What is the role of pump technology in ITB treatment of spasticity?

Updated: Jun 28, 2019
  • Author: Krupa Pandey, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

ITB (SynchroMed Infusion System) provides direct, pattern-controlled delivery of baclofen to its target via an implanted, programmable pump. This precise delivery yields better spasticity reduction at lower doses with less systemic side effects than oral baclofen.

The pump is a small titanium disk that is about 3 inches in diameter and 1 inch thick. It contains a refillable reservoir for the liquid baclofen as well as a computer chip that regulates the battery-operated pump. A telemetric wand programs the dose of baclofen to be received. A flexible silicone catheter serves as the pathway through which the baclofen flows to the intrathecal space. To prevent accidental depletion of baclofen, the pump contains a programmable alarm that sounds when the reservoir needs to be refilled, the battery is low, or the pump is not delivering the baclofen.

The ITB pump generally is implanted near the waistline. The tip of a catheter rests between the first and second lumbar vertebrae in the intrathecal space. The distal end of the catheter loops around the torso and connects to the pump. The dose delivered by the pump is adjusted using the programmer and telemetry wand. This system is noninvasive and affords flexibility in individualizing doses.


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