鞘内注射巴氯芬治疗期间因导管断裂导致痉挛加重：一例报告

Worsening spasticity due to catheter breakage during intrathecal baclofen therapy: a case report.

作者信息

Takagi Yasutaka, Yamada Hiroshi, Ebara Hidehumi, Hayashi Hiroyuki, Inatani Hiroyuki, Nakamura Yuta, Sugihara Ryo, Nakanami Aki, Kagechika Kenji, Yahata Tetsutaro, Demura Satoru

机构信息

Department of Orthopedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami City, Toyama, 939-1395, Japan.

Department of Rehabilitation Medicine, Tonami General Hospital, 1-61 Shintomi-cho, Tonami City, Toyama, 939-1395, Japan.

出版信息

J Med Case Rep. 2025 Jan 20;19(1):22. doi: 10.1186/s13256-025-05045-0.

DOI:10.1186/s13256-025-05045-0

PMID:39833871

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744879/

Abstract

BACKGROUND

Intrathecal baclofen therapy can substantially improve symptoms in patients with severe spasticity owing to traumatic spinal cord injury, multiple sclerosis, cerebral paresis, or tethered cord syndrome. Problems associated with intrathecal catheters include migration, laceration, occlusion, or disconnection. Several case reports have described the management of catheter fragments. To the best of our knowledge, this is the first detailed report of the insertion of a new catheter.

CASE PRESENTATION

A 64-year-old Japanese man with spinal myoclonus was undergoing intrathecal baclofen therapy; his spasticity was well controlled with intrathecal baclofen therapy but worsened 13 years after pump implantation. Imaging revealed spinal catheter breakage, and the catheter was retained in the spinal canal. We inserted a new catheter through a different intervertebral space without removing the original catheter. Postoperatively, the spasticity remained well controlled with intrathecal baclofen therapy.

CONCLUSION

This is the first detailed report on the insertion of a new catheter for intrathecal baclofen therapy at a different intervertebral space from the catheter breakage, without removal of the old intrathecal catheter.

摘要