An intrathecal pump (shown in the top illustration) is a drug delivery system, also known as a pain pump. It’s about the size and shape of a hockey puck. Surgically implanted under the skin of your abdomen, the pump sends preprogrammed amounts of medication right where you need it, such as around your spinal cord, through a plastic tube called a catheter.
An intrathecal pump is more efficient than taking oral medication because it delivers medicine directly, so it uses a much smaller dosage. The pump also helps reduce side effects from the prescribed drugs.
Candidates for the pump implant include those for whom a conservative approach has failed to relieve chronic pain and surgery is not likely to help. An intrathecal pump implant is considered pain management therapy since it does nothing to address the cause of your pain. While the catheter is permanent, you can have the pump surgically removed.
As shown in the second illustration, an intrathecal pump relieves chronic pain by delivering small amounts of medication directly to the intrathecal space: the area surrounding your spinal cord. This therapy prevents pain signals from reaching your brain. The pump contains a refillable reservoir that holds the medication. The procedure is detailed below. Talk to your surgeon about your risks and recovery expectations.
1. CONNECTING THE TRIAL SYSTEM
A board-certified surgeon administers a local anesthetic and then inserts a temporary catheter through a needle or small incision into the intrathecal space around your spinal cord. This catheter is connected to a temporary pump that you will use for a several-day trial period. If it effectively decreases your pain, you may be ready for the permanent system.
2. IMPLANTING THE PERMANENT CATHETER
Your surgeon usually performs this second procedure while you are under general anesthesia. He or she will remove the temporary catheter and implant the permanent catheter, again through a needle or incision.
3. IMPLANTING THE INTRATHECAL PUMP
While you are still under anesthesia, your surgeon implants the pump under the skin, usually in the abdomen (per the bottom illustration). He or she then connects the catheter to the pump. The pump’s battery lasts three to five years, although you can have a new pump implanted.
4. RECOVERING FROM THE PROCEDURE
After surgery, you may experience some mild discomfort and swelling at the incision sites for several days. Your pump is programmed to release medication over a specific period of time. You need regular doctor visits to refill the pump’s reservoir. Over time, the catheter may move enough to require repositioning. Strenuous activity can damage the catheter or the pump, leading to replacement surgery.