Effect of Intrathecal Baclofen Pumps on Curve Progression in Neuromuscular Scoliosis

Objectives: Intrathecal baclofen (ITB) therapy is widely used to manage spasticity in cerebral palsy (CP), yet its relationship to scoliosis progression remains debated. This study examined whether ITB therapy accelerates curve progression or affects outcomes after spinal fusion in neuromuscular scoliosis. Material and Methods: We reviewed 64 patients with CP who underwent spinal fusion between 2018 and 2021, divided into ITB ( n= 19) and non-ITB ( n= 45) cohorts. For patients with a preexisting ITB pump, we additionally recorded age at time of pump implantation and mean age at implantation was 9.7 years ± 3.1. Cobb angle at the time of pump implantation and baclofen therapy dosage could not be compared due to incomplete and inconsistent data availability. Cobb angles were measured at two preoperative time points (mean interval 31.6 months) to determine annual curve progression. Postoperative outcomes included curve correction, percent correction, length of stay, operative time, and surgical site infection (SSI). Groups were compared using independent samples t-tests and Fisher's exact test. Results: Mean age was 13.1 years; 39 (62%) were female. Baseline characteristics were well matched. Annual curve progression was similar between cohorts (17.0° ± 15.6° vs. 15.8° ± 9.9°/year, p= 0.73). Postoperative correction did not differ significantly (−42.5° ± 19.0° vs. −48.4° ± 19.3°, p= 0.28), nor did percent correction (47.3% vs. 56.1%, p= 0.09), length of stay (9.5 vs. 11.5 days, p= 0.56), or operative time (6.96 vs. 7.28 hours, p= 0.44). SSI rates were low in both groups (5.3% vs. 8.9%, p= 1.0). Conclusion: No significant difference in scoliosis progression or worse surgical outcomes in this population was identified between patients with ITB therapy and without ITB therapy. However, given the limited sample size these findings should be considered preliminary.