The surgery may be performed under local or general anesthesia. Operative times vary from 1 to 1-1/2 hours. The pump is inserted into a pocket that is surgically created in the subcutaneous skin of the abdomen.

A one-piece radiopaque catheter is advanced into the lumbar subarachnoid space and advanced until the tip is between T10 and L1. In selected patients treated in referral centers, catheters have been placed in the cervical region, or even as high as the cisterna magnum. The catheter is tunneled around the abdomen connecting to the implanted pump.

References

• Concalves J, Barcia-March G, Sanchez-Ledesma MJ, et al. Management of intractable spasticity of supraspinal origin by chronic cervical intrathecal infusion of baclofen. Stereotact Funct Neurosurg 1994;62:108-12.
• Kamensek J. Continuous intrathecal baclofen infusions: an introduction and review. Axone 1999;20:67-72. 
• Ried S, Pellegrino L, Albinson-Scull S, et al. The Management of Spasticity. In: Pelligino L, Dormans JP, eds. Caring for Children with Cerebral Palsy. 2nd ed. Baltimore, Md: Paul H Brooks Publishing Co; 2000:99-124.