Atypical baclofen pump catheter dislodgement in spastic cerebral palsy - A case report.
Alex Landau, Kevin Batti, Tejas Shah and 2 others
A 16-year-old with spastic CP had his baclofen pump catheter migrate in front of the refill port and calcify.
No withdrawal symptoms were present and pump interrogation was normal. The problem was found only by touch at a routine visit and required urgent surgery.
Key findings
1The catheter had migrated to the front of the pump and the tubing had calcified over the refill port, blocking access. The patient had no withdrawal symptoms and the pump interrogation was unremarkable. A mobile mass was palpated over the port during a routine refill visit, and point-of-care ultrasound confirmed a low-density structure there.
2No cause for the migration was identified. The patient had no trauma, no change in body mass, a negative scoliosis survey, and the pump itself was firmly in place at surgery. The authors state no prior case in the literature describes this specific presentation in a pediatric CP patient.
3At one year post-implantation, hip abductor and flexor spasticity improved from MAS 3 to MAS 2, which the team linked to easier clothing and diaper changes for caregivers. After the surgical repair and a dose increase to 313 mcg/day, lower-extremity spasticity and ankle clonus improved, though bilateral hamstring tightness remained at MAS 2.
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What it does not show
One patient. What happened to him is not evidence of a pattern, and the complication described is explicitly stated as not previously documented in the literature. No tissue sample was taken from the calcified tubing, so the nature of the calcification is unconfirmed. No cause for the catheter migration was identified. The authors rule out trauma, body-mass change, scoliosis, and pump displacement, but the mechanism remains unknown. The spasticity improvement (MAS 3 to 2) occurred in the context of concurrent physical therapy, bracing, and prior botulinum toxin injections, so it cannot be attributed to the pump alone. Follow-up after the surgical repair was only about six weeks (September to late October 2025), so the long-term stability of the repositioned catheter is unknown.
Declared interests
The authors received no financial support and declared no conflicts of interest.
The easy way to misread this
This is one patient, and the spasticity improvement from MAS 3 to MAS 2 occurred while he was also receiving physical therapy, bracing, and had previously had botulinum toxin injections, so the gain cannot be attributed to the pump alone. The catheter complication described is explicitly stated as not previously documented in the literature. It should not be read as a common or expected risk of IT baclofen pumps.
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