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Intrathecal Pump (aka Spinal Pain Pump)

If you suffer from chronic pain of any kind, and you find yourself having to constantly take pain medication just to get through the day, this highly advanced treatment may be for you.

What is an Intrathecal Pump?

An intrathecal pump (also called a spinal drug pump, pain pump, or infusion pump) can help provide chronic pain patients round-the-clock pain relief.  Spinal pumps are implanted directly into the body. They are programmable devices that deliver a measured and safe drug dose to meet the patient’s daily needs for pain management.

An intrathecal pump is a device that is able to get medication DIRECTLY into the central nervous system (CNS). It can maximize pain relief and minimize side effects like constipation and excessive sleepiness/grogginess. The pump works around the clock to control your pain, even when you are asleep.

Indications

Intrathecal pumps (aka pain pumps) can be used to treat a wide variety of chronic pain syndromes:

Intrathecal Pump - Pain Pump  Cancer Pain
 Nocioceptive Pain
 Nerve Root Injury
 Deafferenation Pain
 Spinal Cord Injury Pain
 Failed Back Surgery Syndrome (FBSS)
 Post-Laminectomy Syndrome
 Arachnoiditis
 Complex Regional Pain Syndrome (CRPS)
 Reflex Sympathetic Dystrophy (RSD)
 Causalgia

Learn More About Complex Regional Pain Syndrome (CRPS)

What Are The Benefits?

Man Biking SmilingUnlike oral pain medications that take time to work, an intrathecal drug pump bypasses the gastrointestinal system completely and delivers medication directly into the cerebrospinal fluid (CSF), in which the brain and spinal cord float.

There are many potential advantages of intrathecal pump therapy:

 Less pain medication is needed
 Pain relief may be more sustained and better controlled
 Side effects are generally reduced (i.e. constipation, nausea)
 Increased quality of life

The success of pain management using an intrathecal drug pump depends on (1) careful patient selection and (2) a successful trial.

How Does It Work?

Spinal Cord LayersThe intrathecal pump is actually a system that consists of an implantable pump unit and one or more catheters. The pump is about the size of a deck of cards and contains a reservoir that holds medication. It is implanted under the skin, usually in the abdomen. The catheter(s) are also implanted under the skin and placed in the intrathecal space of the spine at one end, and plugged into the pump unit at the other. The pump then delivers small amounts of medication through the catheter to drip into the intrathecal space.

There are a few different models of intrathecal pumps available. Your physician may discuss which type of system is best for you.

Learn More About the Anatomy of the Spinal Cord

Testing Out the Intrathecal Pump Beforehand

An intrathecal pump system is permanently implanted in the body. Before this is done, the physician will often assess the patient’s response to therapy in a trial period. This can be done as:

  • An intraspinal morphine injection to evaluate how well the patient responds to the drug in the spine
  • An epidural injection
  • Continuous drug infusion via a catheter system

Pain reduction in response to drug therapy in the spine can vary among individuals even with the same condition.

Most physicians consider a trial successful if it can reduce pain by 50% or more.  The physician will also evaluate any possible side effects. After the trial, the physician may discuss permanent implantation of the pump system.

Am I a Candidate?

Careful patient selection is important to a successful outcome and may include a psychological evaluation, as a spinal pump is not suitable treatment for everyone.  Some points that a physician may consider in determining appropriate candidates for intrathecal drug pump therapy include:

 Nonoperative treatments have failed to relieve pain
 Surgery is not an option
 Surgery is not expected to improve pain
 Spine surgery has failed (i.e. failed back syndrome)
 The patient does not have substance abuse issues

Is an Intrathecal Pump Right for Me?

The intrathecal drug pump is a new and promising therapeutic option that has provided significant benefits for certain patients. It is permanently implanted in the body and delivers small amounts of powerful pain medications directly into the cerebrospinal fluid. In certain patients, this provides pain relief at very low doses of medication with reduced or no side effects. Not all patients are appropriate candidates for this type of therapy.

Contact the Ainsworth Institute to set up an initial evaluation to find out if you are a candidate.

Procedure - Patient Details

The intrathecal pump is implanted in patients under general anesthesia. The physician uses fluoroscopy, a kind of video X-ray, to help guide the surgery. The pump is implanted in the abdomen on the right or left side, depending on the patient’s anatomy, preferences, and the implanting physician’s discretion. The catheter is plugged into the pump at one end and then fixated in the intrathecal space.

The pump is filled with medication and tested during surgery to assure proper function.

Procedure Aftercare
The implantation may require a short hospital stay. At discharge, the patient is given written instructions regarding home care. Patients are encouraged to walk and resume everyday activities as soon as they can; however, they may be restricted in terms of lifting, twisting, bending, and stretching. The physician will provide specific aftercare advice.

The physician typically will follow up with the patient 24 to 48 hours after the surgery. The patient may be asked to maintain a “pain diary” to record symptoms and activities. Such records can help the physician refine therapy to provide optimal pain relief.

Risk Factors

Implantation of a spinal pump, like other surgical and medical procedures, carries with it certain inherent risks. Complications include risk of infection, bleeding, headache, allergic reaction, spinal fluid leakage, paralysis, and device malfunction. The physician will discuss the risks and benefits of intrathecal drug pump implantation with each individual patient.

Refills

The reservoir in the pump contains a limited amount of medication. When it is exhausted, the patient must return to the physician to have the pump refilled. The refill procedure is done as an office visit. The pump has a self-sealing membrane that faces toward the skin. The physician or nurse injects medication through the skin and through this membrane to refill the pump. It is typical for a pump patient to return to the clinic monthly for a refill.

The refill procedure also allows the physician and his or her staff to:

  • Check the patient’s condition
  • Adjust the dose of medication, as needed
  • Determine if other pain management strategies are required
  • Discuss and re-evaluate therapeutic goals

The Ainsworth Institute is Here to Help

If you are suffering from chronic pain that has failed to respond to treatment, and would like to see if you may be a candidate for this exciting procedure, contact the Ainsworth Institute of Pain Management today. Schedule an appointment with one of our Board Certified Physicians to learn more about an intrathecal pump and to see if you qualify.

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