In the past, if baclofen taken by mouth was not tolerated because of side effects or ineffectiveness, the only remaining option was irreversible surgery to destroy nerve connections. However, with today's technology, baclofen can now be inserted directly into the spinal fluid.
This drug is delivered by a pump that is implanted under the skin. When baclofen is put into the spinal fluid, the effectiveness of the drug is improved and the side effects are reduced. Baclofen has been approved by the Food and Drug Administration (FDA) for this purpose.
Spasticity is a tightness or stiffness that makes it difficult for patients to move their arms and legs the way they want them to move. These abnormal muscle contractions happen when nerve signals do not travel properly from the brain or spinal cord to the muscles. Spinal cord injury, multiple sclerosis, cerebral palsy and some hereditary conditions may cause spasticity.
Medications taken by mouth are the first line of treatment for spasticity. To decrease spasticity, the doctor may prescribe baclofen, Dantrium, Valium, Zanaflex or other oral medications, but these medications are not always effective. It is possible they may produce side effects like weakness, drowsiness or nausea.
Intrathecal baclofen is not a cure for what is causing spasticity. It can, however, decrease spasticity so that patients' daily activities may improve. In addition, patients may experience much less muscle stiffness (making it easier to move), improved sleep and less pain. Side effects associated with medications taken by mouth will also improve, as these medications are slowly tapered and eventually stopped.
Patients have an initial meeting with a nurse before being started on an IV. This allows intravenous medication to be administered to help deal with any potential side effects. The physician will then administer a dose of baclofen directly into the spinal fluid.Following the procedure, patients are transferred to the recovery area for ongoing monitoring. An evaluation by a physical therapist is then performed, and if the patient is doing well and experiencing no complications, he or she will be discharged after a few hours.