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What is Intrathecal Baclofen

Patient Information    
Complications and side effects 

Baclofen is a useful drug that relaxes muscles. You may have tried this drug before in
the form of tablets and found it to be ineffective or the side effects too unpleasant.
When Baclofen is put directly into your spinal fluid it can work very effectively and in
turn, work at a much lower dose than when you take tablets. This also makes it likely
that you will have fewer side effects. We use a pump to deliver this drug on a
continuous basis. This pump is similar in size to a shoe polish tin, approximately seven
centimetres in diameter and two and a half centimetres in depth.

How does baclofen work?

Spasticity is caused by an imbalance of excitatory and inhibitory input in the spinal cord. This imbalance causes hyperactive muscle stretch reflexes. These reflexes result in involuntary spasms and increased muscle tone.

Baclofen (a gamma-aminobutyric acid (GABA) agonist) works by restoring the balance of excitatory and inhibitory input to reduce muscle hyperactivity. In this way, it allows more normal motor movements.

Test dose admission 

You have been referred here by your specialist managing your spasticity or your GP.
We think that intrathecal baclofen (into your spinal fluid) will help manage your
symptoms. We will plan for you to come into hospital to test out a dose..
You will probably only have to stay one day for this trial but we can arrange for an
overnight bed in hospital if it is required. You will have a number of injections into the
spinal fluid (lumbar punctures) and several assessments of your spasms/spasticity.
You will be given a set of gradually increasing doses until an effective dose is found.
If the trial is successful we will arrange for you to meet the Consultant Neurosurgeon
in clinic to discuss the operation and the risks involved. If the Neurosurgeon decides
that you are suitable for surgery, he/his team will arrange for funding to be sought
from your Primary Care Trust (PCT). The decision from the PCT can take several
weeks or even months. When we hear that funding is approved, you will go onto the
waiting list for surgery and you will be sent an admission date.

Implantation of the pump 

You will be admitted to hospital for the pump implantation the day before surgery.
You will have surgery in the operating theatre and you will be asleep for the whole
procedure. You will be able to take your normal tablets for spasticity unless the
Anaesthetist has told you not to. The pump is inserted into your tummy under a layer
of fat. A tube, called a catheter, is tunnelled around your back into the spinal fluid.

Patient Information   
Complications and side effects 


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