The key to successful employment of ITB is the proper selection of candidates. Patients should be clinically stable, have severe multifocal and regional muscle overactivity and have failed an adequate trial of oral agents. Implantation is body -size dependent.

Consequently, patients are usually 4 years of age or older and weigh more than 30 pounds. However, severely affected patients not meeting these criteria may sometimes be treated.

The patient and the caregiver should have realistic goals for the outcomes of therapy. In addition, they should be motivated and committed to ensure the success of ITB therapy.

Penn RD, Savoy SM, Corcos D, et al. Intrathecal baclofen for severe spinal spasticity. N Engl J Med 1989;320:1517-21.