Intrathecal baclofen pump

Baclofen is a medication that treats muscle spasms by relaxing certain muscles in your body. It helps ease muscle contractions, tension, and tightness resulting from conditions like multiple sclerosis, cerebral palsy, or spinal injuries. While it doesn’t cure these issues, it can enhance the effectiveness of complementary treatments like physical therapy. Intrathecal baclofen works on the central nervous system—the brain and the spinal cord—to relax muscles, which leads to improved mobility.

An intrathecal baclofen pump is a device that continuously delivers baclofen directly into your spinal fluid. About the size of a hockey puck, the pump is implanted under the skin in your abdomen. A small tube called a catheter connects the pump to your spine. Sometimes referred to as intrathecal baclofen therapy (ITB therapy), the pump contains a battery, a supply of baclofen medication, and a chip that allows your doctor to program the device. The device dispenses baclofen on a set schedule. When the supply of baclofen needs to be refilled, your doctor injects the medication into the pump’s reservoir using a needle. Every patient’s dose is different, but most people get their baclofen reservoir refilled about twice a year. 

Doctors called neurosurgeons perform intrathecal baclofen pump implantations. Neurologists at Penn Medicine are among the leading neurology providers in the southeastern Pennsylvania and South Jersey region who are experts in performing intrathecal baclofen pump implantation procedures and follow-up care. 

Your Penn Medicine provider may recommend a baclofen pump if oral medications haven’t been helpful in treating severe spasticity or muscle stiffness caused by conditions such as: 

• Cerebral palsy
• Multiple sclerosis
• Spinal cord injury
• Stroke
• Traumatic brain injury
• Other neurological disorders 

To determine if you’re a candidate for an intrathecal baclofen pump, our doctors carefully consider which treatment will give you the best possible outcome. To help them decide, your provider will inject a small dose of baclofen into your spinal fluid through a procedure called a spinal tap. After a few hours, your care team will evaluate the effects of the injection to see how your body responds. Your provider will review the results and determine if the pump is right for you.

There are several reasons your provider may recommend a pump to deliver baclofen. 

• Most patients experience fewer side effects than oral baclofen. 
• Receiving baclofen directly into the spinal fluid is more effective than taking baclofen orally or through a feeding tube, which can lead to better symptom relief. 
• The pump provides continuous medication delivery, and the dose can be adjusted as needed. 
• The medication doesn’t enter the bloodstream, so it won’t interact with other medications you may be taking for seizures or other conditions.

Using the latest technologies and up-to-date surgical approaches, our providers are dedicated to relieving your symptoms and improving your quality of life. Before your intrathecal baclofen pump implantation, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery.

On the day of the procedure, you can expect the following:

• Your surgery will be done at a hospital or surgery center.
• You’ll have anesthesia with sedation, so you’re asleep and pain-free during surgery. Your care team will monitor you the entire time to ensure your safety.
• Your surgeon will make a small incision in the skin next to your belly button to insert the pump.
• Once the pump is placed, your surgeon will connect a catheter from the pump to the fluid in your spinal column.
• Your surgeon will fill the pump with baclofen and program it with your appropriate dose and schedule.
• The surgery takes about two hours.
• After the surgery, you’ll be monitored closely as you wake up from anesthesia. Most patients are discharged from the hospital after a couple of days.
• You may experience some discomfort or pain at the surgical site, which can be managed with medication prescribed by your Penn Medicine team.

Recovery from an intrathecal baclofen pump surgery can take six to eight weeks depending on your specific situation. After being released from the hospital, some patients also go to a rehabilitation center to get used to the pump before going home. Your care team will teach you about the device and any additional recovery instructions. Regular follow-up appointments are necessary to monitor the effectiveness of the treatment, adjust the dosage if needed, and address any complications.

At Penn Medicine, our mission is to find the right treatment to relieve your symptoms. We’re dedicated to guiding you through every phase of your medical journey to make sure you get the highest care and support every step of the way. 

Rare complications associated with the pump and catheter may include an interruption or overdose of your baclofen dose, a catheter shift or blockage, mechanical failure, or skin damage due to contact with the pump or the catheter.

If you experience an interruption to your baclofen dose due to a malfunction or the pump being empty, you could experience baclofen withdrawal symptoms. Contact your doctor immediately if you have any of the following symptoms: 

• Dizziness
• Extreme sweating
• Fever
• Itchy skin without signs of a rash
• Nausea
• Seizures
• Severe muscle spasms or stiffness
• Severe pain in the area where the pump was implanted 

If you experience an overdose of baclofen—a rare complication that typically happens close to a pump refill or change in programming—contact your doctor immediately. Symptoms include: 

• Difficulty breathing
• Drowsiness
• Loss of consciousness
• Low blood pressure or body temperature
• Muscle weakness
• Seizures
• Trouble standing up, sitting up, or moving your arms and legs 

Contact your doctor immediately if you have any concerns about your pump. Our care team is here to provide you with answers and support throughout the entire process.