| Recurrent intrathecal baclofen pump catheter leakage: A surgical observation with recommendations. | |
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MedLine Citation:
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PMID: 12037778 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Intrathecal baclofen pump catheter complications are the most common cause for failure in drug delivery. A 4-year-old boy presented with repeated signs of baclofen tolerance despite progressive increases in dosing. External computerized interrogation of the pump and radiograph evaluation of the pump-catheter-intrathecal sac system were normal. Subsequently, he was taken to the emergency room for baclofen overdosage and brought to the operating room for exploration of the implant. Intraoperative assessment of the pump catheter found a cut on the catheter neck that was visible only when the catheter neck was flexed. The catheter was replaced without complications. Two months later, the patient returned with similar symptoms. Repeat computerized and radiographic assessment of the pump were normal. Intraoperative assessment showed a cut within the same portion of the catheter as previously discovered. The catheter cut was in the least flexible portion, the pump-catheter neck, which was found to be overlying the iliac crest in both surgeries. The authors hypothesize that the repetitive compressive forces of the catheter overlying the iliac crest led to catheter breakdown. Surgical placement of the pump-catheter neck should be superio-medial to reduce the likelihood of either internal or external compressive forces. |
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Authors:
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Rob D Dickerman; Steven J Schneider |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 37 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2002 Jun |
Date Detail:
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Created Date: 2002-05-30 Completed Date: 2002-12-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: E17 Citation Subset: IM |
Copyright Information:
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Copyright 2002, Elsevier Science (USA). All rights reserved. |
Affiliation:
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Division of Pediatric Neurosurgery, Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Baclofen
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administration & dosage* Catheterization Cerebral Palsy / drug therapy Child, Preschool Equipment Failure Equipment Failure Analysis Humans Infusion Pumps, Implantable* Injections, Spinal Male Monitoring, Intraoperative Recurrence |
| Chemical | |
Reg. No./Substance:
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1134-47-0/Baclofen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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