{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T01:05:05Z","timestamp":1774141505830,"version":"3.50.1"},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Intrathecal baclofen therapy has been used successfully for intractable spasticity in children with cerebral palsy. Infections are rare, but they are potentially life threatening if complicated by bacteremia or meningitis. Treatment without removal of the system is desirable if it can be done safely and effectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors reviewed the records of 207 patients ranging from 3 to 18 years of age with cerebral palsy who underwent placement or revision of a baclofen pump. They identified 38 patients with suspected or documented infectious complications. Initial attempts were made to eradicate infection with the devices in situ in all patients. Methods and effectiveness of pump salvage were evaluated.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 38 patients identified, 13 (34.2%) had documented infections; 11 had deep wound\/pocket empyemas and 2 had meningitis. Eight patients with deep wound infections received intravenous antibiotics alone. All required pump explantation. The remaining 3 patients underwent a washout procedure as well; the infection was cured in 1 patient. Both patients with meningitis received intravenous and intrathecal antibiotics, and both required device explantation. In addition, 25 patients (65.8%) had excessive or increasing wound erythema. No objective criteria to document a superficial infection were present. The wounds were considered suspicious and were managed with serial examinations and oral antibiotics. The erythema resolved in 24 of the 25 patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In general, observation, wound care, and oral antibiotics are sufficient for wounds that are suspicious for superficial infection. For deep-seated infection, antibiotic therapy alone is generally insufficient and explantation is required. Washout procedures can be considered, but failures are common.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.9.peds12121","type":"journal-article","created":{"date-parts":[[2012,10,5]],"date-time":"2012-10-05T17:19:57Z","timestamp":1349457597000},"page":"548-554","source":"Crossref","is-referenced-by-count":24,"title":["Evaluation of salvage techniques for infected baclofen pumps in pediatric patients with cerebral palsy"],"prefix":"10.3171","volume":"10","author":[{"given":"Sydney M.","family":"Hester","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Medical College of Georgia, Georgia Health Sciences University, Augusta, Georgia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Lee","sequence":"additional","affiliation":[{"name":"Pediatric Surgical Subspecialists, Dell Children's Medical Center of Central Texas, Austin, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Macomson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"Vender","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds12121","series-title":"J Neurosurg","doi-asserted-by":"publisher","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":"Albright","year":"1998"},{"key":"b2-peds12121","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3171\/jns.2003.98.2.0291","article-title":"Long-term intrathecal baclofen therapy for severe spasticity of cerebral origin","volume":"98","author":"Albright","year":"2003"},{"issue":"4 Suppl","key":"b3-peds12121","series-title":"J Neurosurg","first-page":"233","article-title":"Best-practice surgical techniques for intrathecal baclofen therapy","volume":"104","author":"Albright","year":"2006"},{"key":"b4-peds12121","series-title":"South Med J","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/00007611-197007000-00001","article-title":"Irrigation-suction technic in the treatment of acute hematogenous osteomyelitis, chronic osteomyelitis, and acute and chronic joint infections","volume":"63","author":"Anderson","year":"1970"},{"key":"b5-peds12121","series-title":"The Prokaryotes: An Evolving Electronic Resource for the Microbiological Community, ed 3, Release 3.14","article-title":"Sphingomonas and related genera","author":"Balkwill","year":"2003"},{"key":"b6-peds12121","series-title":"Pain","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/0304-3959(94)90100-7","article-title":"Staphylococcal meningitis following Synchromed intrathecal pump implant: a case report","volume":"56","author":"Bennett","year":"1994"},{"key":"b7-peds12121","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1097\/BPO.0b013e3181c6b257","article-title":"Complications of intrathecal baclofen pump therapy in pediatric patients","volume":"30","author":"Borowski","year":"2010"},{"key":"b8-peds12121","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1097\/BRS.0b013e31817bab42","article-title":"Baclofen pump implantation and spinal fusion in children: techniques and complications","volume":"33","author":"Borowski","year":"2008"},{"key":"b9-peds12121","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s00701-004-0217-4","article-title":"Infected CNS infusion pumps. 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