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What is Intrathecal Pump Implantation?

An intrathecal pump, or pain pump, is a device implanted surgically to administer medication directly into the fluid surrounding the spinal cord. This method is particularly useful for managing severe, chronic pain or spasticity that hasn’t responded to other treatments. The components of an intrathecal pump include a pump, a medication reservoir, and a catheter. The pump is programmed to deliver precise amounts of medication from the reservoir through the catheter into the spinal cord, where it can interrupt abnormal nerve signals effectively. 

Compared to oral or intravenous medication, this targeted delivery system is more efficient and requires smaller doses, reducing potential side effects. Two studies examining patients with cancer-related pain and pain associated with AIDS discovered that intrathecal pumps provided superior pain management and easier-to-handle side effects compared to conventional oral medications.

Diseases Cured by Intrathecal Pump Implantation

Intrathecal pump implantation can effectively treat a range of challenging chronic pain conditions. 

  • Back or neck pain, including from compression fractures, disk pain, spinal stenosis, or spondylosis.
  • Persistent pain following previous surgical procedures.
  • Abdominal or pelvic pain.
  • Extreme pain.
  • Complex regional pain syndrome.
  • Trunk pain, including postherpetic neuralgia.
  • Cancer pain from the cancer itself or treatments like chemotherapy
  • Pain resulting from peripheral nerve injuries.
  • Neuropathic pain.
  • Spasticity caused by stroke, multiple sclerosis, cerebral palsy, or brain/spinal cord injury.
  • Other severe chronic pain conditions that haven’t responded to conservative treatments.

How Does It Work?

During an intrathecal pump implantation, several components are surgically placed within the body. These include a catheter inserted into the intrathecal space surrounding the spinal cord, an extension catheter connecting to the main catheter and looping around the torso, and the pump itself. The pump, about 1 inch thick and 3 inches across, is implanted under the abdominal skin.

The pump is programmed by the surgeon to deliver specific doses of medication directly into the intrathecal space at scheduled intervals. It contains a refillable reservoir for the medication, which can be replenished with a needle when empty. Additionally, a personal therapy manager (PTM) device is provided to administer extra doses, if necessary, preset with the correct dosage by the doctor for safe use.

The PTM, powered by two AA batteries, allows patients to self-administer additional medication when needed, enhancing flexibility and control over pain management while ensuring the device is always ready for use with fresh batteries.

Post Recovery Care

Following intrathecal pump implantation, post-recovery care is crucial for optimal healing and pain management. After being monitored in the recovery room to ensure stability, you’ll likely be discharged home. The pump will be programmed to deliver medication continuously.

Expect some swelling or discomfort at the incision sites initially, which can be managed with prescribed pain relief. Your doctor will provide instructions on wound care, including when to remove bandages and how to shower safely.

You’ll receive an abdominal binder to support the pump site and aid in healing. Follow-up appointments with your surgeon are scheduled to monitor incision healing and overall progress.

During the initial weeks post-surgery, avoid heavy lifting, twisting at the waist, or exposure to extreme temperatures. These precautions promote proper healing and reduce the risk of complications, ensuring a smoother recovery and effective pain relief from the intrathecal pump.

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