Intrathecal baclofen therapy (ITB) is an effective treatment for spasticity and dystonia in children with cerebral palsy (CP). Implantation of ITB devices in children is associated with a high rate of surgical site infection (SSI). Surgical protocols have reduced SSI in children with other central nervous system implants. QI protocol is one of these protocols that aims specifically to reduce SSI for ITB surgery in children with CP.
Note: Currently the total number of enrollments in CPRN registry is 2681
- Since January 2018 until March 2021, 160 ITB surgeries were performed on 136 unique patients.
- The bar chart below shows the distribution of all BP Surgeries per site performed since January 2018 until March 2021:
- The surgeries were as follows: 69 new ITB system implantations, 58 pump replacements, 11 catheter revisions, 3 wound revision, 18 system removals, and 1 pump repositioned to the left side.
Note: For 4 patients, there is a potential missing data related to previous BP surgeries. 3 of these 4 patients (1 from NT75, 1 from OM82, and the other from BE65) have data only reported for the system removal surgery. Whereas the fourth patient's reported surgeries were a system removal, then a pump replacement a month later, this patient is also from OM82.
Within 90 days of ITB surgery, 5 procedures were complicated by an SSI and reported as Culture-Positive, and 3 was reported as Suspected Infection. More details can be found in the table below:
- Important notes and infection-related findings:
Table below shows the numbers of steps followed in all surgeries:
Mean age was 12.8 years (range 3-26), BMI 17.38 (10.76-34.06), 103 patients were GMFCS 4-5, and 14 patients had an ostomy.
Majority of patients underwent ITB for spasticity or mixed spasticity and dystonia