The baclofen pump therapy is the way doctors give the drug directly into the spinal fluid. The system consists of a catheter (a small, flexible tube) and a pump.
The pump (a round metal disc, about 1 inch thick and 3 inches in diameter) is surgically placed under the skin of the abdomen near the waistline and the pump stores and releases prescribed amounts of medicine through the catheter. Using an external programmer, treatment team can make adjustments in the dose, rate, and timing of the medication.
Every 1-3 months, the patient must return to their doctor's office for pump refills and medication adjustments and usually every 5-7 years the pump is taken out and replaced at the end of the battery's life span.
Spasticity is a muscle problem characterized by tight or stiff muscles that may interfere with voluntary muscle movements. It is caused by an imbalance of electrical signals coming from the spinal cord through the nerves to the muscle and imbalance causes the muscle to become hyperactive, resulting in involuntary spasms and it can be related to multiple sclerosis, spinal cord injuries, or other neurological diseases.
Baclofen is a medication commonly used to decrease spasticity by restoring the normal balance and reducing muscle hyperactivity and allows for more normal muscle movements. It can be taken orally as a pill or delivered directly into an area of the spine called the intrathecal space which contains the cerebrospinal fluid (the fluid surrounding the spinal cord and nerve roots).
Orally baclofen can cause unpleasant side effects, such as confusion, weakness, and sleepiness but intrathecal baclofen delivers the drug right to the target site in the spinal cord so since the medication does not circulate throughout the body, only tiny doses are required to be effective.
Before surgery, the patient can have a trial of the therapy to test the potential effectiveness of the medication during which baclofen is injected into the spinal canal (using a small needle) and the treatment team assesses its effectiveness over 2-4 hours.
If the patient experiences positive results with the intrathecal medication, then he/she can decide with his doctor and family members if he/she should have a baclofen pump system implanted during a surgical procedure.