Intrathecal Baclofen (ITB) Therapy
Intrathecal Baclofen (ITB) Therapy provides relief for those suffering from severe spasticity. This therapy consists of an implanted, programmable pump with a catheter that administers medication directly into the spinal fluid. An ITB pump delivers 1/100 of the total daily dose compared to oral baclofen, significantly reducing side effects. This results in 35 to 50 times more medication in the spinal fluid, thus making it more effective.
Is ITB for me?
A trial provides you the opportunity to discover whether your body will respond to the treatment before you consider the surgical pump implant. A trial consists of a single epidural spinal injection of a small dose of baclofen. The trial is accompanied by physical therapy evaluations prior to the injection and at two hours and four hours after the injection. This allows for a thorough review of how this therapy may assist in accomplishing your long-term goals.
Many compare this screening test to a light switch – either it is completely ‘on’ or entirely ‘off.’ Long-term ITB therapy is like giving that light switch a dimmer. The medication can be adjusted to the precise amount needed so your muscles are not too loose or too tight.
In clinical studies, the test dose was effective for 97 percent of patients with spasticity related to the spine and 94 percent of patients with spasticity related to the brain.
If you and your care team decide that an ITB pump is the right therapy for you, we will refer you to a surgical specialist for the pump implant. At the time of the implant, the pump is filled with baclofen. Approximately two weeks after the pump is implanted, you will return to our office. This is when we start to make adjustments to the pump to find the right dose. We may also begin decreasing oral medications at this visit. As unique individuals, each patient responds differently to an ITB pump. As a result, it may take several months to find the optimum dose for you.
ITB Therapy will not cure severe spasticity or the medical condition causing it, but it may help control spasticity long term. In addition to your new ITB pump, ongoing spasticity management may include physical therapy, occupational therapy, serial casting, bracing and a home exercise program. We are committed as your long-term partner in accomplishing your goals and improving quality of life for you and those you love.