Calcification of the pump pouch in patients receiving ITB therapy: A rare complication affecting refill procedure – Analysis of two cases

Intrathecal baclofen therapy (ITB) is an effective treatment for reducing spasticity but can be associated with various complications, including infection and implant malfunction. This retrospective cohort study analyzed refill reports, complications, and functional outcomes in 40 consecutive patients with intractable spasticity or dystonia undergoing ITB. Among the 40 patients, 8 experienced complications, including two cases of calcification of the baclofen pump pouch and surrounding tissue, a rare complication not extensively described in the literature. Calcification, in addition to port access difficulties, could lead to drug delivery failure. We hypothesize that calcification may result from microtrauma or needlestick injury to the subcutaneous tissue and muscle fascia. The length of time the pump stays in the pocket could also contribute to favoring this phenomenon. As the number of patients receiving ITB increases, physicians must be aware of potential life-threatening complications. The risk of pouch calcification should be further investigated and considered in managing patients undergoing ITB, as it could significantly impact patient care. •ITB reduces spasticity but has complications.•Study: 40 patients with ITB, 8 complications, including rare pouch calcification.•Calcification affects refill port access, with the potential to cause drug delivery failure.•Hypothesized causes: microtrauma, needlestick injury, pump duration.•Pouch calcification may prove to be an unfamiliar and challenging complication to manage.