What is intrathecal baclofen therapy?

Baclofen is usually taken by mouth several times per day. Intrathecal baclofen therapy (ITB) consists of delivering a liquid form of baclofen into the spinal fluid, using a device called a baclofen pump. ITB is approved by the FDA for the treatment of severe spasticity. ITB has been used at the Mellen Center since 1990.

What is a baclofen pump?

The baclofen pump system consists of a pump and a catheter that brings the medication from the pump into the spinal fluid. The pump is a round metallic disc (about 1 inch thick and 3 inches in diameter), which is surgically implanted under the skin of the abdomen.

The pump contains a battery, which usually lasts between 5 and 7 years, a reservoir for the medication, and a microprocessor. The pump can be programmed with a small computer which communicates with the pump via a wand placed over the skin. The catheter is a thin flexible tube implanted under the skin. One end of the catheter is connected to the pump, and the other end is inserted into the spine at various levels.

What is involved in the management of a baclofen pump?

The pump needs to be refilled at regular intervals (usually every 1 to 6 months) by a trained healthcare professional who possesses the equipment needed. The pump is refilled by inserting a needle through the skin into a refill port on the pump. In some cases the refills can be done at home, but follow-up visits are needed one to two times per year to ensure that the therapy is working appropriately. The dose of baclofen can be adjusted at any time, but the adjustment must be done by a trained professional. When the battery approaches the end of its life, the pump needs to be replaced (but not the catheter). When a problem with the baclofen pump is suspected, medical attention should be sought as soon as possible.

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