Intrathecal Drug Delivery System
For Spasticity

Spasticity of spinal cord and cerebral origin, such as seen in spinal cord trauma, degenerative spinal disease, cerebral palsy and brain injury is a challenging disorder to control effectively. Traditional rehabilation therapies and oral antispastic drugs often fail to relieve severe spasticity in such patients with intractable spasticity. This therapy consists of long-term delivery of baclofen, a peripherally acting muscle relaxnt, directly into subarachnoid space using an implantable, programmable pump and aspinal catheter. The does of the drug is adjusted by an external programmer.










Case Studies For Spasticity and Rigidity


Mr Sanjeet Sandhu 25 years Male resident of UK SPASTICITY PATIENT STORY

Mr. Sanjeet Sandhu met with a road side accident in summer of 2001.He noticed tremor in the left upper limb after 6 weeks of injury. Gradually his symptoms progressed. He became more lethargic and became fatigue easily. Patient developed stiffness, difficulty in walking and balance problem. The symptoms progressed very rapidly and for last 6 months he was on wheelchair and even on wheelchair he required assistance. He was put on all anti-Parkinson medication and on oral baclofen at highest dose without any significant improvement. His MRI was normal. He was diagnosed to have Parkinson plus syndrome. He was told that no therapy could benefit him. He was brought to India at VIMHANS, New Delhi in the month of Oct2004.After detailed evaluation it was decided that if his stiffness can be reduced he would be more manageable. Trial bolus of Intrathecal baclofen 50ug was given and he responded very well and rigidity (stiffness) reduced significantly. Dr Alok Gupta, Consultant Neurosurgeon, VIMHANS, and New Delhi operated him on 28/10/04. Implantation of Synchromed-II intrathecal programmable baclofen pump was done. He responded very well to therapy. At the time of his departure from INDIA patient was walking with minimal support. His family was happy. Intrathecal Baclofen therapy improved his quality of life and activities of daily living.




Mr Raja Ram 58yrs/M had an road accident in Oct 2003,followed by weakness of right upper limb. After one week of injury he reported excruciating pain in right upper limb. His NCV revealed right Pan brachial plexus injury. He was operated at VIMHANS, New Delhi. Microsurgical neurolysis was done on 13/08/04 which did not improve his pain He was lateron subjected to two successive stelliate ganglion block, which also could not improve his pain. The pain was so bad that patient wanted his right upper limb to be amputed as early as possible. On 1/09/04 he was given a trial bolus of intrathecal morphine. Patient gets immediately pain relief for a day. He was advised to undergo implantation of intrathecal morphine delivery pump. Dr Alok Gupta, Consultant Neurosurgeon, VIMHANS, and New Delhi operated him on 2/09/04. Patient responded very well and has complete pain relief till date. Patient is on only 1.9mg/day dose. Of morphine infusion.