Complications after Spinal Fusion in Patients with Baclofen Pumps: A Controlled Study

Methods: Ten patients with indwelling baclofen pumps underwent spinal fusion and instrumentation at one institution in a 6 year period. Complication rates and types were compared with those from the 20 patients with spastic quadriparetic cerebral palsy who underwent spinal fusion and instrumentation at the same institution during the same period.

Results: Three patients in the baclofen pump group had pump related complications requiring reoperation (one catheter breakage, one catheter withdrew from the intrathecal space and became infected after revision, and one pump became positional). The deep infection rate in the pump group was 3/10 (30%) vs. 2/20 (10%) in the CP patients without pumps. Major complications were encountered in 5/10 (50%) of the pump patients (4/10 with major complications not directly related to the pumps) (7 total major complications) and 4/20 (20%) of the patients without pumps (4 total major complications).

Conclusion: Patients with preexisting baclofen pumps appear more likely to encounter a major complication after spine fusion surgery then are spastic quadriparetic CP patients without pumps. Some but not all of this difference appears directly due to pump and catheter related issues.