In a patient receiving intrathecal baclofen injections for intractable
trunk and leg spasms, positioning the subarachnoid catheter tip just
caudal to the spinal segments innervating the spastic muscles enhanced
the spasmolytic effect of bolus injections of intrathecal baclofen on
the affected muscles. Such selective positioning of subarachnoid cath
eters may facilitate segmental spasmolysis with lower intrathecal dose
s of baclofen and provide an important alternative to relying only on
ascending CSF concentration gradients of baclofen from chronic lumbar
intrathecal infusion.