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Neurological Rehabilitation

Intrathecal Baclofen Pump Site Infection Secondary to Skin Breakdown from Wheelchair Contact: A Case Report

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 6

    Primary Author(s)

  • AG

    Adam Goddard, MD MBA

    Resident - PGY4
    University of Cincinnati Medical Center/College of Medicine PM&R Program
    Cincinnati, Ohio

    • Poster Presenter(s)

  • Evan Zeldin, MD

    Associate Residency Program Director
    University of Cincinnati
    Cincinnati, Ohio

Disclosure(s):
Adam Goddard, MD MBA: No financial relationships to disclose
Evan Zeldin, MD: No financial relationships to disclose
Case Diagnosis: Cellulitis Over Intrathecal Baclofen Pump

Case Description or Program Description: A 52-year-old male with a history of cervical myelopathy with resultant incomplete cervical spinal cord injury, who had a baclofen pump implanted one year earlier for poorly controlled spasticity, presented to the emergency department with a one-week history of chills, edema, erythema, and tenderness over the baclofen pump. The pump was located in the lateral abdomen and was in intermittent contact with the armrest of his wheelchair. A scab was noted over the pump site.

Setting: Academic Medical Center

Assessment/Results: An abdominal CT scan revealed cellulitis of the skin overlying the baclofen pump. In an attempt to avoid pump removal, the patient was started on intravenous antibiotics. One month later the patient returned with severe abdominal pain, accompanied by tenderness, erythema, and edema over the pump site. He was again diagnosed with pump site cellulitis, and the pump was explanted.

Discussion (relevance): Intrathecal baclofen pumps provide a reliable and effective option for treatment of spasticity. Compared to other treatment options, they are more invasive given the surgical implantation. Pump placement frequently protrudes from the abdominal wall, which can cause potential for friction and shearing of the overlying skin, increasing the risk of wound formation and infection. The risk is further elevated when a patient's assistive device, such as a wheelchair, places pressure on the area over the pump. Providers should evaluate pump sites and patient wheelchairs during visits as a preventive measure against cellulitis. While antibiotics can effectively treat cellulitis without requiring pump removal, if the hardware becomes infected or an abscess develops, the pump must be explanted.

Conclusions: The placement of the pump adjacent to our patient's wheelchair armrest led to friction, skin breakdown, and cellulitis, ultimately necessitating pump removal. When consulting surgery for baclofen pump implantation, it is important to consider patient’s assistive devices to minimize potential complications.