Characterization of standard work tools for intrathecal baclofen therapy

Ajay Patel, Samuel Stegelmann, Josue D. Ordaz, Virendra Desai, Francisco Angulo-Parker, Sara Cartwright, Gloria Fritsch, Philip Flory, Ann Coon, Sarah K. Johnson, Sarah Delima, Jeffrey S. Raskin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Intrathecal baclofen (ITB) has been an effective therapy since the 1980s, with widely reported revision, infection, and complication rates. Publications targeting surgical workflow have resulted in decreased infection and revision rates, but a standard workflow for the entire pathway has not been described. To present, define, and test standard work tools for patients receiving ITB to promote uniformity and standard of care in the field. Methods: A multidisciplinary approach from the movement disorder program of a tertiary care center defined all steps comprising the ITB pathway, and then developed standard work tools to decrease variability with respect to preoperative workup, day of surgery protocol, post-operative care, and also evaluation and treatment with respect to pump infection or malfunction. Results: Defined steps used at specific points of ITB pathway are presented with a single institution’s outcome using the protocol from July 2017 to November 2020. A total of 60 procedures were performed. The overall complication rate was 14.5% at 6 months. Complications included an infection rate of 3.6% at 6 months, wound revision rate of 1.8% at 6 months, CSF leak rate of 1.7% at 6 months, and a 30-day readmission rate related to initial surgery of 6.7%. Conclusions: Workflow efficiency and optimization for ITB patients can be used to obtain lower complication rates compared to historical cohorts in literature. A single-center, retrospective review highlights this.

Original languageEnglish (US)
Pages (from-to)3073-3081
Number of pages9
JournalChild's Nervous System
Volume37
Issue number10
DOIs
StatePublished - Oct 2021
Externally publishedYes

Keywords

  • Complication
  • Dystonia
  • Infections
  • Intrathecal baclofen
  • Protocol
  • Quality improvement
  • Spasticity
  • Standard work

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Characterization of standard work tools for intrathecal baclofen therapy'. Together they form a unique fingerprint.

Cite this