Neuraxial Trialing Techniques for Spasticity

Intrathecal baclofen is an effective treatment for the management of patients with spasticity, which is not adequately treated with oral medications. It is best practice to proceed with a trial to assess efficacy as well as tolerability to the therapy prior to implant. There are several scales to document improvement in symptoms, the Modified Ashworth Scale being the most commonly used. Successful trial patients will proceed with implantation of an intrathecal catheter and subcutaneous pump. Once implanted, management of the intrathecal dosing can be performed to match the patient's response and symptom improvement.