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Intrathecal Baclofen

Leah having her pump interrogated by APNP Vicki

What is Intrathecal Baclofen (ITB)

ITB therapy is a treatment for severe spasticity using an implantable pump system that delivers anti-spastic medication to the 
site it is needed.
The technique for pump implantation involves surgery under general anaesthetic. The pump is placed under the skin of the 
lower abdomen and is attached to a thin silicon tube called a catheter. This catheter runs from the pump into the space around 
the spinal cord (intrathecal space), where the medication is delivered.
Intrathecal Baclofen Therapy is for children with global spasticity that cannot be adequately managed by other treatments, 
including: oral antispasmodics, botulinum toxin, 24 hour postural management programmes and orthotics.
They will have a combination of the following factors: 1. Uncontrolled painful spasms. 2. Disrupted sleep. 3. Difficult postural management, poor seating tolerance. 4. Time consuming and difficulty meeting care giving needs; toileting, washing, dressing. 5. Decline in mobility as a result of increased spasticity in an ambulant child. 6. Difficulty of swallowing.
How does it work? Intrathecal baclofen is a liquid form of oral baclofen. By delivering this directly into the intrathecal space, this bypasses the blood-brain barrier and gets straight to the receptors. Only very small doses of intrathecal baclofen are needed to significant reduce the spasticity. This effect is primarily seen in the lower limbs. The pump settings can be altered to suit the individual and therefore can deliver more precise doses of medication throughout the day.
What are the benefits of ITB? • Reduces spasticity • Enables easier care giving • Increases ability to maintain range of movement • Improves function and independence • Improves control painful spasms • Improves postural management to prevent further contractures or deformities • Reduces need for oral medication • Provides a continuous baclofen dose covering the whole 24hour period