Unique form of catheter malconnection following intrathecal baclofen surgery for spinal cord injury: a case report

This case report describes a unique complication following intrathecal baclofen (ITB) therapy for a patient with spinal cord injury (SCI). After revision surgery for a catheter obstruction, the patient's spasticity returned. The issue was found to be a curled-up silicone layer around the sutureless pump connector, causing a malconnection. This specific type of malconnection has not been previously reported. The authors suggest that surgeons should carefully inspect the silicone connector before completing the connection to prevent this complication. Early diagnosis can be challenging, requiring specific imaging techniques.

• 1
  A novel form of catheter malconnection was identified, involving the curling of the silicone layer surrounding the sutureless pump connector in an intrathecal baclofen (ITB) system.
• 2
  Standard diagnostic methods like conventional radiography and CT scans may not detect this subtle malconnection, emphasizing the need for more sensitive techniques like Indium SPECT-CT.
• 3
  Inspection of the watertight connection of the sutureless pump connector prior to definite connection is crucial to avoid this complication.