Hip status in cerebral palsy after one year of continuous intrathecal baclofen infusion

Krach, Linda E; Kriel, Robert L; Gilmartin, Richard C; Swift, Dale M; Storrs, Bruce B; Abbott, Rick; Ward, John D; Bloom, Karen K; Brooks, William H; Madsen, Joseph R; McLaughlin, John F; Nadell, Joseph M

doi:10.1016/j.pediatrneurol.2003.08.006

« Previous Next »Pediatric Neurology
Volume 30, Issue 3 , Pages 163-168, March 2004

Hip status in cerebral palsy after one year of continuous intrathecal baclofen infusion

This study was presented at the Annual Meeting of the American Academy of Physical Medicine and Rehabilitation on Nov 4, 2000 in San Francisco, CA.

Linda E Krach, MD
- Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA
- Communications should be addressed to:Dr. Krach; 200 East University Avenue; St. Paul, MN 55101, USA.
Robert L Kriel, MD
- Pediatrics and Neurology at Hennepin County Medical Center, Minneapolis, Minnesota, USA
Richard C Gilmartin, MD
- Department of Pediatrics, University of Kansas School of Medicine, Kansas City, Kansas, USA
Dale M Swift, MD
- Department of Neurosurgery, Children's Medical Center of Dallas, Dallas, Texas, USA
Bruce B Storrs, MD
- Division of Neurosurgery, Children's Hospital of New Mexico, Albequerque, New Mexico, USA
Rick Abbott, MD
- Division of Pediatric Neurosurgery, Beth Israel Medical Center, Singer Division, New York, New York, USA
John D Ward, MD
- Division of Neurosurgery Medical College of Virginia, Richmond, Virginia, USA
Karen K Bloom, MD
- Division of Physical Medicine and Rehabilitation, Frazier Rehabilitation Center, Louisville, Kentucky, USA
William H Brooks, MD
- Department of Neurosurgery, Pain Care Center, Lexington, Kentucky, USA
Joseph R Madsen, MD
- Department of Neurosurgery, Children's Hospital of Boston, Boston, Massachusetts, USA
John F McLaughlin, MD
- Department of Pediatrics, Children's Hospital and Medical Center, Seattle, Washington, USA
Joseph M Nadell, MD
- Division of Neuroscience, Children's Hospital of Louisiana, New Orleans, Louisiana, USA

Received 20 March 2003; accepted 26 August 2003.

Abstract

The purpose of this study was to assess whether reduction of muscle tone by continuous intrathecal baclofen infusion affects the progression of hip subluxation in persons with cerebral palsy. This prospective, open-label, case series was conducted at multiple specialty referral centers. There were 33 subjects, ages 4 to 31 years. All had a pretreatment lower extremity Ashworth score of ≥3; all subjects had a significant reduction in tone after a bolus injection of intrathecal baclofen and received an implanted pump for continuous delivery of intrathecal baclofen. Subjects had hip x-rays before and 1 year after pump implantation. The primary outcome measure was change in absolute hip migration percentage. One third of the hips had an increase of absolute migration percentage of 5% or more; 12% of the hips had a decrease of migration percentage of 5% or more. Change of migration percentage class was used as a second outcome criterion. 90.9% of hips manifested no deterioration or had improvement of their migration percentage class during the year of intrathecal baclofen therapy. The observed changes were not associated with the subject's age or the severity of cerebral palsy.