{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:09:38Z","timestamp":1787612978873,"version":"build-2736575974"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Intrathecal baclofen (ITB) pumps are commonly used in pediatric patients with cerebral palsy (CP) and medically refractory spasticity. However, catheter malfunction and associated risk factors are not well understood. The aim of this study was to examine potential risk factors for spinal catheter malfunction and characterize postoperative follow-up to understand the clinical consequences.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients who received ITB pump replacement or revision at Boston Children\u2019s Hospital between 2010 and 2023 were retrospectively reviewed. The spinal catheter revision cohort (SCRC) included patients whose spinal catheter was occluded requiring lumbar catheter revision. The second cohort included abdominal pump replacements only (APRC). Between-group comparisons and multivariable regression identified factors associated with catheter revision and postoperative outcomes.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Forty-one (33.6%) patients underwent spinal catheter revision and were compared with 81 patients (66.4%) who underwent abdominal pump replacement only. Younger age at surgery and an elevated preoperative lower-extremity modified Ashworth scale grade were associated with spinal catheter revision (p < 0.05). Catheter model type, tip location, and history of spinal fusion were not associated with obstruction. Postoperatively, SCRC patients experienced a higher rate of infection (17.1%) relative to APRC patients (0%) within 30 days from their ITB pump replacement procedure (p < 0.05) and greater likelihood of subsequent ITB system removal compared with the APRC (24.4% vs 7.4%, p < 0.05). Although not differing preoperatively, SCRC patients had lower postoperative ITB doses when compared with the APRC group (median dose 143 vs 350 \u00b5g\/day, p < 0.05) at hospital discharge and remained statistically different at the 6-month and 1-year follow-ups (p < 0.05). There were no postoperative differences in baclofen overdose, withdrawal, or median number of hospital readmissions within 30 days. Overall, 31.7% of spinal catheter revisions were unanticipated by the clinical team at time of surgery.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Younger age at surgery and increased preoperative lower-extremity tone may be risk factors for catheter obstruction, resulting in a higher rate of postoperative infection and subsequent ITB pump removal compared with pump replacement alone. Spinal catheter occlusion can complicate revision or replacement procedures, especially when unanticipated. Routine clinical assessment may be inadequate for diagnosing insidious catheter malfunction. Catheter occlusion deserves further study, and routine assessment of catheter patency may be warranted to prevent suboptimal tone therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.3.focus2467","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T05:42:50Z","timestamp":1717220570000},"page":"E11","source":"Crossref","is-referenced-by-count":3,"title":["Spinal catheter revision in pediatric intrathecal baclofen pumps: risk factors and postoperative outcomes"],"prefix":"10.3171","volume":"56","author":[{"given":"Amanda M.","family":"Mosher","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Keusch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna E.","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Buxton","sequence":"additional","affiliation":[{"name":"Baclofen Pump Program, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Morgan","sequence":"additional","affiliation":[{"name":"Baclofen Pump Program, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scellig S. D.","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Baclofen Pump Program, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weston T.","family":"Northam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Baclofen Pump Program, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4 Suppl","key":"b1","series-title":"J Neurosurg","first-page":"233","article-title":"Best-practice surgical techniques for intrathecal baclofen therapy","volume":"104","author":"Albright AL","year":"2006","unstructured":"Albright AL, Turner M, Pattisapu JV. Best-practice surgical techniques for intrathecal baclofen therapy. J Neurosurg. 2006;104(4 Suppl):233\u2013239."},{"issue":"1","key":"b2","series-title":"J Pediatr Orthop","first-page":"76","article-title":"Complications of intrathecal baclofen pump therapy in pediatric patients","volume":"30","author":"Borowski A","year":"2010","unstructured":"Borowski A, Littleton AG, Borkhuu B, Complications of intrathecal baclofen pump therapy in pediatric patients. J Pediatr Orthop. 2010;30(1):76\u201381."},{"issue":"4","key":"b3","series-title":"Pediatr Emerg Care","first-page":"271","article-title":"Baclofen pumps: uses and complications","volume":"33","author":"Woolf SM","year":"2017","unstructured":"Woolf SM, Baum CR. Baclofen pumps: uses and complications. Pediatr Emerg Care. 2017;33(4):271\u2013275."},{"issue":"11","key":"b4","series-title":"JAMA","first-page":"1418","article-title":"Intrathecal baclofen for spasticity in cerebral palsy","volume":"265","author":"Albright AL","year":"1991","unstructured":"Albright AL, Cervi A, Singletary J. Intrathecal baclofen for spasticity in cerebral palsy. JAMA. 1991;265(11):1418\u20131422."},{"issue":"8447","key":"b5","series-title":"Lancet","first-page":"125","article-title":"Continuous intrathecal baclofen for severe spasticity","volume":"2","author":"Penn RD","year":"1985","unstructured":"Penn RD, Kroin JS. Continuous intrathecal baclofen for severe spasticity. Lancet. 1985;2(8447):125\u2013127."},{"issue":"1 Suppl","key":"b6","series-title":"J Neurosurg","first-page":"9","article-title":"Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients","volume":"104","author":"Vender JR","year":"2006","unstructured":"Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg. 2006;104(1 Suppl):9\u201315."},{"issue":"5","key":"b7","series-title":"Eur J Paediatr Neurol","first-page":"443","article-title":"Goals and outcomes for non ambulant children receiving continuous infusion of intrathecal baclofen","volume":"16","author":"Gray N","year":"2012","unstructured":"Gray N, Morton RE, Brimlow K, Keetley R, Vloeberghs M. Goals and outcomes for non ambulant children receiving continuous infusion of intrathecal baclofen. Eur J Paediatr Neurol. 2012;16(5):443\u2013448."},{"issue":"3","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"301","article-title":"Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience","volume":"13","author":"Motta F","year":"2014","unstructured":"Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014;13(3):301\u2013306."},{"issue":"9","key":"b9","series-title":"Dev Med Child Neurol","first-page":"634","article-title":"Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy","volume":"42","author":"Butler C","year":"2000","unstructured":"Butler C, Campbell S. Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy. Dev Med Child Neurol. 2000;42(9):634\u2013645."},{"issue":"4","key":"b10","series-title":"Pediatr Neurosurg","first-page":"334","article-title":"Pediatric intrathecal baclofen pumps: a descriptive analysis of hospital course and associated costs","volume":"56","author":"Dallas J","year":"2021","unstructured":"Dallas J, Naftel RP, Shannon CN. Pediatric intrathecal baclofen pumps: a descriptive analysis of hospital course and associated costs. Pediatr Neurosurg. 2021;56(4):334\u2013344."},{"issue":"7","key":"b11","series-title":"Neuromodulation","first-page":"1003","article-title":"Screening intrathecal baclofen pump systems for catheter patency via catheter access port aspiration","volume":"23","author":"Skalsky AJ","year":"2020","unstructured":"Skalsky AJ, Dalal P, Le J, Ewing E, Yaszay B. Screening intrathecal baclofen pump systems for catheter patency via catheter access port aspiration. Neuromodulation. 2020;23(7):1003\u20131008."},{"issue":"6","key":"b12","series-title":"Neuromodulation","first-page":"632","article-title":"Best practices for intrathecal baclofen therapy: troubleshooting","volume":"19","author":"Saulino M","year":"2016","unstructured":"Saulino M, Anderson DJ, Doble J, Best practices for intrathecal baclofen therapy: troubleshooting. Neuromodulation. 2016;19(6):632\u2013641."},{"issue":"3","key":"b13","series-title":"Pediatr Neurosurg","first-page":"138","article-title":"Complications of intrathecal baclofen pumps in children: experience from a tertiary care center","volume":"49","author":"Ghosh D","year":"2013","unstructured":"Ghosh D, Mainali G, Khera J, Luciano M. Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatr Neurosurg. 2013;49(3):138\u2013144."},{"issue":"6","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"756","article-title":"Risk factors for baclofen pump infection in children: a multivariate analysis","volume":"17","author":"Spader HS","year":"2016","unstructured":"Spader HS, Bollo RJ, Bowers CA, Riva-Cambrin J. Risk factors for baclofen pump infection in children: a multivariate analysis. J Neurosurg Pediatr. 2016;17(6):756\u2013762."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"444","article-title":"A multicenter initiative to reduce intrathecal baclofen pump surgical site infection: a Cerebral Palsy Research Network quality improvement project","volume":"31","author":"Bollo RJ","year":"2023","unstructured":"Bollo RJ, Gross PH, Rocque BG, A multicenter initiative to reduce intrathecal baclofen pump surgical site infection: a Cerebral Palsy Research Network quality improvement project. J Neurosurg Pediatr. 2023;31(5):444\u2013452."},{"issue":"3","key":"b16","series-title":"Childs Nerv Syst","first-page":"421","article-title":"Intrathecal baclofen therapy: complication avoidance and management","volume":"27","author":"Haranhalli N","year":"2011","unstructured":"Haranhalli N, Anand D, Wisoff JH. Intrathecal baclofen therapy: complication avoidance and management. Childs Nerv Syst. 2011;27(3):421\u2013427."},{"issue":"5","key":"b17","series-title":"J Child Orthop","first-page":"529","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":"Imerci A","year":"2019","unstructured":"Imerci A, Rogers KJ, Pargas C, Sees JP, Miller F. Identification of complications in paediatric cerebral palsy treated with intrathecal baclofen pump: a descriptive analysis of 15 years at one institution. J Child Orthop. 2019;13(5):529\u2013535."},{"issue":"5","key":"b18","series-title":"J Neurosurg Pediatr","first-page":"487","article-title":"Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors","volume":"4","author":"Fjelstad AB","year":"2009","unstructured":"Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009;4(5):487\u2013493."},{"issue":"4","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"395","article-title":"A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative","volume":"21","author":"Desai VR","year":"2018","unstructured":"Desai VR, Raskin JS, Mohan A, A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative. J Neurosurg Pediatr. 2018;21(4):395\u2013400."},{"issue":"2","key":"b20","series-title":"J Paediatr Child Health","first-page":"258","article-title":"Adverse events associated with paediatric intrathecal baclofen in Australia: 5 years of data collection","volume":"57","author":"Tyack L","year":"2021","unstructured":"Tyack L, Copeland L, McCartney L, Waugh MC. Adverse events associated with paediatric intrathecal baclofen in Australia: 5 years of data collection. J Paediatr Child Health. 2021;57(2):258\u2013262."},{"issue":"8","key":"b21","series-title":"Childs Nerv Syst","first-page":"1405","article-title":"Outcome of ventriculoperitoneal shunt and predictors of shunt revision in infants with posthemorrhagic hydrocephalus","volume":"32","author":"Bir SC","year":"2016","unstructured":"Bir SC, Konar S, Maiti TK, Kalakoti P, Bollam P, Nanda A. Outcome of ventriculoperitoneal shunt and predictors of shunt revision in infants with posthemorrhagic hydrocephalus. Childs Nerv Syst. 2016;32(8):1405\u20131414."},{"issue":"1","key":"b22","series-title":"Spine Deform","first-page":"115","article-title":"Does an intrathecal baclofen pump impact scoliosis progression and complicate posterior spine fusion in patients with cerebral palsy?","volume":"8","author":"Lins LAB","year":"2020","unstructured":"Lins LAB, Nechyporenko AV, Halanski MA, Hetzel SJ, Noonan KJ. Does an intrathecal baclofen pump impact scoliosis progression and complicate posterior spine fusion in patients with cerebral palsy? Spine Deform. 2020;8(1):115\u2013121."},{"issue":"6","key":"b23","series-title":"Spine Deform","first-page":"424","article-title":"Does intrathecal baclofen therapy increase prevalence and\/or progression of neuromuscular scoliosis?","volume":"5","author":"Walker KR","year":"2017","unstructured":"Walker KR, Novotny SA, Krach LE. Does intrathecal baclofen therapy increase prevalence and\/or progression of neuromuscular scoliosis? Spine Deform. 2017;5(6):424\u2013429."},{"issue":"2","key":"b24","series-title":"Orthop Nurs","first-page":"136","article-title":"Intrathecal baclofen therapy prior to spinal fusion for patients with Gross Motor Function Classification System IV-V cerebral palsy","volume":"37","author":"Buxton K","year":"2018","unstructured":"Buxton K, Difazio R, Morgan A, McCabe M, Forbes PW. Intrathecal baclofen therapy prior to spinal fusion for patients with Gross Motor Function Classification System IV-V cerebral palsy. Orthop Nurs. 2018;37(2):136\u2013143."},{"issue":"2","key":"b25","series-title":"Spine Deform","first-page":"473","article-title":"Baclofen pumps do not increase risk of complications following spinal fusion","volume":"12","author":"Levy KH","year":"2024","unstructured":"Levy KH, Yaszay B, Abel MF, Shah SA, Samdani AF, Sponseller PD. Baclofen pumps do not increase risk of complications following spinal fusion. Spine Deform. 2024;12(2):473\u2013480."},{"issue":"4","key":"b26","series-title":"Spine Surg Relat Res","first-page":"385","article-title":"Does the intrathecal baclofen dose need to be changed after spinal fusion surgery for neuromuscular scoliosis?","volume":"7","author":"DeFoe KM","year":"2023","unstructured":"DeFoe KM, Atkinson J, Stansbury J, Sinner A, H Truong W. Does the intrathecal baclofen dose need to be changed after spinal fusion surgery for neuromuscular scoliosis? Spine Surg Relat Res. 2023;7(4):385\u2013389."},{"issue":"3","key":"b27","series-title":"Neurosurgery","first-page":"634","article-title":"Cervical catheter tip placement for intrathecal baclofen administration","volume":"59","author":"McCall TD","year":"2006","unstructured":"McCall TD, MacDonald JD. Cervical catheter tip placement for intrathecal baclofen administration. Neurosurgery. 2006;59(3):634\u2013640."},{"issue":"2","key":"b28","series-title":"Phys Ther","first-page":"206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity","volume":"67","author":"Bohannon RW","year":"1987","unstructured":"Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67(2):206\u2013207."},{"issue":"4","key":"b29","series-title":"Dev Med Child Neurol","first-page":"214","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano R","year":"1997","unstructured":"Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. 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J Neurosurg. 2006;104(4 Suppl):233\u2013239."},{"issue":"1","key":"b2","series-title":"J Pediatr Orthop","first-page":"76","article-title":"Complications of intrathecal baclofen pump therapy in pediatric patients","volume":"30","author":"Borowski A","year":"2010","unstructured":"Borowski A, Littleton AG, Borkhuu B, Complications of intrathecal baclofen pump therapy in pediatric patients. J Pediatr Orthop. 2010;30(1):76\u201381."},{"issue":"4","key":"b3","series-title":"Pediatr Emerg Care","first-page":"271","article-title":"Baclofen pumps: uses and complications","volume":"33","author":"Woolf SM","year":"2017","unstructured":"Woolf SM, Baum CR. Baclofen pumps: uses and complications. Pediatr Emerg Care. 2017;33(4):271\u2013275."},{"issue":"11","key":"b4","series-title":"JAMA","first-page":"1418","article-title":"Intrathecal baclofen for spasticity in cerebral palsy","volume":"265","author":"Albright AL","year":"1991","unstructured":"Albright AL, Cervi A, Singletary J. Intrathecal baclofen for spasticity in cerebral palsy. JAMA. 1991;265(11):1418\u20131422."},{"issue":"8447","key":"b5","series-title":"Lancet","first-page":"125","article-title":"Continuous intrathecal baclofen for severe spasticity","volume":"2","author":"Penn RD","year":"1985","unstructured":"Penn RD, Kroin JS. Continuous intrathecal baclofen for severe spasticity. Lancet. 1985;2(8447):125\u2013127."},{"issue":"1 Suppl","key":"b6","series-title":"J Neurosurg","first-page":"9","article-title":"Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients","volume":"104","author":"Vender JR","year":"2006","unstructured":"Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg. 2006;104(1 Suppl):9\u201315."},{"issue":"5","key":"b7","series-title":"Eur J Paediatr Neurol","first-page":"443","article-title":"Goals and outcomes for non ambulant children receiving continuous infusion of intrathecal baclofen","volume":"16","author":"Gray N","year":"2012","unstructured":"Gray N, Morton RE, Brimlow K, Keetley R, Vloeberghs M. Goals and outcomes for non ambulant children receiving continuous infusion of intrathecal baclofen. Eur J Paediatr Neurol. 2012;16(5):443\u2013448."},{"issue":"3","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"301","article-title":"Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience","volume":"13","author":"Motta F","year":"2014","unstructured":"Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014;13(3):301\u2013306."},{"issue":"9","key":"b9","series-title":"Dev Med Child Neurol","first-page":"634","article-title":"Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy","volume":"42","author":"Butler C","year":"2000","unstructured":"Butler C, Campbell S. Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy. Dev Med Child Neurol. 2000;42(9):634\u2013645."},{"issue":"4","key":"b10","series-title":"Pediatr Neurosurg","first-page":"334","article-title":"Pediatric intrathecal baclofen pumps: a descriptive analysis of hospital course and associated costs","volume":"56","author":"Dallas J","year":"2021","unstructured":"Dallas J, Naftel RP, Shannon CN. Pediatric intrathecal baclofen pumps: a descriptive analysis of hospital course and associated costs. Pediatr Neurosurg. 2021;56(4):334\u2013344."},{"issue":"7","key":"b11","series-title":"Neuromodulation","first-page":"1003","article-title":"Screening intrathecal baclofen pump systems for catheter patency via catheter access port aspiration","volume":"23","author":"Skalsky AJ","year":"2020","unstructured":"Skalsky AJ, Dalal P, Le J, Ewing E, Yaszay B. Screening intrathecal baclofen pump systems for catheter patency via catheter access port aspiration. Neuromodulation. 2020;23(7):1003\u20131008."},{"issue":"6","key":"b12","series-title":"Neuromodulation","first-page":"632","article-title":"Best practices for intrathecal baclofen therapy: troubleshooting","volume":"19","author":"Saulino M","year":"2016","unstructured":"Saulino M, Anderson DJ, Doble J, Best practices for intrathecal baclofen therapy: troubleshooting. Neuromodulation. 2016;19(6):632\u2013641."},{"issue":"3","key":"b13","series-title":"Pediatr Neurosurg","first-page":"138","article-title":"Complications of intrathecal baclofen pumps in children: experience from a tertiary care center","volume":"49","author":"Ghosh D","year":"2013","unstructured":"Ghosh D, Mainali G, Khera J, Luciano M. Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatr Neurosurg. 2013;49(3):138\u2013144."},{"issue":"6","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"756","article-title":"Risk factors for baclofen pump infection in children: a multivariate analysis","volume":"17","author":"Spader HS","year":"2016","unstructured":"Spader HS, Bollo RJ, Bowers CA, Riva-Cambrin J. Risk factors for baclofen pump infection in children: a multivariate analysis. J Neurosurg Pediatr. 2016;17(6):756\u2013762."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"444","article-title":"A multicenter initiative to reduce intrathecal baclofen pump surgical site infection: a Cerebral Palsy Research Network quality improvement project","volume":"31","author":"Bollo RJ","year":"2023","unstructured":"Bollo RJ, Gross PH, Rocque BG, A multicenter initiative to reduce intrathecal baclofen pump surgical site infection: a Cerebral Palsy Research Network quality improvement project. J Neurosurg Pediatr. 2023;31(5):444\u2013452."},{"issue":"3","key":"b16","series-title":"Childs Nerv Syst","first-page":"421","article-title":"Intrathecal baclofen therapy: complication avoidance and management","volume":"27","author":"Haranhalli N","year":"2011","unstructured":"Haranhalli N, Anand D, Wisoff JH. Intrathecal baclofen therapy: complication avoidance and management. Childs Nerv Syst. 2011;27(3):421\u2013427."},{"issue":"5","key":"b17","series-title":"J Child Orthop","first-page":"529","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":"Imerci A","year":"2019","unstructured":"Imerci A, Rogers KJ, Pargas C, Sees JP, Miller F. Identification of complications in paediatric cerebral palsy treated with intrathecal baclofen pump: a descriptive analysis of 15 years at one institution. J Child Orthop. 2019;13(5):529\u2013535."},{"issue":"5","key":"b18","series-title":"J Neurosurg Pediatr","first-page":"487","article-title":"Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors","volume":"4","author":"Fjelstad AB","year":"2009","unstructured":"Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009;4(5):487\u2013493."},{"issue":"4","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"395","article-title":"A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative","volume":"21","author":"Desai VR","year":"2018","unstructured":"Desai VR, Raskin JS, Mohan A, A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative. J Neurosurg Pediatr. 2018;21(4):395\u2013400."},{"issue":"2","key":"b20","series-title":"J Paediatr Child Health","first-page":"258","article-title":"Adverse events associated with paediatric intrathecal baclofen in Australia: 5 years of data collection","volume":"57","author":"Tyack L","year":"2021","unstructured":"Tyack L, Copeland L, McCartney L, Waugh MC. 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