Private Kiang Wu Hospital announced in a statement yesterday that it successfully performed Macau’s first intrathecal baclofen (ITB) pump implantation this month on a patient who suffers from long-term spastic dystonia following a severe traumatic brain injury.
Following the surgery, muscle tone in the patient’s lower limbs was significantly reduced and spastic pain was completely relieved, leading to significant improvements in both sleep and overall quality of life, according to the statement.
The statement pointed out that the patient had previously relied on high oral doses of baclofen, a common muscle relaxant. However, due to the drug’s poor permeability across the blood-brain barrier, these high doses triggered pronounced side effects such as dizziness, fatigue, and drowsiness without effectively alleviating the symptoms.
The ITB procedure is a minimally invasive surgery that delivers medication directly to the body’s target area. Guided by C-arm fluoroscopy, surgeons insert a drug-infusion catheter into the patient’s subarachnoid space* through a spinal puncture, positioning the catheter’s tip at the spinal segment corresponding to the most severely affected limbs, the statement said.
According to DeepSeek, C-arm fluoroscopy is a real-time X-ray imaging machine shaped like a large “C” that slides around the patient.
Because the ITB pump enables medication to be delivered directly to the central nervous system, it achieves strong therapeutic efficacy at a fraction of the standard oral dosage while drastically reducing systemic side effects, the statement said, adding that the procedure is also fully reversible, meaning the entire system can be surgically removed if necessary.
The statement underscored that the procedure enables treatment for patients with cerebral palsy (CP), hereditary spastic paraplegia*** (HSP), and severe post-trauma or post-tumour limb spasticity (stiffness), as well as patients who experience side effects from oral anti-spasticity drugs.
Dr Liao Ting, from the Department of Neurosurgery at Kiang Wu Hospital, said in the statement that candidates for ITB pump implantation must undergo a thorough evaluation prior to surgery. Because the procedure involves implanting a foreign medical device, strict aseptic protocols are required to prevent infection.
Following the operation, patients typically undergo a period of routine device programming and parameter adjustments managed by the medical team to optimise dosages, Dr Liao added.
* The subarachnoid space is the fluid-filled compartment surrounding the brain and spinal cord. - Gemini
**Cerebral Palsy is a group of permanent neurological disorders that affect movement, muscle tone, and posture. It is caused by damage to or abnormal development in the parts of the brain that control motor function, typically occurring before, during, or shortly after birth. - Gemini
***Hereditary Spastic Paraplegia refers to a large group of rare, inherited neurological disorders characterised by progressive stiffness and weakness in the legs. It is caused by the gradual degeneration of the long nerve fibres (corticospinal tracts) running down the spinal cord that convey signals to the lower limbs. - Gemini
This undated handout photo provided by the private Kiang Wu Hospital yesterday shows a physician preparing to insert an intrathecal baclofen (ITB) pump into the patient’s subarachnoid space.
