Toru Fukuhara
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Neurosurgery 2,
   Position   Professor with Special Assignment
Article types 原著
Language English
Peer review Peer reviewed
Title Tangled catheter as a rare cause of baclofen pump malfunction.
Journal Formal name:Surg Neurol.
Domestic / ForeginForegin
Volume, Issue, Page 72(1),pp.80-82
Author and coauthor FukuharaToru,TanakaT,NambaY,KuyamaH
Authorship Lead author
Publication date 2009/07
Summary BACKGROUND:

Several catheter problems have been reported as causes of baclofen pump malfunction; however, a tangled catheter has never been described.

CASE DESCRIPTION:

A 52-year-old woman with bilateral leg spasticity because of spinal multiple sclerosis underwent baclofen pump implantation, which was subcutaneously placed in the right upper quadrant. She visited for a pump refill 3 months postimplantation with reworsening of her leg spasticity. It was noted that there was more baclofen remaining in the pump than programmed. Abdominal x-ray indicated the kink of the catheter around the pump, and the catheter was explored under local anesthesia. Upon exposure, the catheter was found to be tangled. After the revision of this tangled catheter, the patient's spasticity improved again.

CONCLUSIONS:

Although the exact mechanism of this complication is unknown, the friction-compression of the catheter against the iliac bone may be the cause. Implanting the pump away from the bony formation may avoid catheter entanglement