We report two patients in whom the intrathecal
baclofen(ITB)
catheter was located in the subdural space, although we had confirmed good outflow of spinal fluid from the spinal
catheter. Patient 1 was a woman in her 30s with
spastic quadriplegia due to
subarachnoid hemorrhage. An ITB pump was implanted, and a good outflow of spinal fluid from the spinal
catheter was observed during the surgery. Postoperatively, her spasticity did not improve.
Catheter myelography revealed that the spinal
catheter was located in the subdural space. Using intraoperative
catheter myelography, we corrected the position of the
catheter. Patient 2 was a man in his 20s diagnosed with
adrenoleukodystrophy. An ITB
therapy was performed to improve his
spastic gait. Intraoperative
catheter myelography showed that the spinal
catheter was located in the subdural space, although there was good outflow of spinal fluid from the
catheter. Our experience suggests that the outflow of spinal fluid alone should not be used to determine the location of the spinal
catheter. Intraoperative
catheter myelography is useful for the correct placement of the spinal
catheter in the subarachnoid space.