{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:05:04Z","timestamp":1788923104479,"version":"build-2803163510"},"reference-count":47,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2015,9,18]],"date-time":"2015-09-18T00:00:00Z","timestamp":1442534400000},"content-version":"unspecified","delay-in-days":7534,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. j. neurol. sci."],"published-print":{"date-parts":[[1995,2]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:p>A prospective trial to demonstrate the efficacy of intrathecal baclofen therapy by implanted pump for adults with spasticity due to spinal cord injury or multiple sclerosis was initiated in our hospital. Of the 140 patients assessed, 7 met the following criteria for inclusion in the study: a modified Ashworth score &gt; 3, a spasm frequency score &gt; 2, and an inadequate response to oral antispasticity drugs, (i.e., baclofen, clonidine and cyproheptadine). All patients responded to intrathecal bolus injection of baclofen in the double blind, placebo-controlled screening phase (mean bolus dose = 42.8 \u03bcg). Programmable Medtronic pumps were implanted in 4 patients while 3 patients received nonprogrammable Infusaid pumps. Post-implantation, a marked decrease in spasticity occurred with a significant reduction of the Ashworth score (mean = 1.8, p &lt; .005), a reduced spasm score (mean = 0.8, p &lt; .005), and an improved leg swing in the pendulum test. These effects were maintained during a follow-up of 24 \u2013 41 months (average infusion dose = 218.7 \u03bcg\/day). The gross cost-savings due to reduced hospitalizations related to spasticity was calculated by comparing the cost for the two year period before pump implantation to the same period after treatment for 6 of the 7 patients. The cost of in-hospital implantation as well as the cost of the pumps were deducted from the gross savings. There was a net cost-saving of $153,120. Our findings agree with the reported efficacy and safety of intrathecal baclofen treatment, and illustrate the cost-effectiveness of this treatment.<\/jats:p>","DOI":"10.1017\/s0317167100040452","type":"journal-article","created":{"date-parts":[[2016,2,17]],"date-time":"2016-02-17T09:08:29Z","timestamp":1455700109000},"page":"22-29","source":"Crossref","is-referenced-by-count":79,"title":["Intrathecal Baclofen Therapy for Adults with Spinal Spasticity: Therapeutic Efficacy and Effect on Hospital Admissions"],"prefix":"10.1017","volume":"22","author":[{"given":"Patricia","family":"Nance","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orpha","family":"Schryvers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hy","family":"Dubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Loveridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Fewer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,9,18]]},"reference":[{"key":"S0317167100040452_ref171","first-page":"465","article-title":"Management of flexor spasms with Lioresal","volume":"55","author":"Shahani","year":"1974","journal-title":"Arch Phys Med Rehabil"},{"key":"S0317167100040452_ref195","first-page":"724","volume-title":"Krusen\u2019s Handbook of Physical Medicine and Rehabilitation","volume":"1982","author":"Perkash"},{"key":"S0317167100040452_ref194","doi-asserted-by":"publisher","DOI":"10.1080\/01952307.1994.11735927"},{"key":"S0317167100040452_ref189","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1017\/S0317167100042244","article-title":"Intrathecal baclofen for intractable spinal spasticity \u2013 a double-blind crossover comparison with placebo in 6 patients","volume":"19","author":"Hugenholtz","year":"1992","journal-title":"Can J Neurol Sci"},{"key":"S0317167100040452_ref187","first-page":"262","article-title":"Intrathecal baclofen in severe spasticity","volume":"49","author":"McLean","year":"1993","journal-title":"Br J Hosp Med"},{"key":"S0317167100040452_ref193","article-title":"Video motion analysis of knee swing in spastic spinal cord injured patients before and after perineal electrostimulation","volume":"18","author":"Nance","year":"1992","journal-title":"Soc Neurosci Abstr"},{"key":"S0317167100040452_ref176","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.36.4.555"},{"key":"S0317167100040452_ref180","article-title":"Intrathecal baclofen for spasticity","volume":"2","author":"Dralle","year":"1985","journal-title":"Lancet"},{"key":"S0317167100040452_ref186","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-199212000-00003"},{"key":"S0317167100040452_ref177","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.28.11.1094"},{"key":"S0317167100040452_ref169","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5778.15"},{"key":"S0317167100040452_ref208","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1987.62.6.2264"},{"key":"S0317167100040452_ref167","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1970.tb05791.x"},{"key":"S0317167100040452_ref178","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1975.tb01366.x"},{"key":"S0317167100040452_ref191","first-page":"179","article-title":"The value of postural reduction in the initial management of closed injuries to the spine with paraplegia and tetraplegia","volume":"7","author":"Frankel","year":"1969","journal-title":"Paraplegia"},{"key":"S0317167100040452_ref175","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/96.1.29"},{"key":"S0317167100040452_ref196","first-page":"771","volume-title":"Krusen\u2019s Handbook of Physical Medicine and Rehabilitation","volume":"1982","author":"Helmholtz"},{"key":"S0317167100040452_ref197","first-page":"641","article-title":"Maximal static respiratory pressure in generalized neuromuscular disease","volume":"103","author":"Black","year":"1971","journal-title":"Am Rev Respir Dis"},{"key":"S0317167100040452_ref181","doi-asserted-by":"crossref","first-page":"465","DOI":"10.5694\/j.1326-5377.1986.tb113877.x","article-title":"Intrathecal baclofen for severe spasticity","volume":"145","author":"Hankey","year":"1986","journal-title":"Med J Aust"},{"key":"S0317167100040452_ref179","first-page":"71","volume-title":"Spasticity: Disordered Motor Control","volume":"1980","author":"Hattab"},{"key":"S0317167100040452_ref174","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.43.12.1132"},{"key":"S0317167100040452_ref168","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.33.4.464"},{"key":"S0317167100040452_ref190","first-page":"304","article-title":"Continuous intrathecal baclofen infusion for the treatment of adults with spinal spasticity","volume":"19","author":"Nance","year":"1992","journal-title":"Can J Neurol Sci"},{"key":"S0317167100040452_ref211","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.9.1171"},{"key":"S0317167100040452_ref172","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.26.5.441"},{"key":"S0317167100040452_ref184","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1990.72.3.0393"},{"key":"S0317167100040452_ref188","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.78.2.0226"},{"key":"S0317167100040452_ref192","first-page":"540","article-title":"Preliminary trial of carisoprodal in multiple sclerosis","volume":"192","author":"Ashworth","year":"1964","journal-title":"Practitioner"},{"key":"S0317167100040452_ref173","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.40.1.30"},{"key":"S0317167100040452_ref183","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198906083202303"},{"key":"S0317167100040452_ref201","author":"Winer","year":"1971"},{"key":"S0317167100040452_ref198","article-title":"Isotope myelography in the assessment of patients with intrathecal pumps","author":"Jamous","year":"1991","journal-title":"Int Med Soc Paraplegia"},{"key":"S0317167100040452_ref165","first-page":"2733","article-title":"Un farmaco ad azione antispastica della muscalatura striata: sperimentazione clinica di un derivato del GABA","volume":"57","author":"Bergamini","year":"1966","journal-title":"Minerva Med"},{"key":"S0317167100040452_ref182","first-page":"155","volume-title":"Local Spinal Therapy of Spasticity","volume":"1988","author":"Muller"},{"key":"S0317167100040452_ref209","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90214-X"},{"key":"S0317167100040452_ref203","doi-asserted-by":"publisher","DOI":"10.1159\/000100205"},{"key":"S0317167100040452_ref199","journal-title":"summary of safety and effectiveness, pre-market approval application"},{"key":"S0317167100040452_ref200","year":"1990"},{"key":"S0317167100040452_ref202","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)38673-1"},{"key":"S0317167100040452_ref206","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-198906000-00002"},{"key":"S0317167100040452_ref204","first-page":"420","article-title":"The effect of intrathecal baclofen on the lower urinary tract in paraplegia","volume":"28","author":"Talalla","year":"1990","journal-title":"Paraplegia"},{"key":"S0317167100040452_ref205","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S0003-9993(21)01642-7","article-title":"Functional outcome after delivery of intrathecal baclofen","volume":"70","author":"Parke","year":"1989","journal-title":"Arch Phys Med Rehabil"},{"key":"S0317167100040452_ref207","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)37048-9"},{"key":"S0317167100040452_ref210","article-title":"Failure of physotigmine in treatment of acute severe intrathecal baclofen intoxication","volume":"322","author":"Saltuari","year":"1990","journal-title":"N Engl J Med"},{"key":"S0317167100040452_ref185","first-page":"48","article-title":"Continuous infusion of intrathecal baclofen: long-term effects on spasticity in spinal cord injury","volume":"29","author":"Loubser","year":"1991","journal-title":"Paraplegia"},{"key":"S0317167100040452_ref170","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(71)90089-X"},{"key":"S0317167100040452_ref166","first-page":"515","article-title":"A double-blind study on the antispastic action of beta- (4-chlophenyl)-gamma-amino butyric acid (CIBA) in multiple sclerosis","volume":"39","author":"Jerusalem","year":"1968","journal-title":"Nervenarzt"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167100040452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T10:03:29Z","timestamp":1654337009000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167100040452\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,2]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1995,2]]}},"alternative-id":["S0317167100040452"],"URL":"https:\/\/doi.org\/10.1017\/s0317167100040452","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,2]]}}}