Am I a Candidate for ITB?

Feb 22, 2023
Am I a Candidate for ITB?
Intrathecal baclofen pump therapy (ITB) can reduce spasticity, a common symptom of neurological disorders. Find out if you can benefit from this treatment for multiple sclerosis and similar diagnoses.

Spasticity (i.e. muscle stiffness) is a primary symptom of many neurological disorders and can limit your movements. It prevents you from stretching your muscles, therefore making everyday tasks like typing or speaking difficult. 

When it comes to treating spasticity, an intrathecal baclofen (ITB) pump is one of the most effective methods. ITB is a powerful muscle relaxant that enters your spinal cord to ease your muscle stiffness. An ITB pump allows you to experience a better quality of life without the common side effects of oral muscle relaxant  medications, such as drowsiness, sleepiness, tiredness, dizziness, nausea etc. Since the baclofen medication is very effective when supplied directly into the spinal cord, only one hundredth of the dose that is given orally is required to achieve desired results.

Delaware NeuroRehab in Dover, Delaware, frequently uses ITB pumps as part of comprehensive neurorehabilitation plans. Our team of Physicians, Occupational therapists, Speech Pathologists, , and other specialists works closely with you as you adjust to taking baclofen. You can also add occupational and physical therapy to your care plan to avoid spasticity complications like frozen joints and joint dislocations. 

When ITB is the right choice

Many neurological disorders and injuries can cause spasticity, i.e. muscle tightness, to varying degrees. It’s a symptom of damage to the nerve pathways in your brain and spinal cord that control your muscles. It’s common to experience spasticity due to:

  • Multiple sclerosis
  • Spinal cord injuries
  • Traumatic brain injuries
  • Stroke
  • Paraplegias
  • Certain metabolic diseases that cause nerve damage

ITB pumps are usually reserved for significant cases of spasticity that don’t improve with conventional treatments  like oral muscle relaxant medications, bracing, daily stretching exercises, and physical therapy. If our team suspects that ITB therapy may be a good option for you, there are tests to confirm if it is right for you prior to getting a surgery. 

Finding out if you can benefit from ITB therapy

A test injection of baclofen is necessary to see if the medication is appropriate and effective. The standard test injection for ITB involves a spinal tap so experts can introduce the baclofen into the fluid surrounding your brain and spinal cord. Our team monitors your response to the medication and can then help you make an informed decision on whether to proceed with getting an ITB pump.  

ITB pump Implant and refills

ITB pump consists of a reservoir which holds the baclofen medication. The device is placed underneath the skin in the fatty tissue layer. It can be programmed from outside to adjust the dose.  A Catheter from the pump goes into the epidural space in the spinal cord in the mid-back region. The medication travels through this catheter into the target area. The pump needs to be refilled once every few months with the medication and it’s done in an office setting is about 5-10 minutes. The reservoir is operated by batteries hence it needs to be replaced surgically once every 7 years.   

Other considerations

The decision of whether to get ITB therapy for spasticity is a complex one, and there are many factors to consider. While a test injection is crucial for finding out if the medication improves your symptoms, you must also consider:

  • Whether your body is big enough for the pump
  • Potential allergies or hypersensitivities to baclofen
  • The amount of time that has passed since a Traumatic Brain Injury, Stroke or Spinal Cord Injury etc
  • The presence of any infections

If you’re not currently a candidate for ITB therapy, you might simply need to wait or you might be a good candidate for other treatment options such as Botulinum toxin injections (BOTOX, XEOMIN, DYSPORT), Phenol nerve blocks etc prior to considering surgeries. 

Talk to an expert today

Is spasticity inhibiting your ability to function even with your current treatment regimen? It may be time to consider an ITB pump. Schedule an appointment over the phone or online at Delaware NeuroRehab for more information today.