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Baclofen pump with pre-brainstem catheter tip placement: technical note and case series

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Abstract

Purpose

This study aims to describe a new baclofen pump implantation technique with pre-brainstem catheter placement and to demonstrate the benefits that this procedure has in treating spasticity and dystonia.

Methods

We described a new technique to place a baclofen pump catheter anterior to the brainstem. To illustrate the technique, we presented five patients with both spasticity and dystonia in whom conventional treatment was not effective. They each received a baclofen pump with a pre-brainstem catheter. We evaluated the results using the Ashworth scale for spasticity, the Barry-Albright scale for dystonia, and the PedsQL for quality of life assessment. Each patient was evaluated before a surgery and after 6 months of follow-up.

Results

There were statistically significant differences in all the physical examination evaluated areas using the Barry-Albright and modified Ashworth scales between the preoperative and the postoperative period. The same applies to the results of the PedsQL quality of life scale.

Conclusion

We presented an innovative baclofen pump implantation technique with pre-brainstem catheter placement that could be a therapeutic alternative in patients with dystonia and spastic quadriparesis for whom conventional therapy is not effective.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are not publicly available due to the sensitive nature of the information and because the participants are underage but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, ZC, Argentina

    Amparo Saenz, Miguel Grijalba, Juan Pablo Mengide, Romina Argañaraz & Beatriz Mantese

  2. Division of Kinesiology, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina

    Fernando Ford

Authors
  1. Amparo Saenz
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  2. Miguel Grijalba
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  3. Juan Pablo Mengide
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  4. Romina Argañaraz
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  5. Fernando Ford
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  6. Beatriz Mantese
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Miguel Grijalba, Romina Argañaraz, Juan Pablo Mengide, and Juan Fernando Ford. The first draft of the manuscript was written by Amparo Saenz and Beatriz Mantese and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript

Corresponding author

Correspondence to Amparo Saenz.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Garrahan’s Pediatric Hospital.

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Informed consent was obtained from all individual participants included in the study

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Patients signed informed consent regarding publishing their data and photographs.

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Saenz, A., Grijalba, M., Mengide, J.P. et al. Baclofen pump with pre-brainstem catheter tip placement: technical note and case series. Childs Nerv Syst 37, 203–210 (2021). https://doi.org/10.1007/s00381-020-04679-3

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  • DOI: https://doi.org/10.1007/s00381-020-04679-3

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