Serial Changes After the Trial Use of Bolus Intrathecal Baclofen for Intractable Spasticity of Spinal Cord Injury Patients

J Korean Assoc EMG Electrodiagn Med 2004;6(1):52-57.
Published online May 10, 2004.

Abstract

Objectives: This study was conducted to add to the information for preselection of intrathecal baclofen (ITB) pump and to evaluate serial changes after the trial use of bolus ITB for intractable spasticity of spinal cord injury (SCI) patients. Methods: Ten SCI patients with severe intractable spasticity who had failed oral antispastic drug therapy were screened with ITB trial bolus testing (50 μg). After bolus injection, changes in spasticity were measured using H/M ratio, Ashworth Scale, Spasm scale and Reflex scale. Results: There was a significant decrease in spasticity in all patients. After injection of ITB, decreased amount of spasticity for 1 hour was as follows: H/M ratio, 50.34±7.35%; Ashworth Scale, 9.85±5.33%; Spasm scale 34.92±5.86%; Reflex scale 14.26±4.46%. Minimal hours for maximal effect of recovery of spasticity were the next: H/M ratio, 6.0±0.0; Ashworth Scale, 7.9±0.6; Spasm scale 9.6±0.7; Reflex scale 8.4±1.1. H/M ratio had a meaningful changes after the trial use of bolus ITB for 1 hour and in minimal hours for maximal effect of recovery of spasticity. Conclusion: Ten SCI patients responded with a reduction in H/M ratio, Ashworth Scale, Spasm scale and Reflex scale scores more than two points in ITB bolus trial. H/M ratio are the most sensitive indicator of serial changes after the trial use of bolus ITB for intractable spasticity of SCI patients.

Key Words: Intrathecal baclofen (ITB), Spasticity, Spinal cord injury (SCI)