Effectiveness of the intrathecal baclofen pump in the treatment of spasticity of different aetiologies: A systematic review and meta-analysis

IF 3.1 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia Pub Date : 2025-07-01 DOI:10.1016/j.nrl.2023.06.007

I. Otero-Luis , A. Saz-Lara , I. Cavero-Redondo , C. Pascual-Morena , I. Martínez-García , S. Nuñez de Arenas-Arroyo

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引用次数: 0

Abstract

Objective

To analyze the effectiveness of intrathecal baclofen in the treatment of spasticity of different aetiologies in the upper limbs, lower limbs, and both children and adults.

Design

Meta-analysis.

Subjects/Patients

People with spasticity of different aetiologies in treatment with intrathecal baclofen.

Methods

A systematic search was performed in the PubMed, Scopus, Cochrane Library, and Web of Science databases with the earliest data available up to November 1, 2022. Random-effects models were used to calculate pooled mean difference estimates and their respective 95% CIs to assess the effectiveness of intrathecal baclofen treatment on spasticity of different aetiologies using the modified Ashworth scale. All statistical analyses were performed with STATA 15 software.

Results

Finally, 11 studies were included in the meta-analysis. The effect of baclofen treatment administered by an intrathecal pump on spasticity measured by the modified Ashworth scale led to a significant decrease in spasticity in both adults (MD: −1.54; 95% CI: −1.80, −1.27) and children (MD: −0.70; 95% CI: −0.91, −0.49), with greater effectiveness for lower limb spasticity (MD: −1.45; 95% CI: −1.93, −0.97). The results should be interpreted with caution since there is heterogeneity due to differences between populations (age or types of diseases).

Conclusion

These findings are important for clinical practice, as they demonstrate the efficacy of intrathecal baclofen in treatment of spasticity, thus improving patient quality of life, being more effective at a younger age and longer duration of treatment, always taking into account statistical limitations.

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鞘内巴氯芬泵治疗不同病因痉挛的有效性：系统回顾和荟萃分析

目的分析鞘内注射巴氯芬治疗上肢、下肢及儿童和成人不同病因痉挛的疗效。不同病因的痉挛患者使用鞘内巴氯芬治疗。方法系统检索PubMed、Scopus、Cochrane Library和Web of Science数据库，检索到2022年11月1日的最早数据。采用随机效应模型计算汇总均差估计值及其各自的95% ci，采用改良Ashworth量表评估鞘内巴氯芬治疗不同病因痉挛的有效性。所有统计分析均采用STATA 15软件进行。结果最终有11项研究被纳入meta分析。经鞘内泵给予巴氯芬治疗对经改良Ashworth量表测量的痉挛的影响导致两名成人的痉挛显著降低(MD: - 1.54；95% CI: - 1.80, - 1.27)和儿童(MD: - 0.70；95% CI: - 0.91, - 0.49)，对下肢痉挛更有效(MD: - 1.45；95% ci:−1.93,−0.97)。由于人群之间的差异（年龄或疾病类型），结果存在异质性，因此应谨慎解释。结论这些发现对临床实践具有重要意义，因为它们证明了鞘内巴氯芬治疗痉挛的有效性，从而改善了患者的生活质量，在考虑到统计局限性的情况下，更年轻、更长的治疗时间更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologia 医学-临床神经学

CiteScore

5.90

自引率

2.60%

发文量

135

审稿时长

48 days

期刊介绍： Neurología es la revista oficial de la Sociedad Española de Neurología y publica, desde 1986 contribuciones científicas en el campo de la neurología clínica y experimental. Los contenidos de Neurología abarcan desde la neuroepidemiología, la clínica neurológica, la gestión y asistencia neurológica y la terapéutica, a la investigación básica en neurociencias aplicada a la neurología. Las áreas temáticas de la revistas incluyen la neurologia infantil, la neuropsicología, la neurorehabilitación y la neurogeriatría. Los artículos publicados en Neurología siguen un proceso de revisión por doble ciego a fin de que los trabajos sean seleccionados atendiendo a su calidad, originalidad e interés y así estén sometidos a un proceso de mejora. El formato de artículos incluye Editoriales, Originales, Revisiones y Cartas al Editor, Neurología es el vehículo de información científica de reconocida calidad en profesionales interesados en la neurología que utilizan el español, como demuestra su inclusión en los más prestigiosos y selectivos índices bibliográficos del mundo.