Intrathecal Pain Pumps
Intrathecal drug delivery (“pain pump”) is more commonly used for cancer-related pain and delivers the drug directly to the central nervous system (CNS). The intrathecal catheter is typically placed below L1, and depending on the location of interest, the radio-opaque catheter tip is advanced under direct visualization via fluoroscopy to a specific spinal level. It is best to place the catheter at the most optimal anatomical location to cover the patient’s pain. It is common to place the catheter higher in the intrathecal space than is necessary as the catheter can always be adjusted without unnecessary dural puncture. The system uses a small pump that is surgically placed by your physician under the skin of your abdomen and delivers medication through a catheter to the area around your spinal cord. A pain pump may be a treatment option if all other traditional methods have failed to relieve your long-term symptoms.
Who Can Benefit from Intrathecal Pumps?
Intrathecal pumps may be used for patients who suffer from an array of severe chronic pain conditions including post-laminectomy pain syndrome (persistent pain after back surgery) and cancer pain. Intrathecal pumps may also be used to treat spasticity associated with multiple sclerosis. Before the intrathecal pump implant, our physicians will perform a trial to assess if the pain pump will be effective for the patient. The drug being delivered intrathecally is typically an opioid used alone, or an opioid combined with a local anesthetic. As the medication is reaching the spinal cord directly, a smaller dose is generally needed for the pain pump than an oral medication would need.