Intrathecal Pain Pumps
Intrathecal pumps (ITPs) are devices which have shown to be effective in treating numerous chronic pains including cancer pain, severe back pain, neuropathic pain, and muscle spasticity to name a few. ITPs are automated pieces of equipment programmed to deliver medication into the spinal fluid through a small catheter. This pain relief technique has been shown to be both safe and effective.
The purpose of the pump is to interrupt pain signals that travel through the spinal cord. Patients perceive less pain when pain signals which normally travel to the brain are treated directly. Medication is delivered into the intrathecal space surrounding the spinal cord. The ITP delivers pain medication directly to the pain receptors in the spinal cord and smaller doses of medication are required to achieve relief.
ITP implants are considered after oral pain medications and other methods of pain control have been exhausted or proven ineffective.
An intrathecal medication trial is performed prior to placing ITPs. Medication is delivered to the spinal fluid. If pain relief is adequate an ITP can be permanently placed to control your pain.
Placement of the ITP can be performed in an outpatient setting or in the hospital. After a sterile scrub, local anesthesia is used to numb the needle entry location. Once the area is numb, a larger needle and catheter are placed into the intrathecal space using X-ray guidance.Once the catheter is in the proper location, the pump is then connected and placed under the skin on the lower part of your abdomen. The catheter and pump are tunneled under your skin, and all wounds are surgically closed.
The pump delivers pain medication such as opiates, local anesthetics, or muscle relaxants directly into the intrathecal space around the spinal cord. The medication reservoir in the pump is refilled every four to six weeks by your pain physician by injecting the medication through your skin into the pump.
The entire procedure typically takes one to two hours and may be performed as an outpatient or inpatient procedure.
ITPs can be used to treat a variety of painful conditions including nociceptive pain, or pain from tissue irritation. This can usually be effectively treated with uploads like morphine.
ITPs have been proven successful in neuropathic pain, peripheral or central nervous system pain, which tends to be more receptive to treatments with local anesthetics than opioids. Examples of neuropathic pain syndromes include complex regional pain syndrome or reflex sympathetic dystrophy, cancer pain, phantom limb pain, post herpetic neuralgia (shingles), carpal tunnel syndrome, failed back surgical syndrome, and peripheral neuropathy from diabetes mellitus or vitamin deficiencies.
Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.
Spasmodic pain can also be successfully treated by ITPs with anti-spastic muscle-relaxing medications like Baclofen. Spasticity may be caused by impairment in the brain or spinal cord and is seen in several conditions, such as stroke, brain injury, spinal cord injury, cerebral palsy, and multiple sclerosis.
As with any medication taken, there are always risks and potential side effects that may occur. All patients receiving a pump implant should be evaluated by their physician and risks of ITPs should be discussed.