Intrathecal Pain Pump System
Overview:
An intrathecal pain pump system is a medical device used to treat chronic pain that has failed to respond to more conservative therapies including physical therapy, medical management, injection therapy and possible surgical correction if needed. An intrathecal pain pump system can help a patient manage chronic pain that is not well controlled by oral pain medications. It uses small amounts of concentrated pain medications delivered directly to the spinal fluid. These blocks pain perception to the brain and thus helps relieve chronic pain.
Conditions Commonly Treated by Intrathecal Pain Pump:
- Failed back surgery syndrome – continued pain despite surgery to the spine
- Radiculopathy – pain that progresses down your arms/hands or legs/feet
- Chronic Pain Syndrome – any type of chronic pain that has failed to respond to more conservative measures
- Arachnoiditis – painful inflammation and scarring of the meninges (nerve protective wrappings)
- Other chronic pain – stump pain, multiple sclerosis, spinal cord injury, peripheral vascular disease
The Procedure:
Intrathecal Pain Pump Trial – The trial is very important part of the process as it will allow us to see if an intrathecal pain pump system will work for your pain.
Please arrive 20 minutes prior to your appointment on procedure day. Our nurses will start an IV if you are requesting sedation and take a pre-operative nurse assessment. All patients are taken to the procedure room on a hospital bed. Once in the procedure room you will be given sedation to help make you comfortable. A cold cleaning solution will be placed on your skin to help decrease chances of infection. The procedure site is then identified by your doctor under x-ray guidance. Once the site is identified a shot of numbing medicine (typically bupivicaine) will be given. This may feel like a bee sting, but will only last a few seconds. An epidural needle is then placed into the intrathecal space using x-ray guidance. Once proper needle placement is confirmed a small catheter (specialized tube) will be inserted through the needle into the intrathecal space. The catheter placement will be confirmed with x-ray dye to insure proper position. The needle will then be removed and the catheter secured to your back with tape. A concentrated pain medication will then be injected through the catheter by your physician. Once the injection is complete you will be transferred back to the recovery room. Here you may walk around, have food/drink and basically “hang out” while we see if the intrathecal system will help relieve your pain. You may receive a second injection of medication in the recovery room and be asked to rate your improvement. Once it is determine that you have a substantial improvement in pain and an improvement in function, without side effects, the catheter will be removed. After observation you will be able to return home.
Intrathecal Pain Pump System Permanent Implantation – Once you have had a successful intrathecal pain pump system trial, you will be referred to a neurosurgeon to have the pump implanted permanently. This is a surgical procedure typically requiring hospital admission and specific instructions from your surgeon.