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Objective To report outcomes of intrathecal baclofen (ITB) therapy for spasticity management in a cohort of patients who had received this treatment for at least 10 years. Design A cross-sectional survey and retrospective chart review. Setting An academic rehabilitation outpatient clinic. Participants Adult patients with spasticity treated with ITB for at least 10 years. Main Outcome Measurements Surveys included the Brief Pain Inventory, Penn Spasm Frequency Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, Diener Satisfaction with Life, Life Satisfaction Questionnaire, and Intrathecal Baclofen Survey. Results Twenty-four subjects completed the surveys. The subjects had been treated with ITB from 10.0-28.4 years, with a mean (standard deviation) of 14.7 ± 4.2 years. The mean (standard deviation) dose of ITB was 627.9 ± 306.7 μg/d, with only 6 subjects averaging daily dose changes of more than 10% compared with 3 years earlier. The mean (standard deviation) scores on outcomes surveys were the following: 2.6 ± 2.3 for pain severity on the Brief Pain Inventory, 1.4 ± 0.7 for spasm severity on the Penn Spasm Frequency Scale, 7.9 ± 5.4 on the Epworth Sleepiness Scale, 4.1 ± 1.6 on the Fatigue Severity Scale, 19.4 ± 8.1 on the Diener Satisfaction with Life, 3.9 ± 0.9 on the Life Satisfaction Questionnaire, and 8.8 ± 1.9 for overall satisfaction with ITB on the Intrathecal Baclofen Survey. On the Brief Pain Inventory, the mean scores for pain severity and interference of pain with life showed moderate inverse correlations with ITB dose ( r = −0.386, P = .115; and r = −0.447, P = .062, respectively). On the Life Satisfaction Questionnaire, the mean scores for life satisfaction showed statistically significant positive correlation with ITB dose ( r = 0.549, P = .021). Conclusions The subjects reported low levels of pain, moderate levels of life satisfaction, normal levels of sleepiness, low-to-moderate levels of fatigue, infrequent spasms at mild-to-moderate severity, and high levels of satisfaction. The efficacy and favorable adverse effect profile of ITB therapy was sustained in this cohort of subjects with more than a decade of treatment.

Disclosures: S. G. Chung, No Disclosures: I Have Nothing To Disclose. Objective: To test whether the nucleus pulposus (NP) of the cervical intervertebral discs (IVD) migrates forward by cervical extension, so-called McKenzie, maneuver. Design: In vivo anatomical measurement before and after intervention. Setting: An MRI center in a university hospital. Participants: 10 young and healthy males (22.4 1.6 years old). Interventions: T2 midline sagittal MR images were obtained in supine position with the cervical spine in neutral and approximately 20 degree extended postures. Main Outcome Measures: The anterior and posterior IVD heights and the horizontal position of the posterior margin of NP were measured and compared between the neutral and extended postures in each IVD of the C3-4, C4-5, C5-6, C6-7 levels. Results or Clinical Course: Anterior IVD heights increased significantly in the C3-4 and C4-5 levels (5.77 0.71mm to 6.45 0.92mm and 6.30 0.85mm to 6.92 0.77mm, respectively, with p