Information obtained by Stuart Schlossman
Medtronic ITB TherapySM (Intrathecal Baclofen Therapy) offers a precise, targeted, adjustable treatment for the management of severe spasticity. ITB Therapy uses an implantable, programmable pump to deliver precise amounts of Lioresal® Intrathecal (baclofen injection) directly to the site of action at the spinal cord via the cerebrospinal fluid (CSF).
The precise mechanism of action of baclofen as a muscle relaxant and antispasticity agent is not fully understood. Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal level, possibly by decreasing excitatory neurotransmitter release from primary afferent terminals, although actions at supraspinal sites may also occur and contribute to its clinical effect.7 Baclofen is a structural analog of the inhibitory neurotransmitter gamma aminobutyric acid (GABA), and may exert its effects by stimulation of the GABAB receptor subtype.7
Because ITB Therapy delivers baclofen directly to the spinal cord, it relieves spasticity with smaller amounts of medication than when taken orally. This helps minimize systemic side effects.
|Anatomic figure adapted from Kroin, JS. Intrathecal drug administration: present use and future trends. Clin Pharmacokinet 1992, 22:319-326.|
Introducing Lioresal Intrathecal directly into the intrathecal space permits effective CSF concentrations to be achieved with resultant plasma concentrations 100 times less than those occurring with oral administration.7