An intrathecal pump is a method of giving medication directly to your spinal cord. The system uses a small pump that is surgically placed under the skin and delivers medication through a catheter to the area around your spinal cord.
The implant procedure usually takes 2-3 hours. During the procedure, a pocket is made under the skin that’s large enough to hold a medicine pump. The pump is usually about one inch thick and three inches wide. A catheter is also inserted, which carries pain medicine from the pump to the intrathecal space around the spinal cord. The implants deliver medicines directly to the spinal cord, where pain signals travel. For this reason, intrathecal drug delivery can provide significant pain control with a fraction of the dose that would be required with pills. In addition, the system can cause fewer side effects than oral medications because less medicine is required to control pain.
The pump is programmed to slowly release medication over a period of time. It can also be programmed to release different amounts of medication at different times of the day, depending on your changing needs. The pump stores the information about your prescription in its memory, and your doctor can easily review this information with the programmer. When the reservoir is empty, the doctor or nurse refills the pump by inserting a needle through your skin and into the fill port on top of the reservoir.
This therapy is completely reversible if you should ever decide to have the pump removed.
Who is a good candidate for intrathecal pump implant?
You may be a candidate for intrathecal drug delivery if you meet the following criteria:
- Conservative therapies have failed
- You would not benefit from additional surgery
- You are dependent on pain medication
- You have no medical conditions that would keep you from undergoing implantation
- You have had positive response with a trial dose of medication
A pump can help lessen chronic pain caused by:
- Failed back surgery syndrome: chronic pain after one or more back or neck surgeries to fails to alleviate persistent low back pain, leg pain
(sciatica or lumbar radiculopathy) or arm pain (cervical radiculopathy).
- Reflex sympathetic dystrophy: a progressive disease of the nervous system in which patients feel constant chronic burning pain.
- Causalgia: a burning pain caused by peripheral nerve injury.
- Arachnoiditis: painful inflammation and scarring of the meninges (protective layers) of the spinal nerves.
- Chronic pancreatitis: chronic abdominal pain caused by inflammation or blockage of the pancreatic duct.
- Cerebral palsy: a nervous disorder that impairs control of body movement.
- Multiple sclerosis: a disorder of the brain and spinal cord caused by damage to the outer layer (myelin) of nerve cells.
- Stroke: damage to the brain from lack of oxygen; due to an interruption of the blood supply.
- Post-traumatic spasticity
- Brain injury
- Spinal cord injury