Intrathecal Pumps

Description

An intrathecal pump is a method of delivering medication directly to the spinal cord. The system is composed of a small pump that is surgically placed under the skin of the abdomen, as well as a catheter through which medicine is pumped to the area surrounding the spinal cord. A compartment inside the pump, called the reservoir, stores the medication. The pump can be programmed to release specific amounts of medicine at specific times of the day, as needed by the patient. When the reservoir is empty, a physician can refill it with medicine by inserting a small needle through the skin. A pump is highly efficient at delivering medicine to the spinal cord, requiring less than 1% of the dosage normally needed for oral intake. The procedure involves the following steps:

  1. Anesthesia is delivered by a board-certified anesthesiologist

  2. The catheter is placed into position

  3. An extension catheter is placed into position

  4. The pump is attached to the extension catheter and appropriately positioned

  5. The incisions are closed and a dressing is applied

Indications

An intrathecal pump is effective in alleviating pain due to the following:

  • Failed back surgery syndrome

  • Cancer pain

  • Reflex sympathetic dystrophy

  • Causalgia

  • Arachnoiditis

  • Chronic pancreatitis

The procedure is also used to reduce spasticity (muscle rigidity and spasms) caused by:

  • Cerebral palsy

  • Multiple sclerosis

  • Stroke

  • Brain injury

  • Spinal cord injury

Furthermore, a patient may be a candidate for an intrathecal pump if the following criteria are met:

  • Conservative therapies failed

  • Additional surgery will provide no benefit

  • Dependency on pain medication