Berg-Johnsen J, Røste G K, Solgaard T, Lundar T
Nevrokirurgisk avdeling Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1998 Sep 10;118(21):3256-60.
Intrathecal administration of baclofen is now generally accepted as a powerful treatment of spasticity caused by spinal lesions. 35 patients with severe spasticity, 29 of spinal origin and six of supraspinal origin resistant to conservative treatment, had a programmable pump (Synchromed, Medtronic) for continuous intrathecal baclofen infusion implanted. The patients were followed-up for an average of 29 months (0-68). The initial effect of the treatment was positive for all patients; spasms were less frequent, there was remission of pain caused by cramps, and in some cases improved ambulation. In five patients, however, the pump was later removed: in two patients the pump ceased to be effective, two patients became infected, and one experienced multiple catheter problems. Problems with the catheter was the most common complication experienced, and this was seen in nine patients. Three patients died of the underlying disease. The majority of patients became accommodated to intrathecal baclofen and it was necessary to administer increasingly larger doses to maintain the clinical effect. Long-term control of spinal spasticity by intrathecal baclofen can be achieved in most patients, but close follow-up is necessary for assessing efficacy and refilling the pump.
鞘内注射巴氯芬目前已被普遍认为是治疗脊髓损伤所致痉挛的有效方法。35例严重痉挛患者，其中29例为脊髓源性，6例为脊髓上源性，对保守治疗无效，植入了可程控泵（美敦力公司的Synchromed）以持续鞘内注射巴氯芬。患者平均随访29个月（0 - 68个月）。所有患者治疗初期效果均为阳性；痉挛发作频率降低，由痉挛引起的疼痛缓解，部分患者行走能力改善。然而，有5例患者后来取出了泵：2例患者泵不再有效，2例患者发生感染，1例出现多次导管问题。导管问题是最常见的并发症，9例患者出现此情况。3例患者死于基础疾病。大多数患者适应了鞘内注射巴氯芬，为维持临床效果有必要逐渐增加剂量。多数患者可通过鞘内注射巴氯芬实现脊髓痉挛的长期控制，但需密切随访以评估疗效并为泵重新注药。
