In severe cases of spasticity, a baclofen pump may be used. This mechanism delivers baclofen directly in the space between the layers of the spinal cord and allows for a continuous infusion of medication. Because the medication is directly pumped into the spinal cord, people with severe spasticity can avoid many of the potentially dangerous side effects seen with high doses of the oral form.
What Is a Baclofen Pump?Baclofen (Lioresal®, Gablofen®) is a prescription medication used to treat spasticity. While it can be taken by mouth, severe cases of spasticity often require the use of a baclofen pump.
How Does It Work?A pump delivers baclofen directly into the intrathecal space between the layers of the spinal cord. A small, flexible tube (called a catheter) is inserted into the intrathecal space. The catheter is connected to the pump, which is surgically placed under the skin -- usually in the abdomen (stomach). The pump contains a reservoir for the medication, which is usually filled by an injection through the skin directly into the pump. Various baclofen pumps are available, and each may differ slightly.
A baclofen pump allows for a continuous infusion of medication directly to the spine. With this form, the blood levels of baclofen are approximately 100 times less than the levels seen when the oral form is used. For many people, in order to get the necessary spasticity relief from baclofen tablets, the dose must be so high that intolerable or dangerous side effects occur. A pump can help avoid this problem.
- Have severe spasticity that interferes with daily living and comfort
- Have a positive response to a test dose of intrathecal baclofen
- Be large enough to have "room" for the pump in the body (this may be a problem for small children or very small adults)
- Have been waiting at least one year after a traumatic spinal cord injury
- Not have any current infections
- Not be allergic to baclofen.
Talk with your healthcare provider about whether a pump may be a good choice in your situation.