Affiliations: Utah Neuro Rehabilitation, Salt Lake City, UT, USA | University of Utah Health Sciences Center, Salt Lake City, UT, USA | Primary Children's Medical Center, Salt Lake City, UT, USA
Note:  Corresponding author: Judith L. Gooch, 5770 South 250 East,
Suite 405, Murray, UT 84107, USA. Tel.: +1 801 314 2100; Fax: +1 801 314 2105;
E-mail: [email protected]
Abstract: AIMS: Children with cerebral palsy often have severe
spasticity leading to deformity that requires multiple orthopedic surgeries.
Intrathecal baclofen pump implantation effectively decreases severe spasticity.
The objective of this study was to determine whether children who have a
baclofen pump implanted at a young age have fewer orthopedic surgeries than
those who have a baclofen pump implanted at later ages. METHODS: In this retrospective study of 310 children, we compared occurrence of surgery in
relation to having or not having the baclofen pump, by using survival analysis
with surgery as the outcome, presence of baclofen pump as the exposure of
interest, modeled as a time-dependent variable, and age as the time scale. RESULTS: There was no significant effect of pump placement on overall surgery
frequency. Analyses by type of surgery showed that those without a pump in
place had a 64% lower hazard of scoliosis surgery. CONCLUSIONS: No evidence was found to indicate that children who have a baclofen pump implanted
at a young age have fewer orthopedic surgeries than those who have a baclofen
pump implanted at later ages.
Keywords: Intrathecal baclofen, spasticity, cerebral palsy, orthopedic surgery