2009 Faculty Researchers

Reza Farid, MD

Clinical Impact of Intrathecal Baclofen on Hip Subluxation in Spastic, Tetraplegic Cerebral Palsy

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Department

Physical Medicine and Rehabilitation

Office Location

315 Business Loop 70 West

Phone #:

Office: (573) 882-3101
Fax: (573) 884-4540

Summary

Much has been tried for the chronic, predictable progression of hip subluxation in patients with Cerebral Palsy. Evidence based research has failed to demonstrate a consistent response to a variety of orthopedic, neurosurgical or physiatric interventions. A commonly accepted mechanism of action concludes that patients with Cerebral Palsy are born with normal hips and surrounding musculature. In time, with continued imposition of externally applied forces due to spasticity, torsional deformities occur, yielding progressive hip dislocations. When inadequately treated, some dislocated hips become painful and require salvage orthopedic procedures to provide relief. The goal of this study is to determine whether the implantation of an intrathecal baclofen (ITB) delivery system has a beneficial impact on the progression of hips from subluxation to frank dislocation. Reimer’s migration percentage and the acetabular angle will be calculated for each patient using radiographic data from the medical record. Data will be compared on a pre- and post- implant basis. To date, only one study examining hip stability after ITB implantation has been done. This study will examine patients in the young, pediatric population who are most likely to undergo rapid progression of hip subluxation.