Spinal Cord Stimulation and Intrathecal Pump Infusion Management in Para-Athletes: A Retrospective Case Series.

Abstract

To present our experience with 4 para-athletes implanted with intrathecal baclofen pump and spinal cord stimulation, detailing their management and the potential complications these patients may face. For spinal cord stimulation, data collected included stimulation level, surgical complications, and pain scale assessment before the procedure and at 3-mo follow-up. For intrathecal baclofen, data collected included catheter level, surgical complications, baclofen concentration and dosage, and Modified Ashworth Scale. The sports practiced by the patients include sitting volleyball, shooting, handcycling, and table tennis. Concerning patients implanted with spinal cord stimulation, the first patient showed benefits on her phantom limb pain allowing her to resume training while the second patient presented an electrode fracture. Patients receiving intrathecal baclofen improved their spasticity. One of the patients required only a continuous infusion, while the other needed a bolus infusion adapted to training hours. The use of spinal cord stimulation and intrathecal baclofen in para-sports is not contraindicated. Only the use of intrathecal morphine requires a therapeutic use exemption. Spinal cord stimulation and intrathecal baclofen require special monitoring, considering the needs of para-athletes and the particularities of the sport they practice. Further studies will be needed to assess the sporting performance of patients implanted with spinal cord stimulation or intrathecal infusion pumps.