{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:56:17Z","timestamp":1792428977877,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010975","name":"Pediatric Orthopaedic Society of North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Children with non-ambulatory cerebral palsy (CP) often have neuromuscular scoliosis (NMS) that requires surgical correction. Many of these children also have co-existing spasticity treated with an intrathecal baclofen pump (ITBP). Theoretically, ITBPs can complicate spine surgery due to the proximity of the pump and catheter to the surgical area, but the evidence on effects of ITBP on spinal deformity surgery outcomes is varied. The aim of this study was to compare surgical outcomes and incidence of complications between children with and without ITBPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included children with CP from a single center who underwent spinal fusion between 2001 and 2021. Complications and outcomes were abstracted from the medical record and compared between those with and without ITBP using Fisher\u2019s exact tests or Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 334 patients were eligible (ITBP:\n                      <jats:italic>n<\/jats:italic>\n                      = 163; no ITBP:\n                      <jats:italic>n<\/jats:italic>\n                      = 171). In general, children with ITBP were not more likely to experience complications compared to those without (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.19). However, those with ITBP had greater odds of surgical site infection (OR 3.11,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), longer surgery duration (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and higher percentage of blood loss (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01). ITBP-related complications occurred in 11% of children with ITBP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The presence of ITBP did not increase the general risk of complications for children with ITBP. However, children with ITBP experienced more surgical site infections, longer surgery durations, and a higher percentage of blood loss. Results will improve counseling between surgeons, children, and caregivers regarding the risk of spinal fusion surgery when ITBPs are present.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01274-5","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T16:45:37Z","timestamp":1768668337000},"page":"999-1008","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The influence of intrathecal baclofen pumps on outcomes following spinal fusion in non-ambulatory patients with cerebral palsy"],"prefix":"10.1007","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7381-4503","authenticated-orcid":false,"given":"Lexi M.","family":"Larson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8848-6724","authenticated-orcid":false,"given":"Daniel J.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Torres-Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7738-0812","authenticated-orcid":false,"given":"Tenner J.","family":"Guillaume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7114-195X","authenticated-orcid":false,"given":"Walter H.","family":"Truong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-396X","authenticated-orcid":false,"given":"Joseph H.","family":"Perra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0993-8199","authenticated-orcid":false,"given":"Linda E.","family":"Krach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9542-1719","authenticated-orcid":false,"given":"Maykala J.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8059-3659","authenticated-orcid":false,"given":"Sara J.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"issue":"4","key":"1274_CR1","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.ocl.2010.06.008","volume":"41","author":"MN Imrie","year":"2010","unstructured":"Imrie MN, Yaszay B (2010) Management of spinal deformity in cerebral palsy. Orthop Clin North Am 41(4):531\u2013547","journal-title":"Orthop Clin North Am"},{"issue":"6","key":"1274_CR2","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/00007632-198111000-00009","volume":"6","author":"RR Madigan","year":"1981","unstructured":"Madigan RR, Wallace SL (1981) Scoliosis in the institutionalized cerebral palsy population. Spine (Phila Pa 1976) 6(6):583\u2013590","journal-title":"Spine (Phila Pa 1976)"},{"issue":"12","key":"1274_CR3","doi-asserted-by":"publisher","first-page":"E708","DOI":"10.1097\/BRS.0b013e318246a962","volume":"37","author":"M Persson-Bunke","year":"2012","unstructured":"Persson-Bunke M, H\u00e4gglund G, Lauge-Pedersen H, Wagner P, Westbom L (2012) Scoliosis in a total population of children with cerebral palsy. Spine (Phila Pa 1976). 37(12):E708-13","journal-title":"Spine (Phila Pa 1976)."},{"issue":"10","key":"1274_CR4","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1542\/pir.2022-005657","volume":"43","author":"J Sheu","year":"2022","unstructured":"Sheu J, Cohen D, Sousa T, Pham KLD (2022) Cerebral palsy: current concepts and practices in musculoskeletal care. Pediatr Rev 43(10):572\u2013581","journal-title":"Pediatr Rev"},{"issue":"6","key":"1274_CR5","doi-asserted-by":"publisher","first-page":"367","DOI":"10.5435\/00124635-200606000-00006","volume":"14","author":"JJ McCarthy","year":"2006","unstructured":"McCarthy JJ, D\u2019Andrea LP, Betz RR, Clements DH (2006) Scoliosis in the child with cerebral palsy. J Am Acad Orthop Surg 14(6):367\u2013375","journal-title":"J Am Acad Orthop Surg"},{"issue":"19","key":"1274_CR6","doi-asserted-by":"publisher","first-page":"2461","DOI":"10.1097\/00007632-200010010-00007","volume":"25","author":"PD Sponseller","year":"2000","unstructured":"Sponseller PD, LaPorte DM, Hungerford MW, Eck K, Bridwell KH, Lenke LG (2000) Deep wound infections after neuromuscular scoliosis surgery: a multicenter study of risk factors and treatment outcomes. Spine (Phila Pa 1976) 25(19):2461\u20132466","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"1274_CR7","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/practneurol-2021-003184","volume":"22","author":"MS Balaratnam","year":"2022","unstructured":"Balaratnam MS, Stevenson VL (2022) Intrathecal baclofen pumps: what the neurologist needs to know. Pract Neurol 22(3):241\u2013246","journal-title":"Pract Neurol"},{"issue":"10","key":"1274_CR8","first-page":"697","volume":"65","author":"J Milligan","year":"2019","unstructured":"Milligan J, Ryan K, Lee J (2019) Demystifying spasticity in primary care. Can Fam Physician 65(10):697\u2013703","journal-title":"Can Fam Physician"},{"key":"1274_CR9","unstructured":"Ghanavatian S, Derian A (2024) Baclofen. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright\u00a9 2024, StatPearls Publishing LLC"},{"issue":"4","key":"1274_CR10","first-page":"345","volume":"24","author":"A Shamsoddini","year":"2014","unstructured":"Shamsoddini A, Amirsalari S, Hollisaz MT, Rahimnia A, Khatibi-Aghda A (2014) Management of spasticity in children with cerebral palsy. Iran J Pediatr 24(4):345\u2013351","journal-title":"Iran J Pediatr"},{"issue":"3","key":"1274_CR11","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.ejpn.2008.04.013","volume":"13","author":"MA Hoving","year":"2009","unstructured":"Hoving MA, van Raak EP, Spincemaille GH, Palmans LJ, Becher JG, Vles JS (2009) Efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy: a randomised controlled trial. Eur J Paediatr Neurol 13(3):240\u2013246","journal-title":"Eur J Paediatr Neurol"},{"issue":"3","key":"1274_CR12","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.K.00157","volume":"2","author":"W McKinnon","year":"2012","unstructured":"McKinnon W, Lee MC, Kanev P (2012) Mortality from intrathecal baclofen withdrawal following posterior spinal fusion: a case report. JBJS Case Connect 2(3):e32","journal-title":"JBJS Case Connect"},{"issue":"4","key":"1274_CR13","doi-asserted-by":"publisher","first-page":"E94","DOI":"10.1097\/BRS.0b013e3181642aae","volume":"33","author":"MS Caird","year":"2008","unstructured":"Caird MS, Palanca AA, Garton H, Hensinger RN, Ayyangar RN, Drongowski A et al (2008) Outcomes of posterior spinal fusion and instrumentation in patients with continuous intrathecal baclofen infusion pumps. Spine (Phila Pa 1976) 33(4):E94-9","journal-title":"Spine (Phila Pa 1976)"},{"issue":"8","key":"1274_CR14","doi-asserted-by":"publisher","first-page":"E219","DOI":"10.1097\/01.brs.0000158869.90908.f8","volume":"30","author":"LS Segal","year":"2005","unstructured":"Segal LS, Wallach DM, Kanev PM (2005) Potential complications of posterior spine fusion and instrumentation in patients with cerebral palsy treated with intrathecal baclofen infusion. Spine (Phila Pa 1976) 30(8):E219-24","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"1274_CR15","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s43390-023-00786-8","volume":"12","author":"KH Levy","year":"2024","unstructured":"Levy KH, Yaszay B, Abel MF, Shah SA, Samdani AF, Sponseller PD (2024) Baclofen pumps do not increase risk of complications following spinal fusion. Spine Deform 12(2):473\u2013480","journal-title":"Spine Deform"},{"issue":"2","key":"1274_CR16","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/NOR.0000000000000434","volume":"37","author":"K Buxton","year":"2018","unstructured":"Buxton K, Difazio R, Morgan A, McCabe M, Forbes PW (2018) Intrathecal baclofen therapy prior to spinal fusion for patients with gross motor function classification system IV-V cerebral palsy. Orthop Nurs 37(2):136\u2013143","journal-title":"Orthop Nurs"},{"issue":"18","key":"1274_CR17","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1097\/BRS.0b013e31817bab42","volume":"33","author":"A Borowski","year":"2008","unstructured":"Borowski A, Shah SA, Littleton AG, Dabney KW, Miller F (2008) Baclofen pump implantation and spinal fusion in children: techniques and complications. Spine (Phila Pa 1976) 33(18):1995\u20132000","journal-title":"Spine (Phila Pa 1976)"},{"issue":"8","key":"1274_CR18","doi-asserted-by":"publisher","first-page":"E504","DOI":"10.1097\/BRS.0000000000000811","volume":"40","author":"B Yaszay","year":"2015","unstructured":"Yaszay B, Scannell BP, Bomar JD, Sponseller PD, Shah SA, Asghar J et al (2015) Although inconvenient, baclofen pumps do not complicate scoliosis surgery in patients with cerebral palsy. Spine (Phila Pa 1976) 40(8):E504-9","journal-title":"Spine (Phila Pa 1976)"},{"key":"1274_CR19","first-page":"77","volume":"28","author":"P Fernandes","year":"2008","unstructured":"Fernandes P, Dolan L, Weinstein SL (2008) Intrathecal baclofen withdrawal syndrome following posterior spinal fusion for neuromuscular scoliosis: a case report. Iowa Orthop J 28:77\u201380","journal-title":"Iowa Orthop J"},{"issue":"1","key":"1274_CR20","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s43390-020-00034-3","volume":"8","author":"LAB Lins","year":"2020","unstructured":"Lins LAB, Nechyporenko AV, Halanski MA, Hetzel SJ, Noonan KJ (2020) Does an intrathecal baclofen pump impact scoliosis progression and complicate posterior spine fusion in patients with cerebral palsy? Spine Deform 8(1):115\u2013121","journal-title":"Spine Deform"},{"key":"1274_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","volume":"95","author":"PA Harris","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O\u2019Neal L et al (2019) The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95:103208","journal-title":"J Biomed Inform"},{"issue":"2","key":"1274_CR22","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377\u2013381","journal-title":"J Biomed Inform"},{"issue":"4","key":"1274_CR23","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","volume":"39","author":"R Palisano","year":"1997","unstructured":"Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 39(4):214\u2013223","journal-title":"Dev Med Child Neurol"},{"issue":"21","key":"1274_CR24","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.2106\/JBJS.15.01359","volume":"98","author":"A Jain","year":"2016","unstructured":"Jain A, Sponseller PD, Shah SA, Samdani A, Cahill PJ, Yaszay B et al (2016) Subclassification of GMFCS level-5 cerebral palsy as a predictor of complications and health-related quality of life after spinal arthrodesis. J Bone Joint Surg Am 98(21):1821\u20131828","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"1274_CR25","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1097\/BPO.0000000000002035","volume":"42","author":"AL Xu","year":"2022","unstructured":"Xu AL, Marrache M, Hardesty CK, Groves ML, Erickson MA, Murphy RF et al (2022) Baclofen pump use: complications after growth-friendly instrumentation for early-onset scoliosis. J Pediatr Orthop 42(2):77\u201382","journal-title":"J Pediatr Orthop"}],"container-title":["Spine Deformity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01274-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43390-026-01274-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01274-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T16:10:24Z","timestamp":1783959024000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43390-026-01274-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,17]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["1274"],"URL":"https:\/\/doi.org\/10.1007\/s43390-026-01274-5","relation":{},"ISSN":["2212-134X","2212-1358"],"issn-type":[{"value":"2212-134X","type":"print"},{"value":"2212-1358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,17]]},"assertion":[{"value":"8 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. Guillaume is a consultant for Globus, Highridge, Medtronic and OrthoPediatrics. Dr. Perra is a consultant for Medtronic. All the other authors have no relevant interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}},{"value":"A waiver of consent was granted due to the retrospective nature of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trials registration"}},{"value":"This retrospective cohort study was reviewed and approved by a\u00a0University of Minnesota Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}