{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:31:42Z","timestamp":1790011902565,"version":"4.0.1"},"reference-count":70,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Combined dorsal\/ventral rhizotomy (CDVR) has emerged as a tone management option for pediatric patients with cerebral palsy and medically refractory spasticity. However, its costs to the patient and the healthcare system compared with those of an intrathecal baclofen (ITB) pump are understudied. The authors aimed to evaluate ITB and CDVR with respect to healthcare cost, resource utilization, and clinical safety.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The records for all pediatric patients who underwent ITB pump placement or CDVR at a single institution between 2003 and 2024 were retrospectively reviewed. Hospital and professional charge data, both inpatient and outpatient, as well as clinical data were collected and analyzed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Seventeen patients underwent CDVR and 392 underwent ITB therapy. There were no clinically significant differences between the two treatment groups in terms of baseline demographics or Gross Motor Function Classification System level, preoperative risk factors, and comorbidities. None of the patients who had undergone CDVR experienced surgical site infection or CSF leakage, whereas 4.1% of patients in the ITB group had surgical site infection and 1.8% had CSF leakage. There were no differences (p \u2265 0.05) between the treatment groups in terms of mean hospital length of stay (6.5 days) and return to the emergency department or readmission within 30 days, although readmissions were longer in the ITB group (3 vs 0 median days). Accounting for professional and hospital charges for surgery, hospitalization, and follow-up care during the 1st postoperative year, patients in the CDVR group saved a median $7907 relative to those in the ITB group. Over a 10-year period, the projected differential would grow and ITB would ultimately be expected to be 4.6 times more expensive than CDVR, yielding a median cost differential of $182,432 per patient (p < 0.005). Additionally, CDVR, as compared to ITB, required less postoperative follow-up, averaging a projected decrease of 15 clinic visits per patient over 10 years, reducing hospital resource utilization, the burden on caregivers, and indirect costs to families associated with lost wages and transport to and from appointments.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n CDVR offers significantly decreased healthcare costs and resource utilization relative to ITB. CDVR has a comparable clinical safety and complication profile and deserves further study as an alternative to ITB.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.2.peds24576","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T22:50:03Z","timestamp":1747435803000},"page":"217-224","source":"Crossref","is-referenced-by-count":4,"title":["Intrathecal baclofen pump versus combined dorsal\/ventral rhizotomy for spastic quadriplegia: healthcare cost and complication analysis"],"prefix":"10.3171","volume":"36","author":[{"given":"Emma","family":"Hartman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Ruppert-Gomez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Mosher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Buxton","sequence":"additional","affiliation":[{"name":"Cerebral Palsy and Spasticity Center, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Morgan","sequence":"additional","affiliation":[{"name":"Cerebral Palsy and Spasticity Center, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scellig","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weston T.","family":"Northam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Cerebral Palsy and Spasticity Center, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","article-title":"National Health Expenditures 2023 Highlights. CMS.gov","unstructured":"National Health Expenditures 2023 Highlights. CMS.gov. Accessed March 11,2025.https:\/\/www.cms.gov\/files\/document\/highlights.pdf"},{"issue":"1","key":"b2","series-title":"Dev Med Child Neurol.","first-page":"59","article-title":"Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning\u2014Autism and Developmental Disabilities Monitoring Network, USA, 2008","volume":"56","author":"Christensen D","year":"2014","unstructured":"Christensen D, Van Naarden Braun K, Doernberg NS, Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning\u2014Autism and Developmental Disabilities Monitoring Network, USA, 2008.Dev Med Child Neurol.2014;56(1):59\u201365."},{"issue":"4","key":"b3","series-title":"Am Fam Physician","first-page":"213","article-title":"Cerebral palsy: an overview","volume":"101","author":"Vitrikas K","year":"2020","unstructured":"Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. Am Fam Physician. 2020;101(4):213\u2013220."},{"issue":"11","key":"b4","series-title":"Dev Med Child Neurol","first-page":"872","article-title":"The relationship of cerebral palsy subtype and functional motor impairment: a population-based study","volume":"51","author":"Shevell MI","year":"2009","unstructured":"Shevell MI, Dagenais L, Hall N. The relationship of cerebral palsy subtype and functional motor impairment: a population-based study. Dev Med Child Neurol. 2009;51(11):872\u2013877."},{"key":"b5","article-title":"National Institute of Neurological Disorders and Stroke","unstructured":"Cerebral Palsy. National Institute of Neurological Disorders and Stroke. Accessed March 11, 2025. https:\/\/www.ninds.nih.gov\/health-information\/disorders\/cerebral-palsy"},{"issue":"3","key":"b6","series-title":"J Pediatr Surg","first-page":"424","article-title":"Postoperative complications in pediatric patients with cerebral palsy","volume":"57","author":"Skertich NJ","year":"2022","unstructured":"Skertich NJ, Ingram ME, Sullivan GA, Postoperative complications in pediatric patients with cerebral palsy. J Pediatr Surg. 2022;57(3):424\u2013429."},{"key":"b7","series-title":"J Orthop","first-page":"14","article-title":"Risk factors for 90-day readmission and prolonged length of stay after hip surgery in children with cerebral palsy","volume":"38","author":"Butler LR","year":"2023","unstructured":"Butler LR, Dominy CL, White CA, Risk factors for 90-day readmission and prolonged length of stay after hip surgery in children with cerebral palsy. J Orthop. 2023;38:14\u201319."},{"issue":"3","key":"b8","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"57","article-title":"Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment\u2014United States, 2003","volume":"53","year":"2004","unstructured":"Centers for Disease Control and Prevention (CDC). Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment\u2014United States, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(3):57\u201359."},{"issue":"7","key":"b9","series-title":"J Manag Care Spec Pharm","article-title":"Prevalence, patterns, and cost of care for children with cerebral palsy enrolled in Medicaid managed care","volume":"25","author":"Pulgar S","year":"2019","unstructured":"Pulgar S, Bains S, Gooch J, Prevalence, patterns, and cost of care for children with cerebral palsy enrolled in Medicaid managed care. J Manag Care Spec Pharm. 2019;25(7):"},{"key":"b10","series-title":"StatPearls","author":"Ghanavatian S","year":"2024","unstructured":"Ghanavatian S, Baclofen Derian A.. In: StatPearls. StatPearls Publishing;2024.Accessed March 11, 2025. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK526037\/"},{"issue":"6","key":"b11","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Spinal catheter revision in pediatric intrathecal baclofen pumps: risk factors and postoperative outcomes","volume":"56","author":"Mosher AM","year":"2024","unstructured":"Mosher AM, Hartman E, Keusch D, Spinal catheter revision in pediatric intrathecal baclofen pumps: risk factors and postoperative outcomes. Neurosurg Focus. 2024;56(6):E11."},{"issue":"8","key":"b12","series-title":"Childs Nerv Syst","first-page":"2597","article-title":"Unusual mechanical failures of intrathecal baclofen pump systems: symptoms, signs, and trouble shooting","volume":"37","author":"Gburek-Augustat J","year":"2021","unstructured":"Gburek-Augustat J, Krause M, Bernhard M, Unusual mechanical failures of intrathecal baclofen pump systems: symptoms, signs, and trouble shooting. Childs Nerv Syst. 2021;37(8):2597\u20132604."},{"issue":"1","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"69","article-title":"Use of intraoperative topical antibiotics to reduce intrathecal baclofen pump surgical site infections: a single institution\u2019s experience over 24 years","volume":"32","author":"Cobourn KD","year":"2023","unstructured":"Cobourn KD, Patel N, Tsering D, Use of intraoperative topical antibiotics to reduce intrathecal baclofen pump surgical site infections: a single institution\u2019s experience over 24 years. J Neurosurg Pediatr. 2023;32(1):69\u201374."},{"issue":"6","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"659","article-title":"Complications of intrathecal baclofen therapy in children and young adults","volume":"34","author":"Ryan MV","year":"2024","unstructured":"Ryan MV, Freeman LM, Blasco S, Complications of intrathecal baclofen therapy in children and young adults. J Neurosurg Pediatr. 2024;34(6):659\u2013670."},{"issue":"6","key":"b15","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Nonselective lumbosacral ventral-dorsal rhizotomy for the management of lower-limb hypertonia in nonambulatory children with cerebral palsy","volume":"56","author":"Abdelmageed S","year":"2024","unstructured":"Abdelmageed S, Dalmage M, Mossner JM, Trierweiler R, Krater T, Raskin JS. Nonselective lumbosacral ventral-dorsal rhizotomy for the management of lower-limb hypertonia in nonambulatory children with cerebral palsy. Neurosurg Focus. 2024;56(6)E9."},{"issue":"20","key":"b16","series-title":"JAMA","first-page":"2475","article-title":"Continuous intrathecal baclofen infusion for spasticity of cerebral origin","volume":"270","author":"Albright AL","year":"1993","unstructured":"Albright AL, Barron WB, Fasick MP, Polinko P, Janosky J. Continuous intrathecal baclofen infusion for spasticity of cerebral origin. JAMA. 1993;270(20):2475\u20132477."},{"issue":"10","key":"b17","series-title":"Cureus","first-page":"e3466","article-title":"Evidence supporting selective dorsal rhizotomy for treatment of spastic cerebral palsy","volume":"10","author":"Park TS","year":"2018","unstructured":"Park TS, Dobbs MB, Cho J. Evidence supporting selective dorsal rhizotomy for treatment of spastic cerebral palsy. Cureus. 2018;10(10):e3466."},{"issue":"2","key":"b18","series-title":"Gait Posture","first-page":"244","article-title":"Gait status 17-26 years after selective dorsal rhizotomy","volume":"35","author":"Langerak NG","year":"2012","unstructured":"Langerak NG, Tam N, Vaughan CL, Fieggen AG, Schwartz MH. Gait status 17-26 years after selective dorsal rhizotomy. Gait Posture. 2012;35(2):244\u2013249."},{"issue":"4","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"380","article-title":"Functional outcomes of childhood dorsal rhizotomy in adults and adolescents with cerebral palsy","volume":"11","author":"Hurvitz EA","year":"2013","unstructured":"Hurvitz EA, Marciniak CM, Daunter AK, Functional outcomes of childhood dorsal rhizotomy in adults and adolescents with cerebral palsy. J Neurosurg Pediatr. 2013;11(4):380\u2013388."},{"issue":"4","key":"b20","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."},{"key":"b21","series-title":"SAGE Open Med","first-page":"20503121211022197","article-title":"Baclofen therapeutics, toxicity, and withdrawal: a narrative review","volume":"9","author":"Romito JW","year":"2021","unstructured":"Romito JW, Turner ER, Rosener JA, Baclofen therapeutics, toxicity, and withdrawal: a narrative review. SAGE Open Med. 2021;9:20503121211022197."},{"issue":"11","key":"b22","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1035","article-title":"The assessment of drug treatment of spastic gait","volume":"44","author":"Corston RN","year":"1981","unstructured":"Corston RN, Johnson F, Godwin-Austen RB. The assessment of drug treatment of spastic gait. J Neurol Neurosurg Psychiatry. 1981;44(11):1035\u20131039."},{"issue":"1","key":"b23","series-title":"Indian J Orthop","first-page":"46","article-title":"Intrathecal baclofen: its effect on symptoms and activities of daily living in severe spasticity due to spinal cord injuries: a pilot study","volume":"43","author":"Jagatsinh Y","year":"2009","unstructured":"Jagatsinh Y. Intrathecal baclofen: its effect on symptoms and activities of daily living in severe spasticity due to spinal cord injuries: a pilot study. Indian J Orthop. 2009;43(1):46\u201349."},{"issue":"1","key":"b24","series-title":"J Neurosurg Pediatr","first-page":"102","article-title":"Conus-level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications","volume":"27","author":"Ahluwalia R","year":"2020","unstructured":"Ahluwalia R, Bass P, Flynn L, Conus-level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications. J Neurosurg Pediatr. 2020;27(1):102\u2013107."},{"issue":"14","key":"b25","series-title":"J Neurosurg Case Lessons","first-page":"CASE2438","article-title":"Cervicothoracic ventral-dorsal rhizotomy for bilateral upper-extremity hypertonia in cerebral palsy: illustrative case","volume":"7","author":"Kelly R","year":"2024","unstructured":"Kelly R, Kemeny HR, Abdelmageed S, Cervicothoracic ventral-dorsal rhizotomy for bilateral upper-extremity hypertonia in cerebral palsy: illustrative case. J Neurosurg Case Lessons. 2024;7(14):CASE2438."},{"issue":"1","key":"b26","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":"10","key":"b27","series-title":"Dev Med Child Neurol","first-page":"1038","article-title":"Readmission and complications within 30 days after intrathecal baclofen pump placement","volume":"60","author":"Lam SK","year":"2018","unstructured":"Lam SK, Mayer RR, Vedantam A, A Staggers K, Harris DA, Pan IW. Readmission and complications within 30 days after intrathecal baclofen pump placement. Dev Med Child Neurol. 2018;60(10):1038\u20131044."},{"issue":"1","key":"b28","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":"b29","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":"5","key":"b30","series-title":"J Neurosurg Pediatr","first-page":"456","article-title":"Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy","volume":"20","author":"Ravindra VM","year":"2017","unstructured":"Ravindra VM, Christensen MT, Onwuzulike K, Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy. J Neurosurg Pediatr. 2017;20(5):456\u2013463."},{"issue":"1","key":"b31","series-title":"Childs Nerv Syst","first-page":"30","article-title":"Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy","volume":"6","author":"Peter JC","year":"1990","unstructured":"Peter JC, Hoffman EB, Arens LJ, Peacock WJ. Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy. Childs Nerv Syst. 1990;6(1):30\u201332."},{"issue":"5","key":"b32","series-title":"Cureus","first-page":"e1256","article-title":"Functional outcomes of childhood selective dorsal rhizotomy 20 to 28 years later","volume":"9","author":"Park TS","year":"2017","unstructured":"Park TS, Liu JL, Edwards C, Walter DM, Dobbs MB. Functional outcomes of childhood selective dorsal rhizotomy 20 to 28 years later. Cureus. 2017;9(5):e1256."},{"issue":"5","key":"b33","series-title":"Pediatr Neurosurg","first-page":"255","article-title":"Cost analysis of continuous intrathecal baclofen versus selective functional posterior rhizotomy in the treatment of spastic quadriplegia associated with cerebral palsy","volume":"22","author":"Steinbok P","year":"1995","unstructured":"Steinbok P, Daneshvar H, Evans D, Kestle JR. Cost analysis of continuous intrathecal baclofen versus selective functional posterior rhizotomy in the treatment of spastic quadriplegia associated with cerebral palsy. Pediatr Neurosurg. 1995;22(5):255\u2013265."},{"issue":"8","key":"b34","series-title":"PLoS One","first-page":"e0236783","article-title":"Selective dorsal rhizotomy; evidence on cost-effectiveness from England","volume":"15","author":"Pennington M","year":"2020","unstructured":"Pennington M, Summers J, Coker B, Selective dorsal rhizotomy; evidence on cost-effectiveness from England. PLoS One. 2020;15(8):e0236783."},{"issue":"6","key":"b35","series-title":"Neurosurg Rev","first-page":"3209","article-title":"Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review","volume":"44","author":"Kudva A","year":"2021","unstructured":"Kudva A, Abraham ME, Gold J, Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review. Neurosurg Rev. 2021;44(6):3209\u20133228."},{"key":"b1","article-title":"National Health Expenditures 2023 Highlights. CMS.gov","unstructured":"National Health Expenditures 2023 Highlights. CMS.gov. Accessed March 11,2025.https:\/\/www.cms.gov\/files\/document\/highlights.pdf"},{"issue":"1","key":"b2","series-title":"Dev Med Child Neurol.","first-page":"59","article-title":"Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning\u2014Autism and Developmental Disabilities Monitoring Network, USA, 2008","volume":"56","author":"Christensen D","year":"2014","unstructured":"Christensen D, Van Naarden Braun K, Doernberg NS, Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning\u2014Autism and Developmental Disabilities Monitoring Network, USA, 2008.Dev Med Child Neurol.2014;56(1):59\u201365."},{"issue":"4","key":"b3","series-title":"Am Fam Physician","first-page":"213","article-title":"Cerebral palsy: an overview","volume":"101","author":"Vitrikas K","year":"2020","unstructured":"Vitrikas K, Dalton H, Breish D. Cerebral palsy: an overview. Am Fam Physician. 2020;101(4):213\u2013220."},{"issue":"11","key":"b4","series-title":"Dev Med Child Neurol","first-page":"872","article-title":"The relationship of cerebral palsy subtype and functional motor impairment: a population-based study","volume":"51","author":"Shevell MI","year":"2009","unstructured":"Shevell MI, Dagenais L, Hall N. The relationship of cerebral palsy subtype and functional motor impairment: a population-based study. Dev Med Child Neurol. 2009;51(11):872\u2013877."},{"key":"b5","article-title":"National Institute of Neurological Disorders and Stroke","unstructured":"Cerebral Palsy. National Institute of Neurological Disorders and Stroke. Accessed March 11, 2025. https:\/\/www.ninds.nih.gov\/health-information\/disorders\/cerebral-palsy"},{"issue":"3","key":"b6","series-title":"J Pediatr Surg","first-page":"424","article-title":"Postoperative complications in pediatric patients with cerebral palsy","volume":"57","author":"Skertich NJ","year":"2022","unstructured":"Skertich NJ, Ingram ME, Sullivan GA, Postoperative complications in pediatric patients with cerebral palsy. J Pediatr Surg. 2022;57(3):424\u2013429."},{"key":"b7","series-title":"J Orthop","first-page":"14","article-title":"Risk factors for 90-day readmission and prolonged length of stay after hip surgery in children with cerebral palsy","volume":"38","author":"Butler LR","year":"2023","unstructured":"Butler LR, Dominy CL, White CA, Risk factors for 90-day readmission and prolonged length of stay after hip surgery in children with cerebral palsy. J Orthop. 2023;38:14\u201319."},{"issue":"3","key":"b8","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"57","article-title":"Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment\u2014United States, 2003","volume":"53","year":"2004","unstructured":"Centers for Disease Control and Prevention (CDC). Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment\u2014United States, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(3):57\u201359."},{"issue":"7","key":"b9","series-title":"J Manag Care Spec Pharm","article-title":"Prevalence, patterns, and cost of care for children with cerebral palsy enrolled in Medicaid managed care","volume":"25","author":"Pulgar S","year":"2019","unstructured":"Pulgar S, Bains S, Gooch J, Prevalence, patterns, and cost of care for children with cerebral palsy enrolled in Medicaid managed care. J Manag Care Spec Pharm. 2019;25(7):"},{"key":"b10","series-title":"StatPearls","author":"Ghanavatian S","year":"2024","unstructured":"Ghanavatian S, Baclofen Derian A.. In: StatPearls. StatPearls Publishing;2024.Accessed March 11, 2025. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK526037\/"},{"issue":"6","key":"b11","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Spinal catheter revision in pediatric intrathecal baclofen pumps: risk factors and postoperative outcomes","volume":"56","author":"Mosher AM","year":"2024","unstructured":"Mosher AM, Hartman E, Keusch D, Spinal catheter revision in pediatric intrathecal baclofen pumps: risk factors and postoperative outcomes. Neurosurg Focus. 2024;56(6):E11."},{"issue":"8","key":"b12","series-title":"Childs Nerv Syst","first-page":"2597","article-title":"Unusual mechanical failures of intrathecal baclofen pump systems: symptoms, signs, and trouble shooting","volume":"37","author":"Gburek-Augustat J","year":"2021","unstructured":"Gburek-Augustat J, Krause M, Bernhard M, Unusual mechanical failures of intrathecal baclofen pump systems: symptoms, signs, and trouble shooting. Childs Nerv Syst. 2021;37(8):2597\u20132604."},{"issue":"1","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"69","article-title":"Use of intraoperative topical antibiotics to reduce intrathecal baclofen pump surgical site infections: a single institution\u2019s experience over 24 years","volume":"32","author":"Cobourn KD","year":"2023","unstructured":"Cobourn KD, Patel N, Tsering D, Use of intraoperative topical antibiotics to reduce intrathecal baclofen pump surgical site infections: a single institution\u2019s experience over 24 years. J Neurosurg Pediatr. 2023;32(1):69\u201374."},{"issue":"6","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"659","article-title":"Complications of intrathecal baclofen therapy in children and young adults","volume":"34","author":"Ryan MV","year":"2024","unstructured":"Ryan MV, Freeman LM, Blasco S, Complications of intrathecal baclofen therapy in children and young adults. J Neurosurg Pediatr. 2024;34(6):659\u2013670."},{"issue":"6","key":"b15","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Nonselective lumbosacral ventral-dorsal rhizotomy for the management of lower-limb hypertonia in nonambulatory children with cerebral palsy","volume":"56","author":"Abdelmageed S","year":"2024","unstructured":"Abdelmageed S, Dalmage M, Mossner JM, Trierweiler R, Krater T, Raskin JS. Nonselective lumbosacral ventral-dorsal rhizotomy for the management of lower-limb hypertonia in nonambulatory children with cerebral palsy. Neurosurg Focus. 2024;56(6)E9."},{"issue":"20","key":"b16","series-title":"JAMA","first-page":"2475","article-title":"Continuous intrathecal baclofen infusion for spasticity of cerebral origin","volume":"270","author":"Albright AL","year":"1993","unstructured":"Albright AL, Barron WB, Fasick MP, Polinko P, Janosky J. Continuous intrathecal baclofen infusion for spasticity of cerebral origin. JAMA. 1993;270(20):2475\u20132477."},{"issue":"10","key":"b17","series-title":"Cureus","first-page":"e3466","article-title":"Evidence supporting selective dorsal rhizotomy for treatment of spastic cerebral palsy","volume":"10","author":"Park TS","year":"2018","unstructured":"Park TS, Dobbs MB, Cho J. Evidence supporting selective dorsal rhizotomy for treatment of spastic cerebral palsy. Cureus. 2018;10(10):e3466."},{"issue":"2","key":"b18","series-title":"Gait Posture","first-page":"244","article-title":"Gait status 17-26 years after selective dorsal rhizotomy","volume":"35","author":"Langerak NG","year":"2012","unstructured":"Langerak NG, Tam N, Vaughan CL, Fieggen AG, Schwartz MH. Gait status 17-26 years after selective dorsal rhizotomy. Gait Posture. 2012;35(2):244\u2013249."},{"issue":"4","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"380","article-title":"Functional outcomes of childhood dorsal rhizotomy in adults and adolescents with cerebral palsy","volume":"11","author":"Hurvitz EA","year":"2013","unstructured":"Hurvitz EA, Marciniak CM, Daunter AK, Functional outcomes of childhood dorsal rhizotomy in adults and adolescents with cerebral palsy. J Neurosurg Pediatr. 2013;11(4):380\u2013388."},{"issue":"4","key":"b20","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."},{"key":"b21","series-title":"SAGE Open Med","first-page":"20503121211022197","article-title":"Baclofen therapeutics, toxicity, and withdrawal: a narrative review","volume":"9","author":"Romito JW","year":"2021","unstructured":"Romito JW, Turner ER, Rosener JA, Baclofen therapeutics, toxicity, and withdrawal: a narrative review. SAGE Open Med. 2021;9:20503121211022197."},{"issue":"11","key":"b22","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1035","article-title":"The assessment of drug treatment of spastic gait","volume":"44","author":"Corston RN","year":"1981","unstructured":"Corston RN, Johnson F, Godwin-Austen RB. The assessment of drug treatment of spastic gait. J Neurol Neurosurg Psychiatry. 1981;44(11):1035\u20131039."},{"issue":"1","key":"b23","series-title":"Indian J Orthop","first-page":"46","article-title":"Intrathecal baclofen: its effect on symptoms and activities of daily living in severe spasticity due to spinal cord injuries: a pilot study","volume":"43","author":"Jagatsinh Y","year":"2009","unstructured":"Jagatsinh Y. Intrathecal baclofen: its effect on symptoms and activities of daily living in severe spasticity due to spinal cord injuries: a pilot study. Indian J Orthop. 2009;43(1):46\u201349."},{"issue":"1","key":"b24","series-title":"J Neurosurg Pediatr","first-page":"102","article-title":"Conus-level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications","volume":"27","author":"Ahluwalia R","year":"2020","unstructured":"Ahluwalia R, Bass P, Flynn L, Conus-level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications. J Neurosurg Pediatr. 2020;27(1):102\u2013107."},{"issue":"14","key":"b25","series-title":"J Neurosurg Case Lessons","first-page":"CASE2438","article-title":"Cervicothoracic ventral-dorsal rhizotomy for bilateral upper-extremity hypertonia in cerebral palsy: illustrative case","volume":"7","author":"Kelly R","year":"2024","unstructured":"Kelly R, Kemeny HR, Abdelmageed S, Cervicothoracic ventral-dorsal rhizotomy for bilateral upper-extremity hypertonia in cerebral palsy: illustrative case. J Neurosurg Case Lessons. 2024;7(14):CASE2438."},{"issue":"1","key":"b26","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":"10","key":"b27","series-title":"Dev Med Child Neurol","first-page":"1038","article-title":"Readmission and complications within 30 days after intrathecal baclofen pump placement","volume":"60","author":"Lam SK","year":"2018","unstructured":"Lam SK, Mayer RR, Vedantam A, A Staggers K, Harris DA, Pan IW. Readmission and complications within 30 days after intrathecal baclofen pump placement. Dev Med Child Neurol. 2018;60(10):1038\u20131044."},{"issue":"1","key":"b28","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":"b29","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":"5","key":"b30","series-title":"J Neurosurg Pediatr","first-page":"456","article-title":"Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy","volume":"20","author":"Ravindra VM","year":"2017","unstructured":"Ravindra VM, Christensen MT, Onwuzulike K, Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy. J Neurosurg Pediatr. 2017;20(5):456\u2013463."},{"issue":"1","key":"b31","series-title":"Childs Nerv Syst","first-page":"30","article-title":"Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy","volume":"6","author":"Peter JC","year":"1990","unstructured":"Peter JC, Hoffman EB, Arens LJ, Peacock WJ. Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy. Childs Nerv Syst. 1990;6(1):30\u201332."},{"issue":"5","key":"b32","series-title":"Cureus","first-page":"e1256","article-title":"Functional outcomes of childhood selective dorsal rhizotomy 20 to 28 years later","volume":"9","author":"Park TS","year":"2017","unstructured":"Park TS, Liu JL, Edwards C, Walter DM, Dobbs MB. Functional outcomes of childhood selective dorsal rhizotomy 20 to 28 years later. Cureus. 2017;9(5):e1256."},{"issue":"5","key":"b33","series-title":"Pediatr Neurosurg","first-page":"255","article-title":"Cost analysis of continuous intrathecal baclofen versus selective functional posterior rhizotomy in the treatment of spastic quadriplegia associated with cerebral palsy","volume":"22","author":"Steinbok P","year":"1995","unstructured":"Steinbok P, Daneshvar H, Evans D, Kestle JR. Cost analysis of continuous intrathecal baclofen versus selective functional posterior rhizotomy in the treatment of spastic quadriplegia associated with cerebral palsy. Pediatr Neurosurg. 1995;22(5):255\u2013265."},{"issue":"8","key":"b34","series-title":"PLoS One","first-page":"e0236783","article-title":"Selective dorsal rhizotomy; evidence on cost-effectiveness from England","volume":"15","author":"Pennington M","year":"2020","unstructured":"Pennington M, Summers J, Coker B, Selective dorsal rhizotomy; evidence on cost-effectiveness from England. PLoS One. 2020;15(8):e0236783."},{"issue":"6","key":"b35","series-title":"Neurosurg Rev","first-page":"3209","article-title":"Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review","volume":"44","author":"Kudva A","year":"2021","unstructured":"Kudva A, Abraham ME, Gold J, Intrathecal baclofen, selective dorsal rhizotomy, and extracorporeal shockwave therapy for the treatment of spasticity in cerebral palsy: a systematic review. Neurosurg Rev. 2021;44(6):3209\u20133228."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/36\/2\/article-p217.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/36\/2\/article-p217.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/36\/2\/article-p217.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:46:10Z","timestamp":1772804770000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/36\/2\/article-p217.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,1]]},"references-count":70,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2025.2.peds24576","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,1]]}}}