It is a medical device that is used to deliver medicine directly into the area between the protective sheath that surrounds the spinal cord and the spinal cord itself. It is used to administer medication when the side effects of intravenous delivery or oral delivery of higher doses are great.
Why is it used?
There are several reasons why an intrathecal pump would be used. The first is for people who have spastic diplegia or another form of spasticity. The second is for patients who can’t handle the side effects of the higher dosed medication that they would take orally. The medicine would be administer through the device directly to the area.
How is it designed?
The intrathecal pump includes a metal pump that stores and administers the medication and a catheter that goes from the pump to the intrathecal area in the spine.
What type is best?
There are two different types of pumps that are available. The first is a constant rate pump that delivers the medicine repeatedly at a constant rate. The second is a programmable pump which delivers the medicine in accordance with what the computer program says.
How does it work?
The device is implanted into the patient’s body right under the skin. A catheter is used to deliver the medication to the site from the device. The surgeon will likely a temporary pump first to see if it makes a difference. If there is significant improvement in the management of their pain, a permanent pump can be implanted.
Why choose this device over just taking the medication orally?
One of the major reasons to choose the use of an intrathecal pump to administer pain medication instead of taken them orally is that when you take them orally, they diffuse throughout the body and it takes a lot more of the medication to ease the pain in the desired area. By using the intrathecal pump, the medication is administered directly where it is needed to help ease the pain. The surgeon will run the catheter to the exact location in the spine where the pain is located and the medication will then be pumped out of the device, through the tubing, and directly to the site.
Who would be a candidate for the implant?
This procedure is usually only done after other methods that are less invasive have failed. There are several procedures that a candidate would have to go through before the procedure is done. The first would be a psychological test to determine if the treatment is right. The second would be a trial test phase where the pump is tested out for a short period of time. The final step would be the permanent implant which would only occur after the trial if the desired results occurred.
How long will it last?
The medication in the pump last up to three months but really depends on how much medication is administered. It can be refilled using a tiny needle that is inserted through the skin and into the pump chamber. It will only take a few minutes to complete. The pump itself will only last as long as the battery does. The whole device will be replaced when the batteries run out every three to five years.
Abdulla, S., Vielhaber, S., Heinze, H., & Abdulla, W. (2015). A new approach using high volume blood patch for prevention of post-dural puncture headache following intrathecal catheter pump exchange. International Journal of Critical Illness & Injury Science, 5(2), 93-98. doi:10.4103/2229-5151.158395
Kochany, J. Z., Tran, N. D., & Sarria, J. E. (2013). Increasing Back and Radicular Pain 2 Years Following Intrathecal Pump Implantation with Review of Arachnoiditis. Pain Medicine, 14(11), 1658-1663. doi:10.1111/pme.12188