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Intrathecal “Pain” Pump

Intrathecal “Pain” Pump

If you’ve been researching potential solutions to chronic pain, you may have run across the term “intrathecal pump,” also known as a pain pump. Recently, the intrathecal pump’s popularity has risen among those in the medical field, but the general public still doesn’t know much about it. And for those dealing with chronic pain, it can be overwhelming to be faced with so much new information.

In hopes of lightening the load, this guide will discuss where an intrathecal pump is placed and how an intrathecal pain pump works, so you have all the information you need before making a decision. Read on to learn what exactly an intrathecal pump is, what benefits it offers and whether a pain pump could be right for you.

 

 

What Is an Intrathecal Pain Pump?

An intrathecal pain pump is a thin, flexible tube surgically inserted into an area around the spinal cord to deliver medicine that relieves certain types of chronic or cancer pain. The pump itself is a small, round metal device connected to the tube with a reservoir inside of it to hold the medication. The pain pump is programmed to incrementally release medication and gets surgically implanted under the abdomen’s skin.

The intrathecal pump gets its name from the space it’s inserted into between the spinal cord and the tissue covering the cord, which is known as the intrathecal space. The intrathecal space holds a liquid called cerebrospinal fluid (CSF), which is the receiver of the medicine that flows through the pain pump.

By administering medicine directly to the CSF, an intrathecal pump may help stop nerves along the spine from sending pain signals to the brain. This approach makes an intrathecal pain pump more effective than oral medication and only a fraction of the typical oral dosage necessary.

An intrathecal pump may help relieve the pain of patients who suffer long-term pain from these causes:

  • Cancer pain: Constant pain from tumors, which compress the spinal nerves, or from radiation therapy scarring.
  • Failed back surgery syndrome: Persistent leg pain despite one or more surgical procedures.
  • Chronic pancreatitis: Long-term abdominal pain due to the pancreatic duct being blocked or chronically inflamed.
  • Reflex sympathetic dystrophy: A nervous system disease that causes a constant burning pain.
  • Causalgia: Severe pain from a peripheral nerve injury.
  • Arachnoiditis: Scarring or inflammation of the meninges (protective layers) of the spinal nerves that leads to chronic pain.

A pain pump may also help decrease spasticity caused by these conditions:

  • Stroke: Damage suffered by the brain because of a lack of oxygen caused by an interruption to the blood supply.
  • Cerebral palsy: A nervous disorder that affects the ability to control body movements.
  • Multiple sclerosis: A brain and spinal cord disorder resulting from damage to the outer layer of nerve cells (myelin).

How Does an Intrathecal Pump Work?

Before being placed in a patient, an intrathecal pump is set up by the healthcare provider to store information about the patient’s prescription in its memory and dispense the proper amount of medication accordingly. Depending on the patient’s needs, the pain pump may be programmed to deliver different amounts of medicine at different points throughout the day.

The intrathecal pump is implanted beneath the patient’s skin, but the electronic device that controls the pain pump remains outside the body. The procedure to put the pump in place is an invasive surgery, so prospective patients must pass a trial of one injection, multiple injections or a catheter of the medicine they’d be receiving from the pain pump before having it implanted. If the responses to the medication are positive, the patient may proceed with the operation.

Here are the main steps of the intrathecal pump surgical process:

  1. Preparation: Before the day of surgery, a patient may go through pre-operation tests. On the day of surgery, patients are given anesthesia, and the insertion zone is prepped by shaving the area.
  2. Catheter placement: A small incision is made in the middle of the patient’s back to expose the vertebra’s arch. The catheter is inserted in the intrathecal space above the spinal cord and stabilized with sutures.
  3. Extension path: An extension to lengthen the catheter passes around the patient’s torso to the abdomen where the pump will be placed.
  4. Pump placement: Another incision is made along the side of the patient’s back or the abdomen to create a pocket for the pump. The pump is carefully placed between the skin and muscle layers and attached to the extension catheter.
  5. Pump positioning: The pump is secured under the skin and sutured to the thick layer of fascia. Finally, both incisions are closed, and dressing is applied.

After the initial surgery to implant the pain pump, the patient will need to schedule regular follow-ups because the reservoir of medicine within the pain pump will need to be replenished periodically. To refill the medication, a doctor or nurse inserts a needle through the patient’s skin into the pump’s fill port.

What do we do?

Providing a thorough diagnosis to know the cause of your pain

Using the least invasive procedure that will relieve your pain quickly

Providing effective follow-up to ensure fast recovery

Ensuring that you remain fit so that you can enjoy long-term relief from pain

Click to watch our patient success story: Anne
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Why Get an Intrathecal Pump?

Although undergoing the operation to have an intrathecal pump implanted is an intensive process, it comes with many benefits.

Here are the top five advantages of the treatment:

  1. Customizable: Intrathecal pumps can be programmed for a patient’s specific needs and may be changed at any time, depending on the patient’s level of pain.
  2. Fewer side effects: Programming pain pumps for a patient’s individualized needs can cut down on the adverse effects that often come with taking oral pain medication.
  3. Ditch pain medication: With an intrathecal pump, most patients can eliminate or at least greatly reduce the use of oral pain medication.
  4. Trial period: Patients go through a trial test before receiving an intrathecal pump, so they can have confidence in their decision.
  5. Impermanence: An intrathecal pump is in no way permanent and may be turned off or surgically removed at any time.

How Long Does an Intrathecal Pump Last?

Generally, a pump needs to be refilled every one to three months. At refill appointments, a patient can discuss with their doctor whether the dosage needs to be adjusted. The batteries within the pump last longer, about three to five years depending on usage, but require an entirely new pump because the batteries can’t be replaced however there is no need to replace the catheter.

Over the course of regular refills, a patient should be able to figure out the dosage right for them and experience a reduction in chronic pain. A patient’s results with a pain pump will vary, depending on the condition being treated and its severity, but spasticity control and the ease of daily activities should noticeably improve.

Who Is a Good Candidate for an Intrathecal Pump?

An intrathecal pump is a viable treatment plan for anyone who has tried conservative therapies, yet still experiences chronic pain. A good pain pump candidate has no other surgical options, no active or untreated drug addiction, no medical contraindications and no psychological conditions that implantable therapy could exacerbate. Finally, a good candidate for a pain pump has successfully gone through a drug trial for the pump.

Relieve Your Pain at Spine Institute of North America

If you’re wondering whether an intrathecal pump is right for you, contact Spine Institute of North America. We offer a unique combination of professional and personable service, so you can have an honest conversation about all your options with experts who will work to find the best treatment plan for you. Our physicians continually travel the world to further their education and training, so they can provide their patients with the most up-to-date medical responses.

At Spine Institute of North America, it’s always our goal to relieve your pain and revive your life. To figure out the best treatment option for you, call (609) 337-6496 today.

Sources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080496/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080496/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080496/
  4. https://www.upstate.edu/anesthesiology/pdf/procedures_morphine.pdf
  5. https://spineina.com/contact/
  6. https://spineina.com/our-providers/

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