Long-term intrathecal baclofen therapy in ambulatory patients with spasticity

Background: Intrathecal baclofen (ITB) is an effective treatment for severe spasticity. In ambulatory patients with spasticity, it is possible that ITB treatment may compromise ambulatory function by unmasking underlying muscle weakness. This retrospective study is designed to determine the long-term ambulatory function in patients receiving ITB. Methods: Thirty-six patients with severe spasticity previously screened for response to ITB were implanted with programmable pumps that allowed for continuous infusion of ITB. Patients were followed after implantation from 1 to 13 years. Results: All 36 patients had decreased spasticity and retained ambulatory function. Three of the 36 patients eventually became paraplegic related to underlying disease progression. Conclusion: ITB therapy may be used in selected ambulatory patients with spasticity and is not associated with loss of ambulatory function.