CASE REPORT article
Front. Rehabil. Sci.
Sec. Medical and Surgical Rehabilitation
Volume 6 - 2025 | doi: 10.3389/fresc.2025.1530801
Use of O-arm to place an Intrathecal Catheter Through a Bony Fusion Mass: case report
Provisionally accepted
- The Ohio State University, Columbus, United States
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Background: Intrathecal baclofen delivery is an approved FDA indication for patients with intractable spasticity. Often, implantation in those patients can be considerably challenging, especially if previous surgical fusion involves the procedure access location.Case report: We describe a 27-year-old female with T2 ASIA A SCI and chronic spastic dystonia. She was maximized on oral medications without satisfactory control of her painful muscle spasms and was a candidate for ITB trial, which ultimately failed due to the difficulty of accessing the spinal canal due to extensive pseudoarthrosis secondary to thoracic to lumbar fusion. A decision was made to directly implant the pump in the operative room using O-Arm-aided neuronavigation to guide catheter access at L5-S1. Currently, at 22 months of follow-up post-pump implant, ITB delivery has led to persistent improvements in her spastic dystonia and many aspects of quality of life.Discussion: The current case indicates that a multi-disciplinary approach when considering surgical treatments for medication-refractory spasticity may help expand the indications to large numbers of patients with post-surgical spine abnormalities.
Keywords: Spasticity, spinal cord injury, O-arm, navigation, Intrathecal baclofen
Received: 19 Nov 2024; Accepted: 05 May 2025.
Copyright: © 2025 Sammartino, Bavishi and Dalm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Francesco Sammartino, The Ohio State University, Columbus, United States
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