Intrathecal baclofen therapy and spinal cord stimulation in the treatment of spasticity in patients due to spinal cord injury: results of 6 month follow up
Abstract
Spasticity is one of the most common complications of spinal cord injury (SCI), the treatment of which is still an unresolved problem. Our goal was to develop an algorithm for personalized selection of patients for surgical treatment using spinal stimulation (SCS) and intrathecal baclofen therapy (ITB ).
We analyzed 28 cases of severe spastic syndrome in patients with SCI, aged 18 to 62 years, with an average age of 33.9 ± 12.9. The patients were divided into 3 groups: the control group that received conservative therapy; the SCS group and the ITB group. The results were evaluated using a modified Ashworth scale, Pen spasm frequency scale, reflex scale, and motor function scale 1, 3 and 6 months after surgery. The first stage was carried out trial SCS in case of positive result of the performed implantation of a pulse generator (14 patients), with a negative result, the patient was performed baclofen trial, the results of which have been implanted pump (14 patients).
As a result, over 6 months of observation obtained the significant decline in spasticity in both study groups compared to the control for all scales except the scale of motor function, where there were no recorded statistically significant changes.
Based on the results of 6-month follow-up, we can make a preliminary conclusion that step-by-step selection through test stimulation is an effective method of personalized treatment of spasticity. Patients who responded to the trial SCS maintain a stable result for a long period of time without detecting significant differences with those receiving ITB .
About the Authors
A. R. Biktimirov
Far Eastern Federal University, medical center
Russian Federation
Russian Federation
Vladivostok
O. I. Pak
Far Eastern Federal University, medical center
Russian Federation
Russian Federation
Vladivostok
R. I. Totorkulov
Far Eastern Federal University, medical center
Russian Federation
Russian Federation
Vladivostok
I. S. Bryukhovetsky
Far Eastern Federal University, Department of fundamental medicine
Russian Federation
Russian Federation
Vladivostok
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Review
For citations:
Biktimirov A.R., Pak O.I., Totorkulov R.I., Bryukhovetsky I.S. Intrathecal baclofen therapy and spinal cord stimulation in the treatment of spasticity in patients due to spinal cord injury: results of 6 month follow up. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2020;12(4):6-13. (In Russ.)
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