Document Detail


Recurrent intrathecal baclofen pump catheter leakage: A surgical observation with recommendations.
MedLine Citation:
PMID:  12037778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Rob D Dickerman; Steven J Schneider
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  37     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-05-30     Completed Date:  2002-12-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E17     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
Affiliation:
Division of Pediatric Neurosurgery, Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Baclofen / 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:
1134-47-0/Baclofen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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