Intrathecal catheter with subcutaneous port for clonidine test bolus injection - A new route and type of treatment for detrusor hyperreflexia in spinal cord-injured patients

Introduction and Objectives: The objective of this study was to assess the feasibitity, technical data and use of intrathecal catheter implantation wi th subcutaneous port for clonidine test injections and individual evaluatio n. Methods: According to approval of the local ethics committee, 9 consecutive SCI patients (6 men, 3 women) had catheter and port implantation between J anuary 1998 and May 1999. All did not respond to systemic drug therapy in c ombination to self-clean intermittent catheterisation (SCIC). Implantation was done under general anesthesia. Needle and catheter were Medtronic Infus ion Synchromed Intraspinal catheter (Indura(TM), 8703W). Clonidine test inj ections were allowed at D5. Results: There were no complications during operation. Follow-up was 8.2 mo nths (0.5-17). After clonidine bolus injection test and validation, 6 patie nts decided to have permanent pump implantation, 2 chose other therapies an d one did not tolerate clonidine intrathecal injections for blood arterial pressure side effects. Conclusions: Intrathecal clonidine may represent a useful conservative trea tment of both severe bladder hyperreflexia and spinal spasticity. Its short -term effects can be individually evaluated through bolus injection in subc utaneous port before definitive pump implantation. Copyright (C) 2000 S. Ka rger AG, Basel.