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Intrathecal baclofen (ITB) therapy is a treatment option for children with severe spasticity (tight, stiff muscles that make movement difficult or uncontrollable) or secondary dystonia (involuntary muscle contractions or spasms) who are not helped by Botox injections or oral medications. ITB therapy may especially benefit children with spasticity or dystonia affecting both the upper and lower body. Over time, it can markedly improve comfort and quality of life and often functioning.
Baclofen is a medication that acts in the nervous system to relax muscle movement. It can be given by mouth or feeding tube, but in ITB therapy, a pump delivers baclofen directly into the cerebrospinal fluid (CSF) in the spine (intrathecally) in constant, small amounts. This ensures that enough of the drug gets to the nerves in the spinal cord and avoids some of the potential side effects of oral or enteral baclofen.
The baclofen pump is surgically implanted in the abdomen, just under the skin, and attached to a catheter whose other end is inserted into the spinal canal in the lower back area, in the space containing the spinal fluid. Once the pump is implanted, medication dosing can be adjusted with a remote programming device by a specially trained medical provider. The pump is refilled every two to six months in an outpatient clinic, also by a specially trained provider. The pump battery must be replaced every seven years, which requires surgery.
For more detailed information about the baclofen pump, click the “In Depth” tab at left.
Boston Children’s team of clinicians integrates all aspects of care for children with baclofen pumps and responds quickly to problems. Our baclofen pump team is available to you 24 hours a day, 7 days a week in case of emergency. We also offer:
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”