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Spasticity, defined as a state of increased muscle tone is not a pathology per se but the direct consequence of the evolution of diverse illnesses, such as spinal cord injuries and multiple sclerosis. The therapeutic value of the baclofène as a treatment for spasticity has been proven. This medicine can be administrated both intrathecally and orally. This two-way administration raises questions about the efficacy, the cost and the practical aspects of each method. On the basis of literature review, we can conclude that intrathecal treatment for spasticity has a medical net value advantage and has fewer side effects. Nevertheless, intrathecal administration of baclofène is limited due to a higher cost and more frequent medical complications. Finally, the intrathecal use of baclofène should be adviced for moderate to severe spasticity, whereas the oral treatment should be administered in case of low spasticity. La spasticité qui se définit comme une tendance d'un muscle à être contracté, n'est pas une pathologie en soi mais bien la conséquence directe de l'évolution de diverses pathologies telles que les lésions médullaires et la sclérose en plaques. Au niveau thérapeutique, l'efficacité du baclofene dans le traitement de la spasticité a clairement été démontrée. Celui-ci pouvant être administré soit par voie orale, soit par voie intrathécale ; des questions se posent quant à leur efficacité respective, leur cout ainsi que leurs aspects pratiques. L'analyse de plusieurs études nous permet ainsi de conclure qu'il y a un net avantage à l'utilisation médicale de la voie intrathécale. Les effets secondaires sont moins fréquents. Néanmoins, l'administration du baclofène par voie intrathécale a un cout supérieur et entraine des complications plus fréquentes, qui en limitent son utilisation. Actuellement, l'administration du baclofène par voie intrathécale est préférée pour traiter la spasticité moyenne à sévère, alors que le traitement par voie orale est à privilégier dans le cas de spasticité légère.

Baclofen --- Injections, Spinal --- Muscle Spasticity

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Medicare. --- Injections, Intradiscal --- Injections, Spinal --- Spine --- Joints --- Finance. --- Treatment

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This book is a comprehensive reference of the neuraxial route for the delivery of therapeutics. It reviews the historical evolution of this approach from its inception in the later 1800's to present day. This amply referenced text covers basic discussions of spinal anatomy, embryogenesis, neuraxial vascularity, cerebrospinal fluid flow dynamics and parenchymal molecule movement. The pharmacokinetic and pharmacodynamic properties of different intrathecal agents are explored in detail with particular reference to clinical correlates in pain and spasticity. Particular attention is paid to the issues relevant to preclinical models of intrathecal delivery and the assessment of spinal pathologies arising from acute and chronic intrathecal drug delivery. Chapters provide essential discussions of clinical aspects of patient care, including patient evaluation and screening, trialing and device management, troubleshooting problems and addressing complications, best practices, cost-effectiveness and future of the therapy. Clinicians and researchers who practice intrathecal therapy and study neuraxial mechanisms will find Neuraxial Therapeutics: A Comprehensive Text, to be an invaluable guide to this treatment modality.

Pain medicine. --- Anesthesiology. --- Neurology. --- Pain Medicine. --- Drugs --- Injections, Spinal. --- Injections, Intravenous. --- Administration.

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Minimally Invasive Percutaneous Spinal Techniques, by Daniel H. Kim, MD, FACS, Kyung Hoon Kim, MD, and Yong Chul Kim, MD, helps you apply methods of spinal pain relief that involve less risk and shorter recovery times. Focusing on the broad appeal of this goal for you and your patients, this volume will help surgeons and specialists in various areas of pain management provide less invasive alternatives and faster recovery procedures for those suffering with spinal injuries. Reduce the risk associated with invasive spinal procedures by considering new perspectives on pain management techniques that can be used by specialists from various disciplines. Address the growing need for less invasive surgeries with shorter recovery times among a large and aging population with musculoskeletal problems.

Spine --- Injections, Spinal. --- Endoscopic surgery. --- Intraspinal injections --- Spinal injections --- Backbone --- Columna vertebralis --- Spinal column --- Vertebral column --- Back --- Bones --- Skeleton

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Anesthesiology --- Anesthesia, Epidural. --- Peridural anesthesia --- Anesthesia, Epidural --- Anesthesia, Extradural --- Anesthesia, Peridural --- Epidural anesthesia --- Extradural anesthesia --- Conduction anesthesia --- Paravertebral anesthesia --- Epidural Anesthesia --- Anesthesias, Epidural --- Anesthesias, Extradural --- Anesthesias, Peridural --- Epidural Anesthesias --- Extradural Anesthesia --- Extradural Anesthesias --- Peridural Anesthesia --- Peridural Anesthesias --- Injections, Epidural --- Injections, Spinal --- Peridural anesthesia. --- Anesthésie péridurale. --- Anesthesia, epidural