Scerrati Alba, De Bonis Pasquale, Norri Nicolò, Cavallo Michele Alessandro
Department of Neurosurgery, Ferrara University Hospital, Ferrara, Italy.
Neurosurg Focus Video. 2020 Oct 1;3(2):V9. doi: 10.3171/2020.7.FOCVID2021. eCollection 2020 Oct.
Most patients with spasticity, rigidity, and other symptoms of the upper motor neuron syndrome respond effectively to surgical treatment with an intrathecal baclofen pump when their symptoms become intractable to nonsurgical measures. Baclofen administered into the lumbar subarachnoid space produces a locally high concentration at the spinal level and a low concentration supraspinally, avoiding most of the central side effects associated with a high oral dose, such as drowsiness and confusion. The aim of surgical treatment is to provide the appropriate volume and concentration of the drug in the subarachnoid space, avoiding the main surgical complications, that is, infections, skin erosion, and catheter displacement. The video can be found here: https://youtu.be/HetelPwwwak.
大多数患有痉挛、强直及上运动神经元综合征其他症状的患者，当其症状经非手术措施难以控制时，鞘内注射巴氯芬泵手术治疗有效。将巴氯芬注入腰段蛛网膜下腔可在脊髓水平产生局部高浓度，而在脊髓以上水平浓度较低，从而避免了高口服剂量相关的大多数中枢性副作用，如嗜睡和意识模糊。手术治疗的目的是在蛛网膜下腔提供合适的药物体积和浓度，避免主要的手术并发症，即感染、皮肤糜烂和导管移位。视频可在此处查看：https://youtu.be/HetelPwwwak 。
