Our Treatments

What is an Intrathecal Pain Pump?

Intrathecal drug delivery, or “pain pump,” is a method of giving medication directly to the spinal cord. The system uses a small pump that is surgically placed under the skin of your abdomen and delivers medication through a catheter to the area around the pain receptors located in the spinal cord.

A pain pump may be a treatment option if all other traditional methods including medications, spinal injections and surgery have failed to relieve chronic pain or cancer pain which can be severe and resistant to oral medication.

An intrathecal drug pump works more efficiently than oral medication because it delivers medicine directly into the CSF, bypassing the path that oral medication takes through your body. In fact, you generally need about 1/300 the amount of medication (morphine or baclofen) with a pump than when taken orally.

The goal of an intrathecal medication pump is to improve pain control when oral drugs fail or produce side effects; thus improving quality of life.

How does this procedure work?

Before implantation, a trial procedure is recommended with a spinal injection of opioid and/or anesthetic. The trial allows the patient to test the intrathecal drug delivery, usually for 24-48 hours, to determine if the implanted device will be successful at helping chronic pain individuals in achieving a better quality of life. During that trial period the patient will document if at least 50% of pain is relieved, daily life activity is increased and whether medications are reduced or working better in concert with the device to reduce 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 (fairly painless) through your skin and into the fill port on top of the reservoir.

The patient is awake or minimal sedation (twilight) may be used during the trial procedure. General anesthesia or heavy sedation is required for the permanent implantable device. Local anesthetic is also used to numb the skin and surrounding soft tissue. Once adequate anesthesia is obtained the process of intrathecal drug delivery begins.

The intrathecal catheter is inserted with the aid of fluoroscopy following a small skin incision made in the middle of the back. After placement of the catheter in the intrathecal space, it is passed under the skin from the spinal area to the fatty tissue layer of the buttock, where the pump reservoir will be implanted, thus internalizing the device where it will not be seen except for the healed incisions. The patient is taken to recovery at the end of the procedure and final programming is performed to tailor delivery that will reduce pain and improve quality of life.

What are the benefits of this treatment?

1. Ambulatory Surgery to observation overnight: The incisions are small.
2. Alternative therapy when all other treatments including physical therapy, oral medication, surgery has failed.
3. Trial procedure for 24 to 48 hours to allow patients to determine if this is a medically appropriate procedure for their chronic or cancer pain.
4. Successful implanted device provide improved quality of life when medication and surgery fails.
5. The implanted device is completely reversible if you should ever decide to have it removed.

What is the recovery time of this procedure?

The procedure is performed in an ambulatory surgery setting. Any regards for initial recovery may require 24 hours when sedation and general anesthesia is used.
The results of the intrathecal pain pump for the usual areas of pain are immediate. Patients may have pain and soreness for a few days to weeks following permanent surgical placement; however, medication is prescribed to help ease surgical discomfort.

Reduced activity is recommended for two weeks following permanent surgery to allow the surgical incisions to heal and the catheter to make permanent attachment to the tissue. Normal or improved activity will usually resume in approximately 2 weeks following the surgery.