PMC4684582_01
a Subcutaneous location of intrathecal baclofen pump device in the right medial thigh 5 months after surgery. b Radiograph showing the subcutaneous placement of the intrathecal baclofen pump device with associated catheter located in the right medial thigh. The catheter is seen passing superiorly from the device towards the right neck of femur
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Fig1
It was first tunnelled out through an intermediate proximal thigh incision, in which the tubing was anchored to the muscle fascia (Fig. 1).
PMC4684582_02
a Dehiscence of scar overlying the original site of intrathecal baclofen pump placement, 4 years after initial surgery. b Erect abdominal radiograph showing the original intrathecal baclofen pump device can be seen in the right lower quadrant of the abdomen with its catheter tracking laterally and posteriorly towards the right flank and onwards to the spinal column. c Lateral view abdominal radiograph depicting the paucity of subcutaneous tissue overlying the original pump site in the right lower quadrant of the abdomen
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Fig2
During a routine follow-up clinic, the ITB pump was visibly protruding through the subcutaneous tissue of the abdominal wall (Fig. 2).
a Revised pump site 6 months postoperatively. Significantly less protrusion is seen with a subsequent decrease in tension on the overlying skin. b Erect abdominal radiograph depicting the re-sited baclofen pump in the posterior rectus fascial pouch. The catheter can be seen tracking into the right flank and onwards towards the spinal column
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Fig3
A new proximal catheter was attached to the pump and brought out superficial to the superficial linea alba, where it was connected to the old distal catheter using a straight connector (Fig. 3).