Vorenkamp Kevin E, Gandhi Savan H, Manolides Andrew S, Warren Daniel T
Virginia Mason Medical Center, 1100 9th Ave, Seattle, WA, 98101, USA.
ECU Health Medical Center, 2100 Statonsburg Rd, Greenville, NC, 27834, USA.
Interv Pain Med. 2023 Oct 14;2(4):100284. doi: 10.1016/j.inpm.2023.100284. eCollection 2023 Dec.
To report a case of intrathecal pump failure following months of diminishing benefit from intrathecal baclofen, and to heighten awareness that intrathecal pump malfunction can occur without precipitating events.
A 40 year-old woman with multiple sclerosis and spastic paraplegia developed worsening spasticity after ten months of therapeutic stability with intrathecal baclofen. After other causes were pursued, this was discovered to be due to pump malfunction only thirteen months after implantation. After pump interrogation and discussion with the manufacturer the pump was replaced urgently and the patient regained therapeutic benefit and had no further complications
We present herein what we believe to be the first report of a verified pump malfunction resulting in disruption of intrathecal baclofen delivery within thirteen months of implantation. Due to the possible severity of acute baclofen withdrawal, the pump was replaced urgently after diagnosis. Because of the patient's and her healthcare providers' vigilance, she experienced no adverse events. Healthcare providers are encouraged to acknowledge the possibility of intrathecal pump malfunction in similar scenarios, ensuring patient safety while systematically examining the underlying problem.
报告一例鞘内注射巴氯芬数月来疗效逐渐降低后鞘内泵故障的病例，并提高对鞘内泵故障可能在无明显诱因情况下发生的认识。
一名患有多发性硬化症和痉挛性截瘫的40岁女性，在鞘内注射巴氯芬治疗稳定10个月后，痉挛症状恶化。在排查了其他原因后，发现这是由于植入泵仅13个月后发生故障所致。在对泵进行检查并与制造商讨论后，紧急更换了泵，患者恢复了治疗效果且未出现进一步并发症。
我们在此报告我们认为是首例经证实的泵故障导致鞘内巴氯芬给药中断的病例，该故障发生在植入后13个月内。由于急性巴氯芬撤药可能的严重性，诊断后紧急更换了泵。由于患者及其医护人员的警惕，她未发生不良事件。鼓励医护人员认识到在类似情况下鞘内泵故障的可能性，在系统检查潜在问题的同时确保患者安全。
