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Editor's Comments Intrathecal baclofen infusion and subsequent orthopedic surgery in patients with spastic cerebral palsy. Peter C. Gerszten, M.D., A. Leland Albright, M.D., and Graham F. Johnstone, M.D. This is a retrospective study of the need for orthopedic surgery of the lower extremities in 48 patients who were treated with intrathecal baclofen infusion (IBI) for spastic cerebral palsy (CP). The authors found that at the time of baclofen pump placement, orthopedic surgery was planned in 58% of patients but after IBI therapy, only 21% underwent orthopedic surgery during the follow-up period. The results indicate that reduction of spasticity with IBI therapy might reduce or prevent the need for orthopedic surgery in some patients with spastic CP. The authors' experience supports a view that spasticity contributes to development of muscle--tendon contractures in spastic CP. However, this should be considered a preliminary finding and further study will be required.