González-Pombo M et al., 2019: M, Márquez-Rivas J. Extracorporeal Shockwave Lithotripsy Procedure in Children With Intrathecal Baclofen Pump
González-Pombo M, Márquez-Rivas J.
Neurosurgery Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Neuroscience Applied Group, Instituto de Biomedicina de Sevilla, Sevilla, Spain.
Intrathecal baclofen therapy is widely accepted as a treatment option for patients with severe muscle spasticity as a consequence of various diseases, such as cerebral palsy (CP) in children. These patients also share some risk factors for developing urinary stones, including recurrent urinary tract infections, indwelling catheters, vesicoureteral reflux, and immobilization-associated hypercalciuria. Depending on their size and type, these calculi may either resolve spontaneously or with medical treatment. In selected cases, extracorporeal shockwave lithotripsy (ESWL) may be an option. The exposure of intrathecal drug delivery devices to shockwaves implies a potential risk of damage to its components. The safety of this technique in these patients has not been completely established. This is a case report of a child with an indwelling intrathecal baclofen pump and treated with ESWL in our hospital.
Neuromodulation. 2019 Jan 25. doi: 10.1111/ner.12917. [Epub ahead of print]
3 similar published cases of stone treatment in patients with intrathecal drug delivery devices are collected by the authors. Medtronic’s user manual gives information about ESWL application in these cases.