Isotopic Scintigraphy in Intrathecal Drug Delivery Failure: A Single-Institution Case Series.

Background: The aim of this study was to assess the feasibility and diagnostic accuracy of an optimized Indium-diethylenetriamine-penta-acetic-acid single-photon-emission computed tomography (CT) ( In-DTPA SPECT-CT) examination in patients with suspected intrathecal drug delivery (ITDD) failure.

Materials And Methods: Retrospective analysis of routinely collected observational data from a case series of patients in the setting of the academic Center for Pain Medicine, Departments of Radiology and Nuclear Medicine and Neurosurgery. Twenty-seven patients participated between January 2014 and January 2019.

Catheter Access Port (Computed Tomography) Myelography in Intrathecal Drug Delivery Troubleshooting: A Case Series of 70 Procedures.

Objectives: Intrathecal drug delivery is used for the treatment of intractable spasticity, dystonia, and pain. When the symptomatology fails to respond to therapy, the cause could be failure of the medication infusion. The purpose of this study is to assess pump catheter access port (CAP)-myelography and CAP-CT-myelography as advanced imaging methods in treatment failure.

Intrathecal baclofen as emergency treatment alleviates severe intractable autonomic dysreflexia in cervical spinal cord injury.

Episodic attacks of autonomic dysreflexia (AD) are regularly experienced by patients with a spinal cord injury (SCI) on T6 or higher levels. The episodes can result in a pounding headache, flushing, blurred vision, anxiety, a stroke, posturing, hyperthermia, retinal bleeding, seizures, myocardial ischemia, cardiac arrhythmias, and death. The observed associated bradycardia is explained as a baroreceptor reflex response to the high blood pressure.

Efficiency and Safety of Aftercare With Intrathecal Baclofen on Location.

Objectives: Patients with intractable spasticity treated with intrathecal baclofen (ITB) need regular evaluation and aftercare in an outpatient clinic or pain clinic setting. Logistically, this can be challenging. A solution could be to perform treatment at the patient's home setting.

Restoration of rostral cerebrospinal fluid flow to solve treatment failure caused by obstruction in long-term intrathecal baclofen administration.

We describe five traumatic spinal cord injury (SCI) patients with an intrathecal baclofen administration (ITB) failure caused by a rostral CSF flow obstruction referred to our expert center between January 2014 and January 2019. We discuss the diagnostic workup, rostral CSF flow obstruction as the cause of the ITB failure and treatment. When we could not determine the cause of the ITB failure through the patient's history, physical spasticity examination, pump readout, absence of fluid in the pump reservoir during aspiration, or plain radiography, we performed pump catheter access port (computed tomography [CT]) myelography.

Low-Dose Computed Tomography With Two- and Three-Dimensional Postprocessing as an Alternative to Plain Radiography for Intrathecal Catheter Visualization: A Phantom Pilot Study.

Objectives: In intrathecal drug delivery, visualization of the device has been performed with plain radiography. However, the visibility of the related structures can be problematic. In troubleshooting, after the contrast material injection via the catheter access port, a computed tomography (CT) scan has been used.

Plain radiography in patients treated with intrathecal drug delivery using an implantable pump device.

Objectives: Intrathecal drug administration using an implanted pump system is well established in intractable spasticity and pain. However, despite continuous advancements in manufacturing technology, adverse events related to the pump and catheter still occur. Most of them, such as migration, damage, disconnection and occlusion, are related to the spinal catheter.

Postdural puncture headache in complex regional pain syndrome: a retrospective observational study.

Objective: To describe the unusual course of postdural puncture headache (PDPH) after pump implantation for intrathecal baclofen (ITB) administration in patients with complex regional pain syndrome (CRPS)-related dystonia.

Design: Case series based on data collected from 1996 to 2005. Setting.

Long-term outcomes of continuous intrathecal baclofen infusion for treatment of spasticity: a prospective multicenter follow-up study.

Long-term outcomes of 115 patients treated with continuous intrathecal baclofen infusion are reported. A prospective follow-up study was conducted in eight centers. Patients were followed up over a 12-month period.