Division of Pediatric Neurosurgery, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245, Buenos Aires, ZC, Argentina.
Division of Kinesiology, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.
Childs Nerv Syst. 2021 Jan;37(1):203-210. doi: 10.1007/s00381-020-04679-3. Epub 2020 Jun 6.
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.
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.
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.
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.
本研究旨在描述一种新的巴氯芬泵植入技术，即前置脑干导管放置，并展示该方法在治疗痉挛和肌张力障碍方面的优势。
我们描述了一种将巴氯芬泵导管前置到脑干前方的新技术。为了说明该技术，我们介绍了 5 例同时患有痉挛和肌张力障碍且常规治疗无效的患者。他们每人都接受了带有前置脑干导管的巴氯芬泵治疗。我们使用改良 Ashworth 痉挛量表、Barry-Albright 肌张力障碍量表和 PedsQL 生活质量评估量表来评估结果。每位患者在手术前和术后 6 个月进行评估。
使用 Barry-Albright 和改良 Ashworth 量表对所有进行体格检查的区域进行评估，术前和术后期间的差异均具有统计学意义。PedsQL 生活质量量表的结果也同样如此。
我们提出了一种新的巴氯芬泵植入技术，即前置脑干导管放置，对于常规治疗无效的伴有痉挛性四肢瘫痪的肌张力障碍患者，这可能是一种有前途的治疗选择。
