{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T23:10:07Z","timestamp":1747091407579,"version":"3.40.5"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The spinal application of intrathecal baclofen (ITB) has been commonly used as treatment for severe dystonia as well spasticity. However, in rare cases, the use of ITB is not possible or ineffective. Therefore, intraventricular application of baclofen (IVB) mostly using endoscopic navigation has been rarely performed over the last years. As a valid alternative, we introduced navigated frameless stereotaxy for intraventricular catheter placement as the most minimally invasive approach feasible.<\/jats:p><jats:p>We retrospectively report on surgical technique, clinical outcome, and long-term complications in all pediatric patients with severe generalized dystonia who received IVB using navigated frameless stereotaxy between April 2009 and June 2021 at our institution.<\/jats:p><jats:p>Twenty patients (median age: 13 years; range: 2\u201323 years) were treated with IVB. Dystonia improved in 19\/20 patients at the time of discharge (median 51 days; range 2\u201393 weeks). During the follow-up period (median: 19 months; range: 3\u201383 months), there was a total of five surgery-associated complications including 3\/20 pump infections and 2\/20 intraventricular catheter dislocations.<\/jats:p><jats:p>This study reveals that navigated frameless catheter positioning in IVB therapy of generalized dystonia is a comparatively low risk and effective surgical procedure.<\/jats:p>","DOI":"10.1055\/a-2541-8620","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T23:44:51Z","timestamp":1741218291000},"page":"180-184","source":"Crossref","is-referenced-by-count":0,"title":["Intraventricular Application of Baclofen Using Navigated Frameless Stereotaxy: A Technical Note"],"prefix":"10.1055","volume":"56","author":[{"given":"Maria","family":"Abel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred","family":"Kudernatsch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany"},{"name":"Research Institute \u201cRehabilitation, Transition, Palliation,\u201d PMU Salzburg, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Persits","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Onyinzo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Herberhold","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Hartlieb","sequence":"additional","affiliation":[{"name":"Research Institute \u201cRehabilitation, Transition, Palliation,\u201d PMU Salzburg, Salzburg, Austria"},{"name":"Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Kluger","sequence":"additional","affiliation":[{"name":"Research Institute \u201cRehabilitation, Transition, Palliation,\u201d PMU Salzburg, Salzburg, Austria"},{"name":"Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Berweck","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany"},{"name":"Dr. von Hauners Children's Hospital, Munich University, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"issue":"S 01","key":"ref1","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1177\/0883073896011001S05","article-title":"Intrathecal baclofen in cerebral palsy movement disorders","volume":"11","author":"A L Albright","year":"1996","journal-title":"J Child Neurol"},{"key":"ref2","first-page":"jrm00241","article-title":"European expert consensus on improving patient selection for the management of disabling spasticity with intrathecal baclofen and\/or botulinum toxin type A","volume":"54","author":"B Biering-Soerensen","year":"2022","journal-title":"J Rehabil Med"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.12968\/bjon.1997.6.5.253","article-title":"A review of intrathecal baclofen in the management of spasticity","volume":"6","author":"B Porter","year":"1997","journal-title":"Br J Nurs"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S1474-4422(17)30252-1","article-title":"Clinical presentation and management of dyskinetic cerebral palsy","volume":"16","author":"E Monbaliu","year":"2017","journal-title":"Lancet Neurol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/dmcn.13652","article-title":"Pharmacological and neurosurgical interventions for managing dystonia in cerebral palsy: a systematic review","volume":"60","author":"D Fehlings","year":"2018","journal-title":"Dev Med Child Neurol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00381-017-3361-x","article-title":"Considerations in deep brain stimulation (DBS) for pediatric secondary dystonia","volume":"33","author":"D Tsering","year":"2017","journal-title":"Childs Nerv Syst"},{"issue":"10","key":"ref7","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1017\/S0012162201001190","article-title":"Intrathecal baclofen for generalized dystonia","volume":"43","author":"A L Albright","year":"2001","journal-title":"Dev Med Child Neurol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3171\/2008.10.PEDS0847","article-title":"Intraventricular baclofen for dystonia: techniques and outcomes. Clinical article","volume":"3","author":"A L Albright","year":"2009","journal-title":"J Neurosurg Pediatr"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3171\/jns.1998.88.1.0073","article-title":"Infusion of intrathecal baclofen for generalized dystonia in cerebral palsy","volume":"88","author":"A L Albright","year":"1998","journal-title":"J Neurosurg"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1002\/mds.870100524","article-title":"Intrathecal baclofen for motor disorders","volume":"10","author":"R D Penn","year":"1995","journal-title":"Mov Disord"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/1531-8257(200011)15:6<1242::AID-MDS1028>3.0.CO;2-Z","article-title":"Intrathecal baclofen for dystonia: benefits and complications during six years of experience","volume":"15","author":"R H Walker","year":"2000","journal-title":"Mov Disord"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/ana.25498","article-title":"The effect of intrathecal baclofen in dyskinetic cerebral palsy: the IDYS Trial","volume":"86","author":"L A Bonouvri\u00e9","year":"2019","journal-title":"Ann Neurol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/BPO.0b013e3181653b2a","article-title":"Effect of intrathecal baclofen on dystonia in children with cerebral palsy and the use of functional scales","volume":"28","author":"F Motta","year":"2008","journal-title":"J Pediatr Orthop"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1007\/s13311-020-00944-0","article-title":"Treatment of dystonia: medications, neurotoxins, neuromodulation, and rehabilitation","volume":"17","author":"I O Bledsoe","year":"2020","journal-title":"Neurotherapeutics"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e550","DOI":"10.1016\/j.wneu.2019.02.092","article-title":"Intrathecal baclofen pump versus globus pallidus interna deep brain stimulation in adult patients with severe cerebral palsy","volume":"126","author":"J H Kim","year":"2019","journal-title":"World Neurosurg"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.nbd.2011.01.026","article-title":"The functional neuroanatomy of dystonia","volume":"42","author":"V K Neychev","year":"2011","journal-title":"Neurobiol Dis"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/(SICI)1097-4598(199809)21:9<1209::AID-MUS15>3.0.CO;2-M","article-title":"Continuous intrathecal baclofen infusions induced a marked increase of the transcranially evoked silent period in a patient with generalized dystonia","volume":"21","author":"H R Siebner","year":"1998","journal-title":"Muscle Nerve"},{"issue":"07","key":"ref18","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1212\/WNL.41.7.1141","article-title":"Intrathecal baclofen for intractable axial dystonia","volume":"41","author":"R K Narayan","year":"1991","journal-title":"Neurology"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3171\/2011.7.PEDS11211","article-title":"Technique for insertion of intraventricular baclofen catheters","volume":"8","author":"A L Albright","year":"2011","journal-title":"J Neurosurg Pediatr"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1093\/brain\/awt138","article-title":"The genetics of dystonia: new twists in an old tale","volume":"136","author":"G Charlesworth","year":"2013","journal-title":"Brain"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.ncl.2020.01.003","article-title":"Medical and surgical treatments for dystonia","volume":"38","author":"H A Jinnah","year":"2020","journal-title":"Neurol Clin"},{"issue":"09","key":"ref22","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1111\/dmcn.15921","article-title":"Pharmacological and neurosurgical management of cerebral palsy and dystonia: clinical practice guideline update","volume":"66","author":"D Fehlings","year":"2024","journal-title":"Dev Med Child Neurol"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00381-020-04679-3","article-title":"Baclofen pump with pre-brainstem catheter tip placement: technical note and case series","volume":"37","author":"A Saenz","year":"2021","journal-title":"Childs Nerv Syst"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/BPO.0b013e3181c6b257","article-title":"Complications of intrathecal baclofen pump therapy in pediatric patients","volume":"30","author":"A Borowski","year":"2010","journal-title":"J Pediatr Orthop"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00381-010-1277-9","article-title":"Intrathecal baclofen therapy: complication avoidance and management","volume":"27","author":"N Haranhalli","year":"2011","journal-title":"Childs Nerv Syst"},{"key":"ref26","first-page":"32","article-title":"The use of intrathecal baclofen pump implants in children and adolescents: safety and complications in 200 consecutive cases","volume":"107","author":"F Motta","year":"2007","journal-title":"J Neurosurg"},{"key":"ref27","first-page":"9","article-title":"Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients","volume":"104","author":"J R Vender","year":"2006","journal-title":"J Neurosurg"},{"key":"ref28","first-page":"321","article-title":"Intraventricular vs intrathecal baclofen for secondary dystonia: a comparison of complications","volume":"70","author":"B G Rocque","year":"2012","journal-title":"Neurosurgery"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1302\/1863-2548.13.190112","article-title":"Identification of complications in paediatric cerebral palsy treated with intrathecal baclofen pump: a descriptive analysis of 15 years at one institution","volume":"13","author":"A Imerci","year":"2019","journal-title":"J Child Orthop"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1055\/s-0034-1387818","article-title":"Use of intrathecal baclofen in children and adolescents: interdisciplinary consensus table 2013","volume":"45","author":"S Berweck","year":"2014","journal-title":"Neuropediatrics"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3171\/2015.5.PEDS14587","article-title":"Intrathecal baclofen trials: complications and positive yield in a pediatric cohort","volume":"17","author":"C Sayer","year":"2016","journal-title":"J Neurosurg Pediatr"}],"container-title":["Neuropediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2541-8620.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T22:52:53Z","timestamp":1747090373000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2541-8620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":31,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2025,5,12]]},"published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2541-8620","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0174-304X","1439-1899"],"issn-type":[{"type":"print","value":"0174-304X"},{"type":"electronic","value":"1439-1899"}],"subject":[],"published":{"date-parts":[[2025,3,5]]}}}