An Intrathecal Pump, commonly referred to as a pain pump, may be recommended to relieve chronic pain or spasticity when more traditional methods to control your symptoms have failed or if the side effects of oral medications cannot be tolerated.
An Intrathecal Pump is an implantable device used to deliver small amounts of medication into the intrathecal space, which is the region of the spine that bathes the spinal cord in fluid. An Intrathecal Pump consists of a metal pump (about the size of a hockey puck) that stores and delivers the medication through a small plastic tube called a catheter, which transfers the medication from the pump to the intrathecal space. An external controller allows your physician to adjust and control the amount and frequency of medication delivered.
To determine if the permanent implantation of an Intrathecal Pump would be effective, your physician will usually perform a trial intrathecal injection or connect you to a temporary external pump. If the level of pain or spasticity significantly decreases during this trial period, a procedure will be scheduled to permanently implant the catheter and pump under the skin.
The procedure is performed under anesthesia in either a hospital or ambulatory surgery center. While lying on your side or stomach, the skin around the injection site is cleaned and numbed with anesthetic. Your physician will use a fluoroscopic X-ray machine to help position the catheter in the intrathecal space.
Once the catheter is in position near the targeted area, the catheter is sutured into place. A four to six-inch incision will be made to create a pocket for the pump in your lower back or most commonly in your abdomen below your waist. The catheter is connected to the pump, and the pump is then sutured or stapled into place. The incision will be closed with sutures.
After the procedure, you will be monitored for an hour or more as you recover. Any discomfort you experience from the implantation procedure will be treated with oral medication. You will need to have someone drive you home.
Within a few weeks, you should be able to return to most of your normal activities while experiencing minimal to no side effects from your medications. You will need to schedule regular appointments to have the pump’s reservoir refilled, which is done through a tiny needle at your doctor’s office. Depending on the brand of pump and the frequency and amount of medication delivered, the pump will need to be replaced in a number of years.