Baclofen Pump for Cerebral Palsy
Neurosurgery specialists at the leading private hospital of Israel, Herzliya Medical Center perform the surgical implantation of the Baclofen pump for cerebral palsy. The clinic is constantly introducing innovative methods of automatic dosing of drugs that manage the symptoms of many chronic diseases of the central nervous system, including the removal of spasticity in infantile cerebral palsy (ICP).
Symptomatic Treatment of Cerebral Palsy in Israel
Cerebral Palsy - a chronic disease characterized by lesions of the motor centers of the brain. Spastic cerebral palsy is the most common form of manifestation of this disease. Skeletal muscle spasticity leads to severe motor disabilities, severe pain and the development of contractures - restriction of movement in the joints with the secondary and irreversible fibrotic changes. Drug treatment aims to remove spasticity of ICP, which significantly improves the condition of patients and improves the efficiency of physiotherapy. Reducing spasticity facilitates voluntary movements and increases functionality. In Israel, the use of the latest drugs are highly selective with minimal side effects.
Baclofen for Cerebral Palsy
The use of baclofen for relief of spasticity caused by cerebral palsy, has changed the course and prognosis of this disease. Baclofen belongs to the pharmacological action of the central group of muscle relaxants - drugs that reduce spasms of skeletal muscles, affecting the biochemical receptors in the brain. Desired pharmacological effect after administration of the drug is achieved within a few days from the start of treatment.
Baclofen Pump Side Effects
One of the major drawbacks of the use of baclofen is the presence of side effects associated with the impact of the drug on the entire body. General weakness, drowsiness and altered mental status may impede the achievement of the required therapeutic concentrations. Modern techniques have been successfully used by the neurologist’s clinic at Herzliya Medical Center, by preventing the development of systemic side effects of baclofen and achieve a selective effect on the centers of the brain, affecting muscle tone.
The Principle of the Baclofen Pump
The preferred effect of baclofen pump achieved by the desired concentration of drug entering the cerebrospinal fluid of the patient. Direct administration of (liquid) baclofen into the cerebrospinal fluid allows the necessary dosage to relieve spasm, without the fear of significant side effects. This form of medication is further aided by implanting a special device - baclofen pump. The baclofen pump system consists of:
- A drug reservoir (of baclofen) in an injection form. The pump is inserted into the subcutaneous tissue of the patient (usually in the abdomen)
- A lumbar catheter attached - one end connected to the pump, the other end is connected along a specific point of the spine (the intrathecal space of the first and second lumbar vertebrae). The catheter is flexible, and is tunneled below the skin
- The pump is electronically controlled, determines the exact dosage of medication injected that is then directed on a regular basis. The drug is injected directly into a cavity that contains the cerebrospinal fluid
All elements of the baclofen pump are not visible to others and implanted under the skin of patients, which does not limit them in everyday life. Application of the baclofen pump for cerebral palsy patients helps them to cope effectively with spasticity - without compromising their general health condition. The method also allows the use of smaller drug dosages, changing the injection amount depending on the patient’s clinical condition and the time of day. If necessary, the pump can be temporarily disabled or completely removed without any side effects.
Application of Baclofen Pump at HMC
Neurologist’s clinic at Herzliya Medical Center will conduct a thorough diagnosis and strictly individual decision, based on indications for use baclofen pumps for cerebral palsy. Implantation of the device carried out by experienced neurosurgeons, carried out in several stages:
- Prior to implantation, to be eligible (baclofen will not affect the patient) a clinical trial is performed. Baclofen is injected into the lumbar region of the spine. Following this, experts estimate the clinical response of the patient. A marked reduction in spasticity is an additional indication for implantation of the pump
- Once eligible, the baclofen pump is surgically implanted and connected with a permanent lumbar catheter
- The pump is set and the optimal dosage is selected, this varies during the day. Changing the dosage is carried out remotely and does not require any invasive procedures
The baclofen pump requires periodic maintenance, carried out by a team of the neurological outpatient hospital at Herzliya Medical Center. Among the necessary procedures, it is important to note:
- Correct dosage of baclofen, dependent on clinical indications and effectiveness of treatment
- Filling the reservoir of the baclofen pump - carried out through a special valve subcutaneously every 30-45 days (depending on the applied dose)
- Replacing the battery and electronic-mechanical pump. The device is designed for autonomous operation for 5-7 years, after which the above mentioned parts require replacement
Patients at Herzliya Medical Center receive a full technical description of the implanted baclofen pump, as well as clear guidance on periodic maintenance of the device.