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