Intrathecal Pain Pump Q&A

An intrathecal pain pump implant can help address long-term chronic pain. It is also known as Intrathecal drug delivery system (IDDS) or targeted drug delivery and provides precise amounts of medication directly to the fluid surrounding the spinal cord via a programmable pump. It sends pain medicine through a thin, flexible tube placed in the space around the spinal cord. The area between the spinal cord and the tissue (membrane) covering the cord is called the intrathecal space. This space contains a fluid called cerebrospinal fluid (CSF).

The tube is connected to a small, round pump. Both are implanted under your skin in a minor surgery. A small electronic device controls the pump which is programmed externally. The pump contains medicine and sends it through the tube into the CSF bathing the segment of the spinal cord believed to be relaying the pain.

What is it?

IDDS is a well-accepted interventional pain management modality used to control many chronic pain conditions. Very effective in cancer pain management, this modality has been shown to be effective in treating non cancer and neuropathic pain as well as spasticity. Baclofen, morphine and ziconotide are medications which are FDA approved for delivery through an IDDS. This is a nuanced system to deliver a precise quantity of the intended medication close to the spinal cord.

How does it work?

Implantation of this device is preceded by a simple trial. This entails having a simple injection of the intended medication in the CSF. This injection is X ray guided and your pain is observed in the period immediately following this injection. Based on relief of pain during this trial, we decide to proceed with implantation of the IDDS.

The intrathecal pump is programmed by Texas Pain Intervention Clinic. The type of medicine used in the pain pump will depend on the type of pain and other patient medical conditions. Typically, the pain pump is refilled with medication based on pain need and refill of the pump is required every 1 to 3 months. At follow up appointments, your providers at Texas Pain Intervention Clinic fill the pump with pain medication. The pump sends the medication through the catheter to the spinal area where pain receptors are located.

What are the advantages?

With the intrathecal pain pump, many patients are able to drastically reduce or eliminate their oral opioid medication and improve their quality of life. Targeted drug delivery systems provide effective pain relief by delivering medication directly to the fluid surrounding the spinal cord through a programmable pump at a much lower dose than oral medications thereby decreasing side effects. The pain pumps provide the following benefits:

• Improved ability to function and participate in day-to-day activities
  
• Effective pain relief
  
• Less or no need for oral pain medication
  
• Patient satisfaction
  
• Personalized, allows you to manage your own pain therapy by delivering a dose of medication within your medical pre-set limits.
  
• Surgically reversible