Intrathecal baclofen in tetraplegia of spinal origin: efficacy for upper extremity hypertonia

Study design: Retrospective analysis. Objectives: To evaluate the efficacy of intrathecal baclofen (ITB) for uppe r extremity spastic hypertonia in tetraplegia of spinal origin. Setting: University of Alabama at Birmingham hospital. Methods: The medical records of 14 individuals with tetraplegia of spinal o rigin who underwent intrathecal baclofen pump placement were reviewed. The effects of intrathecal baclofen on spasm frequency, deep tendon reflexes, a nd tone (Ashworth scale) were assessed for the upper and lower extremities for a 1-year follow-up period. Results: There were statistically significant declines in upper extremity s pasm scores (1.8 points, P = 0.012), reflex scores (1.4 points, P < 0.0001) and Ashworth scores (0.6 points, P < 0.0001) for the 1-year follow-up peri od. For the lower extremities, all decreases were significant (P < 0.0001). There was also a statistically significant (P < 0.0001) increase in intrat hecal baclofen dosage requirements during the 1-year follow-up period to ma intain the reductions in spasm frequency, reflexes and tone. Conclusions: Intrathecal baclofen is a safe and effective intervention for treating upper extremity hypertonia of spinal origin. In addition, the leve l of intrathecal catheter placement is felt to be of importance.