This movement disorder, which manifests itself primarily as a stiffness in the arms and legs, is often a permanent and progressive complication of injuries to the brain or spinal cord. It is also seen in children and adults with cerebral palsy, stroke, multiple sclerosis (MS) amyotrophic lateral sclerosis (ALS), and a variety of other disorders.
Spasticity, in its milder and more localized forms, may respond to stretching exercises, the use of a variety of medications, or the local injection of Botox, a drug which partially and temporarily interferes with the way nerves cause muscles to contract. When spasticity and its accompanying involuntary, and sometimes painful, muscle spasms are severe, a more aggressive treatment program is needed.
One of these advanced options involves the use of intrathecal Baclofen, a drug which helps control the over stimulation of motor nerves which cause spasticity. Using an implantable, programmable and refillable pump, Baclofen can be delivered directly to the areas of the spinal cord where it is needed to loosen muscles and prevent spasms. This continuous infusion avoids the sedative effects commonly seen when the same drug is given orally.
To determine if a patient is a candidate for the implanted device, a single trial dose of Baclofen is administered directly into the spinal space. With the assistance of a physical therapist, changes in the patient’s muscle tone or spasm severity are then monitored for four to six hours, which is the approximate duration of the test dose’s effect. If the patient responds in a positive way, a surgical procedure can be performed to place a small pump underneath the abdominal wall and a catheter in the spinal space, thereby providing continuous delivery of Baclofen. Typically, a patient will have his or her pump refilled every four to six weeks. The pumps themselves, which are battery powered can last anywhere from seven to ten years.
The greatest advantage of this treatment option is the pump’s ability to be programmed after it is implanted. This allows us to precisely meet the patient’s need for spasticity control. In the past, the options for patients with severe spasticity were a variety of destructive and irreversible surgical procedures.
The specific causes of spasticity varies from patient to patient. These individuals range in age from 7 to 66 years old, and represent many different conditions which cause spasticity. Clinics are held in the practice’s Charlotte office on a regular basis for new and established patients.