Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review
Objective: To evaluate the effectiveness and safety of intrathecal baclofen treatment of spasticity, administered via a cervical catheter tip. Design: A review of PubMed and the Cochrane Library up to September 2020. No restriction in study design. Two reviewers independently evaluated eligibility,...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2021-07-01
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| Series: | Journal of Rehabilitation Medicine |
| Subjects: | |
| Online Access: |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2857
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| _version_ | 1798016912454582272 |
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| author | Nora W. Jacobs Ellen M. Maas Marjolein Brusse-Keizer Hans J.S. Rietman |
| author_facet | Nora W. Jacobs Ellen M. Maas Marjolein Brusse-Keizer Hans J.S. Rietman |
| author_sort | Nora W. Jacobs |
| collection | DOAJ |
| description | Objective: To evaluate the effectiveness and safety of intrathecal baclofen treatment of spasticity, administered via a cervical catheter tip.
Design: A review of PubMed and the Cochrane Library up to September 2020. No restriction in study design. Two reviewers independently evaluated eligibility, extracted data and evaluated risk of bias. Studies were included in which patients were treated with intrathecal baclofen for spasticity, with the catheter tip at or above the first thoracic level, independent of diagnosis and age.
Results: Thirteen studies were eligible, with a moderate to critical risk of bias. Improvement in spasticity was seen only in the upper extremity in 6% of subjects, only in the lower extremity in 2%, in both upper and lower extremities in 50% and without specification of location in 41%. Upper extremity function improved in 88% of cases. Neither drug-related (1%) nor technical (21%) complications occurred more often than in lower placement of the tip. Effects on respiratory function and sleep apnoea were not investigated.
Conclusion: Cervically administered intrathecal baclofen seems to improve upper extremity spasticity and function, without causing more complications than thoracolumbar intrathecal baclofen. However, the mainly drug-related complications have not been thoroughly investigated and the available literature is of poor methodological quality. Further research is needed to confirm the efficacy and safety of this procedure. |
| first_indexed | 2024-04-11T15:57:04Z |
| format | Article |
| id | doaj.art-a75c61d412974a5faadd589ed0fa7284 |
| institution | Directory Open Access Journal |
| issn | 1650-1977 1651-2081 |
| language | English |
| last_indexed | 2024-04-11T15:57:04Z |
| publishDate | 2021-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj.art-a75c61d412974a5faadd589ed0fa72842022-12-22T04:15:07ZengMedical Journals SwedenJournal of Rehabilitation Medicine1650-19771651-20812021-07-01537jrm0021510.2340/16501977-28572812Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic reviewNora W. Jacobs0Ellen M. MaasMarjolein Brusse-KeizerHans J.S. Rietman Rehabilitation, Roessingh Center for Rehabilitation, Enschede, The Netherlands. E-mail: n.jacobs@roessingh.nl. Objective: To evaluate the effectiveness and safety of intrathecal baclofen treatment of spasticity, administered via a cervical catheter tip. Design: A review of PubMed and the Cochrane Library up to September 2020. No restriction in study design. Two reviewers independently evaluated eligibility, extracted data and evaluated risk of bias. Studies were included in which patients were treated with intrathecal baclofen for spasticity, with the catheter tip at or above the first thoracic level, independent of diagnosis and age. Results: Thirteen studies were eligible, with a moderate to critical risk of bias. Improvement in spasticity was seen only in the upper extremity in 6% of subjects, only in the lower extremity in 2%, in both upper and lower extremities in 50% and without specification of location in 41%. Upper extremity function improved in 88% of cases. Neither drug-related (1%) nor technical (21%) complications occurred more often than in lower placement of the tip. Effects on respiratory function and sleep apnoea were not investigated. Conclusion: Cervically administered intrathecal baclofen seems to improve upper extremity spasticity and function, without causing more complications than thoracolumbar intrathecal baclofen. However, the mainly drug-related complications have not been thoroughly investigated and the available literature is of poor methodological quality. Further research is needed to confirm the efficacy and safety of this procedure. https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2857 intrathecal baclofen tip placement cervical upper extremity spasticity |
| spellingShingle | Nora W. Jacobs Ellen M. Maas Marjolein Brusse-Keizer Hans J.S. Rietman Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review Journal of Rehabilitation Medicine intrathecal baclofen tip placement cervical upper extremity spasticity |
| title | Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review |
| title_full | Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review |
| title_fullStr | Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review |
| title_full_unstemmed | Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review |
| title_short | Effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity: A systematic review |
| title_sort | effectiveness and safety of cervical catheter tip placement in intrathecal baclofen treatment of spasticity a systematic review |
| topic | intrathecal baclofen tip placement cervical upper extremity spasticity |
| url |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2857
|
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