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Neuropediatrics 2025; 56(03): 180-184
DOI: 10.1055/a-2541-8620
Original Article

Intraventricular Application of Baclofen Using Navigated Frameless Stereotaxy: A Technical Note

Maria Abel
1   Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Manfred Kudernatsch
1   Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany
2   Research Institute “Rehabilitation, Transition, Palliation,” PMU Salzburg, Salzburg, Austria
,
Sergey Persits
1   Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Christina Onyinzo
1   Department of Neurosurgery and Epilepsy Surgery, Spine and Scoliosis Surgery, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Thomas Herberhold
3   Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Till Hartlieb
2   Research Institute “Rehabilitation, Transition, Palliation,” PMU Salzburg, Salzburg, Austria
3   Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Gerhard Kluger
2   Research Institute “Rehabilitation, Transition, Palliation,” PMU Salzburg, Salzburg, Austria
3   Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany
,
Steffen Berweck
3   Department of Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic Vogtareuth, Vogtareuth, Germany
4   Dr. von Hauners Children's Hospital, Munich University, Munich, Germany
› Author Affiliations
Funding None.
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Abstract

Objective

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.

Methods

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.

Results

Twenty patients (median age: 13 years; range: 2–23 years) were treated with IVB. Dystonia improved in 19/20 patients at the time of discharge (median 51 days; range 2–93 weeks). During the follow-up period (median: 19 months; range: 3–83 months), there was a total of five surgery-associated complications including 3/20 pump infections and 2/20 intraventricular catheter dislocations.

Conclusion

This study reveals that navigated frameless catheter positioning in IVB therapy of generalized dystonia is a comparatively low risk and effective surgical procedure.

Keywords

dystonia - intraventricular baclofen - navigated frameless stereotaxy


Publication History

Received: 08 September 2024

Accepted: 18 February 2025

Article published online:
05 March 2025

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