DOI: 10.36347/sjams.2018.v06i04.030

Pages: 1526-1531

Our aim is to emphasize appropriate patient selection for intrathecal baclofen (ITB) therapy in those suffering from severe spasticity despite various non-pharmacological and pharmacological interventions. The study included 10 patients (6 males, 4 females; mean age 31.5±10.8 years, range, 13 - 41 years) with spasticity that had undergone ITB therapy, and did not respond adequately to conventional physical therapy, medical therapy or focal treatments. The 10 patients enrolled in the study comprised 6 (60%) males and 4 (40%) females, with a mean age of 31.5±10.8 years. Three (30%) patients had spinal cord injury (SCI), 3 (30%) patients had multiple sclerosis (MS), and 4 (40%) patients had cerebral palsy (CP) history. The mean MAS score decreased from 3.6±0.5 to 1.0±0.0 (p <0.001); the mean VAS score decreased from 38.0±12.0 to 20.0±8.1 at the final follow-up (p=0.001). Expanded Disability Status Scale (EDSS) scores in the patients with MS were 5.0, 6.5, and 7.0 points at baseline and the final visit. ITB is a safe and effective therapy for reducing spasticity and pain, and it improves function via implantation. Indications for ITB are as follows: diffuse or regional spasticity (if MAS score or PFSF score was > 2), ambulatory MS patients (if EDSS ≤ 5.5), non-ambulatory MS patients (if EDSS ≥ 7.0), non-ambulatory CP patients with global spasticity (if GMFCS Level 5), diplegic CP patients with severe hypertonia (if GMFCS Level -5).