Intrathecal Pump
Intrathecal administration is a method of introducing medication directly into the cerebrospinal fluid (CSF). This direct infusion bypasses natural processes in 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.
The device used to administer medication in this way is called an intrathecal pump.
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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.
How can I get an intrathecal pump?
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 an intrathecal pump trial?
During the trial, a special needle is used to inject a small dose of pain medication into the intrathecal space. You will receive sedation prior to the procedure. Once you are in the procedure room, you will be laid down on a special table. A physician will then perform the injection.
You will remain at the surgery center for about an hour after the procedure. During this time, a nurse will have you carefully perform a few activities that would normally cause you pain. At the end of the hour, your pain levels will be assessed.
The trial is considered a success if you achieve at least 50% pain relief. If you decide to pursue an implanted system, we will submit to your insurance company for authorization.
What can I expect during an intrathecal pump 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.
Moving forward, you would return to the clinic as needed to have your pump refilled. How often you need to have your pump refilled will depend on the dosage being used in your treatment plan. Twin Cities Pain Clinic offers pump refills at all of our metro area locations.
Intrathecal pump therapy at Twin Cities Pain Clinic
Twin Cities Pain Clinic is one of an exclusive few organizations with specialized expertise in intrathecal pump therapy. Our highly skilled pain management providers use only the most current pump models and advanced techniques to ensure you receive optimal pain relief and maximum comfort.
An intrathecal pump can be utilized as a treatment for:
Schedule a consultation with Twin Cities Pain Clinic to discuss if an intrathecal pump can help with your pain.
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