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Intrathecal Pumps – Trial and Implant

An intrathecal pump is used to relieve chronic pain. The pump, placed under the skin of the abdomen, delivers a targeted dose of pain medication into the spinal cord blocking pain signals from being perceived by the brain. This pain management technique often reduces the amount of medication required to alleviate pain compared to an oral agent.

Before implanting a pump, a trial is done to determine the effectives of the intrathecal pump. If the trail pump relieves a patient’s pain by 50 percent or greater, a permanent pump is placed.

Intrathecal pumps are ideal for patients who have not benefited from more conservative pain management therapies. An intrathecal pump is reversible and can be removed at any time.

What Happens during Intrathecal Pumps?

Prior to starting the procedure, the patient is given sedative anesthesia and the area is prepped for surgery.

The implantation procedure is performed in two parts. First, a catheter is placed in the intrathecal space surrounding the spinal cord. A small incision is made in the middle of the back where the catheter is placed above the spinal cord and secured into place. Second, the pump is placed in the abdomen. An extension catheter is moved down the spine and into the abdomen where the pump will be implanted. A small incision is then made in the abdomen, just below the waistline. The pump is secured in a pocket between the skin and muscle layers. The pump and extension catheter are then attached. After the pump is attached to the fascia layer overlying the stomach muscles, the incision is closed and a dressing is applied.

Possible Side Effects & Risks

Although complications are rare, some side effects include:

  • Infection
  • Bleeding
  • Swelling at the surgical site
  • Difficulty urinating
  • Accumulation of fluid around the pump
  • Consistent and severe headache
  • Increased pain or weakness

Post-Operative Care

Patients will receive post-operative care instructions from their physician immediately following surgery.

Patients are observed for a few hours after the procedure, but are generally discharged the same day. Oral pain medication is recommended for the first few weeks after surgery.

Bending, stretching, stair climbing or any strenuous exercise is prohibiting for up to 8 weeks after the pump is implanted. Driving is also not recommended for 2 to 4 weeks after the procedure. Patients are advised to gradually return to normal activity with input from their physician.

Possible Outcomes

Intrathecal pumps for pain management are generally very successful in reducing chronic pain. Patients may experience a decrease in pain, rigidity and muscle spasms. Patients may also reduce their dependence on oral pain medication.