Intrathecal administration is a method of introducing medication directly into the cerebrospinal fluid (CSF). This direct infusion bypasses natural process within the body that may stop other kinds of medication from passing into the brain. As a result, intrathecal administration of pain medication can offer fast and effective results.
What is an Intrathecal Pump?
An intrathecal pump is an implanted device that can provide a lifetime of pain relief without the potential side effects of oral opioid medication.
The pump is surgically implanted in the lower abdomen. Medication travels through a specially placed catheter and directly into the cerebrospinal fluid, providing relief.
This treatment may be prescribed for those who have often tried more conservative pain treatments and received little to no relief. A pump can also administer Baclofen medication to treat patients with spasticity.
What is required to try the device?
A trial is performed prior to the permanent implant to determine the effectiveness of the treatment. There are a few tasks that must be completed prior to beginning the trial:
- A physical therapy regimen within the last 12 months
- A one-time psychological evaluation
- A pre-operative history and physical evaluation from a primary care provider
- A trial education appointment with a Twin Cities Pain Clinic provider.
A prior authorization is also required by your insurance company before the trial can begin. We will assist in obtaining this authorization for you.
What can I expect during the trial?
You will receive sedation through an IV prior to the procedure. Once you are in the procedure room, the injection site will be cleaned and a local anesthetic will be used to numb your skin. The procedure is performed by a physician who will use an x-ray to place the catheter into the spine. The catheter will then be connected to a temporary, external pump.
You will be placed in an observation area for the rest of the day. During this time, a nurse and your physician will slowly increase the amount of pain medication you will receive through the pump. Once pain relief is achieved, the catheter is removed by a nurse and you will be asked to lay flat for one to two hours in observation. You should expect to be at the surgery center for six to eight hours.
The trial is considered a success if you begin to achieve pain relief and do not have any side effects to the medication. If you decide to pursue an implanted system, we will submit to your insurance company for authorization.
What can I expect during the implant surgery?
Prior to the implant surgery, you will also need to have an implant education appointment with your Twin Cities Pain Clinic provider.
The implant surgery is performed by a physician at an outpatient surgery center. After being admitted, you will receive sedation through an IV prior to the procedure. When you are brought into the procedure room, your skin will be prepped and cleaned prior to any incisions being made. Using x-ray and a small needle, the physician will place the permanent catheter for the pump into the intrathecal space of the spine. Once the catheter is placed, it will be connected to the pump internally.
The surgery is an outpatient procedure and you should plan on being at the surgery center for three to four hours.
What can I expect after the surgery?
You will receive an antibiotic to prevent infection. You will then be brought to the patient recovery area and monitored by a nurse until your anesthesia wears off. For your safety, you will need a driver to take you home.
There are certain activities that should be avoided for six to eight weeks after the surgery to prevent movement of the implanted catheter including bending at the waist, twisting, reaching overhead, and lifting more than five pounds.
You will return to the clinic three to fours days after the surgery for a visit with a nurse who will examine your incision site. Two weeks after the implant, you will return to the clinic to have the pump filled and programmed. A nurse will fill your pump with pain medication through a needle, using ultrasound to verify proper placement. Your provider may ask you to come to the clinic more often as they fine tune your medication dose.
The final step is to go out and enjoy your improved quality of life!
Schedule a consultation with Twin Cities Pain Clinic to discuss if an intrathecal pump can help with your pain.
RELIEVE YOUR PAIN, RENEW YOUR LIFE!