Takagi Yasutaka, Yamada Hiroshi, Ebara Hidehumi, Hayashi Hiroyuki, Inatani Hiroyuki, Nakamura Yuta, Sugihara Ryo, Nakanami Aki, Kagechika Kenji, Yahata Tetsutaro, Demura Satoru
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.
J Med Case Rep. 2025 Jan 20;19(1):22. doi: 10.1186/s13256-025-05045-0.
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.
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.
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.
鞘内注射巴氯芬疗法可显著改善因创伤性脊髓损伤、多发性硬化症、脑性瘫痪或脊髓拴系综合征导致的严重痉挛患者的症状。与鞘内导管相关的问题包括移位、撕裂、堵塞或断开。已有多篇病例报告描述了导管碎片的处理方法。据我们所知，这是关于插入新导管的首份详细报告。
一名64岁患有脊髓性肌阵挛的日本男性正在接受鞘内注射巴氯芬治疗；鞘内注射巴氯芬疗法能很好地控制其痉挛，但在泵植入13年后症状恶化。影像学检查显示脊髓导管断裂，导管留在椎管内。我们在未取出原有导管的情况下，通过不同的椎间隙插入了一根新导管。术后，鞘内注射巴氯芬疗法仍能很好地控制痉挛。
这是首份关于在与导管断裂处不同的椎间隙插入新导管用于鞘内注射巴氯芬疗法，且未取出旧的鞘内导管的详细报告。
