A Simplified Procedure for Intrathecal Baclofen Catheter Replacement Through a Granulation Tunnel Using a 16-Gauge Peripheral Vein Catheter

Cureus, 2025 · DOI: 10.7759/cureus.77686 · Published: January 19, 2025

Simple Explanation

This paper describes a new surgical technique to replace intrathecal baclofen (ITB) catheters, used to manage spasticity. The traditional approach involves a new dural puncture, which carries risks. The new technique utilizes the granulation tunnel that forms around the old catheter. A 16-gauge peripheral vein catheter is inserted into this tunnel, acting as a guide for the new catheter. This method avoids the need for a new dural puncture, potentially reducing complications like CSF leaks, nerve injury, and hemorrhage. It may also lead to shorter surgical times and lower radiation exposure.

Study Duration

9 months

Participants

A 79-year-old man

Evidence Level

Case Report

Key Findings

1
The intrathecal catheter was successfully replaced through the granulation tunnel using a 16-gauge peripheral vein catheter as a guide.
2
The patient experienced relief from truncal tightening with a lower dose of baclofen after the catheter replacement.
3
No surgical complications were observed during or after the catheter replacement procedure.

Research Summary

The study presents a simplified surgical technique for intrathecal baclofen (ITB) catheter replacement. It uses a 16-gauge peripheral vein catheter to guide the new catheter through the granulation tunnel formed around the old catheter. This approach eliminates the need for a new dural puncture, which is typically required in traditional catheter replacement procedures. Avoiding a new puncture could reduce risks such as CSF leakage and nerve injury. The case report demonstrates the successful application of this technique in a 79-year-old man, resulting in symptom relief and no surgical complications. The authors suggest this method can simplify the procedure and reduce potential risks.

Practical Implications

Reduced Complications

This technique may reduce the risk of complications associated with dural punctures, such as CSF leaks, nerve injury, and hemorrhage.

Simplified Procedure

The method simplifies the catheter replacement process, potentially shortening surgical time and radiation exposure.

Broader Applicability

This technique could be beneficial for patients with scoliosis or vertebral deformities, where traditional dural puncture is challenging.

Study Limitations

1
Single case report limits generalizability.
2
Further investigation is required to determine whether this procedure can be successfully replicated in other cases
3
Off-label use of venous catheters requires hospital approval.

Your Feedback

Was this summary helpful?

Back to Neurology