Intrathecal pain pump insertion is a procedure to help with pain management. A small pump will be inserted in your body. The pump will be able to deliver pain medication to the area around your spinal cord.
This pain management technique is often only used if noninvasive pain management has failed or has negative side effects. An intrathecal pain pump can be used to manage long-term pain problems caused by:
Many people have a significant reduction in pain and are better able to function in daily life after having an intrathecal pain pump insertion.
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Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:
Factors that may increase the risk of complications include:
Your doctor may do the following:
Before the surgery, you will undergo a trial to see if the pump will actually decrease your pain. Pain medication will be injected into the area around your spine one or more times. In some test trials, a catheter may be placed in the area around your spine. The catheter is then connected to an external pump. The proper placement of the catheter and ideal dose of medication for you will also be found in the trial period.
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Leading up to your procedure:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
General anesthesia may be used.
A small incision will be made in the middle of the back. The catheter is placed in a space near the spinal cord and secured with stitches. An x-ray machine will be used to make sure the catheter is in the right place. Once secured, the catheter is run from the spine to the abdomen where the pump is placed. The catheter is run under the skin.
After the abdomen is opened with a small incision, the pump is put in place below the waistline. The pump will sit in a pocket that is made between the skin and muscles. The catheter will be attached to the pump. After the pump is secured, stitches will be used to close the incision.
After the procedure, you will be taken to a recovery area. Your blood pressure, heart rate, and breathing will be monitored. The staff will watch for potential side effects, like:
About 3-4 hours.
You will be under anesthesia for the procedure. You should not feel pain. You will experience some pain after the surgery. It will be managed with medications.
After returning home, you should do the following:
You will need to carry an Implanted Device identification card because the pump will set off metal detectors. The battery in your pump will need to be replaced every 5-7 years. You will need to go for regular visits to your doctor to have the pump reservoir refilled with medication at regular intervals.
After arriving home, contact your doctor if any of the following occur:
Opioid withdrawal symptoms may include:
If you think you have an emergency, call for emergency medical services right away.
American Chronic Pain Association
American Academy of Craniofacial Pain
Canadian Pain Coalition
Canadian Pain Society
Intrathecal drug pump. Mayfield Spine Surgery Center website. Available at: http://www.mayfieldclinic.com/PE-PUMP.htm. Updated April 2016. Accessed June 20, 2016.
Knight KH, Brand FM. Implantable intrathecal pumps for chronic pain: highlights and updates. Croat Med J. 2007;48(1):22-34.
Last reviewed June 2016 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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