Table 1

Chronology of clinical events, dose of intrathecal baclofen, location of tip of catheter for delivery of baclofen and presence of bladder stones

Days

Clinical event

Dose of intrathecal baclofen Micro-grams/day

Location of catheter tip

Bladder stones

Day 0

Road traffic accident Spinal cord injury

-

-

-

412

Implantation of Medtronic Synchromed EL pump

300

T-10

-

487

Intravenous urography

530

T-10

Yes*

500

Back ache

575

-

-

689

X-ray of abdomen

875

The catheter has come out of the spinal canal. The catheter is coiled in the paraspinal space at L-4 level.*

Yes

700

Cystoscopy and electrohydraulic lithotripsy of vesical calculi

875

-

-

738

X-ray of abdomen

1300

The catheter has come out of the spinal canal. The catheter is coiled in the paraspinal space at L-4 level.

No

759

MRI and CT scan of lumbar spine

1300

No CSF collection in paravertebral soft tissue. The tip of catheter is coiled superficially within right longissimus lumborum muscle.

No

763

Exploration revealed the catheter lying under the sheath of paraspinal muscle.

300

A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level, which was confirmed by X-ray screening.

No

* These observations were made in retrospect after seeing the X-ray, which was taken on day 738.

Vaidyanathan et al. BMC Urology 2003 3:3   doi:10.1186/1471-2490-3-3