Intrathecal Pump Implant
An intrathecal pump, or ‘pain pump’, is a medical device used to deliver medications directly into the space between the spinal cord and the protective sheath surrounding the spinal cord. Medications such as baclofen, morphine, or other medication combinations may be delivered in this manner to minimize the side effects often associated with the higher doses used in oral or intravenous delivery of these drugs. It is used first on a trial basis and after a successful trial is determined, and then a permanent implant is undertaken and maintained with refilling of the pain needed on a regular basis.
There can be multiple indications for inthecal pump, or ‘pain pump’, implant after a successful trial. These can include the treatment of chronic pain after failed back surgery, sometimes called FBS or post laminectomy syndrome, non-radicular back pain that does not go below the hip area, cancer pain, or response to narcotic therapy traditionally that has now has produced tolerance or side effects.
What to Expect
After a successful trial of narcotics, usually morphine at low dose, by way of a small catheter and trialed over several days the implant will be undertaken. The procedure is done as an outpatient with local and IV sedation with the catheter place again in a similar fashion and now connected to a pump reservoir that is usually placed in the abdomen, buttock area or other choice of access position. You will go home the same day usually and the pump will have been filled and programmed accordingly. Infection precautions will be given and usually antibiotics maintained for a brief period of time.
Outcomes and long term results of placement for interthecal pain pumps using single drug low dose morphine are well documented as effective in the treatment for chronic pain. Infection and mechanical dislodgement of the catheter are the main concerns. Refill and maintenance of the pump with possible battery replacement after prolonged use are longer term maintenance issues.