Intrathecal pump therapy is the implantation of intrathecal pain pump. Intrathecal pain pump is an implanted medical device that delivers opioid medication to the patient. It is implanted in the intrathecal space that is the space between the spinal cord and the protective sheath surrounding the spinal cord.
Why it is implanted in spinal region?
Spinal cord is the main pathway for pain signals so applying medication directly to the spine provides powerful pain management and relief with very small doses by blocking pain impulses at the spinal level.
Medicines which have been using in intrathecal pump therapy:
The intrathecal pump therapy uses following medicines for pain management;
These medicines are delivering in this manner that intrathecal pump therapy minimize the side effects which are often associated with the higher doses used in oral or intravenous delivery of these drugs.
The procedure of intrathecal pump therapy includes the steps which listed below;
- The procedure is performed under the effect of anesthesia.
- A small incision is made in the middle of your back.
- The catheter is placed in the intrathecal space, above the spinal cord and secured in place with sutures.
- Then an extension catheter is passed under the skin from the spine, around your torso to the abdomen and here the pump will be implanted.
- The surgeon creates a pocket for the pump between the skin and muscle layers.
- The extension catheter is attached to the pump.
- Pump is correctly positioned under the skin and sutured to the thick fascia layer overlying the stomach muscles.
- The incision in your back and abdomen are then closed with sutures and a dressing is applied.
The whole procedure for intrathecal pump therapy takes 3 to 4 hours. And the pump will need to be refilled every 3 months. Refilling is done by inserting a needle through the abdominal wall. The batteries in the pump last from about 3 to 5 years.
Candidates of intrathecal therapy:
You can opt for intrathecal pump therapy if you have gone through one or more of the following conditions;
- If conservative therapies have failed to minimize your pain
- You would not benefit from additional surgery
- If you are dependent on pain medications
- You do not have psychological problems
- If there is no medical conditions that would keep you from undergoing implantation
- The drugs which are using is not causing any allergy to you
- You have had positive response with a trial dose of medication
Medical conditions in which intrathecal pump is useful:
Intrathecal pump therapy is beneficial in many medical conditions. Following is the list of some medical conditions in which intrathecal pump therapy can successfully reduce pain or pain related symptoms.
- Some cancer patients with opioid resistant pain or serious side effects may benefit from intrathecal pain management.
- Probably, only some benign patients with opioid resistant pain or serious side effects are suitable for intrathecal treatment.
- Chronic back and neck pain
- Chronic abdominal pain
- Failed back and neck surgery
- Cancer and reflex sympathetic dystrophy
- Complex regional pain syndrome.
Side effects of intrathecal pump therapy are minimal but they do exist.
- Catheter could move or become blocked, or the pump could stop working
- Accumulation of fluid can occur around the pump causing a clear watery discharge from your incisions
Drugs which are using in intrathecal pump therapy can cause;
- Respiratory depression
- Muscle spasm
- Urinary retention
Zaki Anwar MD is an Anesthesiologist and Interventional Pain Management Specialist. He has vast expertise for the diagnosis and treatment of back pain, headaches, migraines, neck pain, sciatica pain and various pain conditions.
For further queries call on 815.412.6166