Intrathecal baclofen therapy for spasticity in a person with spinal cord injury and end-stage renal disease dependent on hemodialysis: a case report.
Spinal Cord Ser Cases
; 10(1): 51, 2024 Jul 28.
Article
en En
| MEDLINE
| ID: mdl-39069535
ABSTRACT
INTRODUCTION:
Spasticity is one of the most common secondary complications following a spinal cord injury (SCI), which can significantly debilitate a patient irrespective of the severity of the injury. Intrathecal baclofen therapy can effectively reduce global spasticity in bilateral lower extremities at lower doses and allows precise dose titration to manage spasticity optimally. In complex patients with spasticity and multiple medical comorbidities, multidisciplinary teamwork is required to assess ITB safety and deliver timely intervention to prevent secondary complications of spasticity and improve quality of life. CASE PRESENTATION A 61-year-old African American male with multiple comorbidities, including end-stage renal disease (ESRD) requiring dialysis sustained non-traumatic SCI due to epidural abscess resulting in paraplegia and severe debilitating spasticity. Spasticity gradually worsened and interfered with his ability to achieve independence with functional activities appropriate for his neurological level of injury. A multidisciplinary team approach in this complex case resulted in a successful ITB trial and subsequent ITB implantation, resulting in reduced spasticity and improved quality of life. To our knowledge, this is the first case report of the administration of intrathecal baclofen pump therapy in a person with SCI and end-stage renal disease (ESRD) dependent on hemodialysis.DISCUSSION:
ITB therapy can be safely delivered in a person with SCI and multiple medical comorbidities, including ESRD, dependent on hemodialysis to manage spasticity. However, a careful evaluation and discussion among the multidisciplinary team managing the patient's morbidities and patient is required to assess the risks and benefits of ITB therapy to allow the patient to make an informed decision.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Traumatismos de la Médula Espinal
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Baclofeno
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Inyecciones Espinales
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Diálisis Renal
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Fallo Renal Crónico
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Relajantes Musculares Centrales
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Espasticidad Muscular
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Spinal Cord Ser Cases
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos