Abstract

Background and objectives. Intrathecal baclofen therapy (ITB) effectively reduces spasticity in various neurological conditions. The first ITB pump in Estonia was implanted in late 2012, but until now, no comprehensive research has documented its usage and complications in the country. The aim of this study was to provide a thorough overview of ITB use and treatment-related complications.
Methods. The study was based on data from healthcare information systems and described the demographic and clinical characteristics of patients who have received an ITB pump, as well as complications related to this treatment.
Results. As of July 2024, 43 patients in Estonia had been implanted with an ITB pump. The median age at the time of the first implantation was 18 years (age range 5-63). Of the patients who received the ITB pump, 60% (n = 26) had low functional capacity and 40% (n = 17) had high functional capacity. The most common clinical syndrome was spastic tetraparesis (n = 24), and the most common diagnosis was cerebral palsy (n = 19). Complications occurred in 16% of all patients with an ITB pump (n = 7, 95% CI [5%, 27%]), with cerebrospinal fluid leakage the most common.
Conclusions. Although ITB has been available in Estonia for over 10 years, and the frequency of complications is low, pump treatment has been applied to only a small number of patients with spasticity. This study not only raises awareness about ITB as an effective treatment option for spasticity, but also highlights the need for increased education among healthcare professionals and improved patient referral pathways.