When conventional therapies have not relieved your pain, intrathecal pain therapy can provide pain relief directly into the spinal fluid. A small internal pump is used to deliver precise medication doses to relieve chronic back pain. The intrathecal pump system consists of a pump/reservoir and a catheter that carries medication to the spinal cord. It is about the size of a hockey puck. It is programmed by a specialized provider to slowly release medication into the spinal cord. Medication is placed in the pump through a needle/access port found on the pump, by your trained provider. Advantages to intrathecal therapy include less or no need for oral pain medication, fewer side effects compared to oral pain medications, and less risk for addiction. Patients will experience more efficient pain relief with intrathecal therapy in comparison to oral pain medications due to the pump’s ability to deliver medication directly into the cerebrospinal fluid, bypassing other organs seen with oral medications.
What to Expect With Intrathecal Therapy
After a thorough evaluation, you will undergo a trial by means of an injection of medication into intrathecal space. During the trial, if the effects are satisfactory, then intrathecal therapy is right for you. An advantage to the trial is to determine if your pain can be relieved before surgical implantation. If, at the end of the trial, your pain has been relieved, you can decide to pursue a permanent implant of an intrathecal pump.
It is important to discuss any medications you are taking before your procedure You will be asked to hold your anticoagulation therapy a certain number of days before the procedure to reduce your risk of bleeding. You may also be asked to stop other medications prior to and after the procedure. You will be instructed on when you can resume your medications.
You may experience numbness after your procedure. You will also receive IV (intravenous) sedation. So, it is important that you have someone to drive you home. You can expect some generalized soreness afterwards. You will be discharged home a few hours after the procedure.
During The Procedure
You will be taken to a surgical area and given IV sedation. Your procedure will be done with x-ray imaging (fluoroscopy) for accuracy. Your skin will be cleaned with a disinfectant, and the area is numbed for better comfort. The physician will make a small surgical incision in your back or stomach, just under the skin. A small catheter is inserted into the intrathecal space and secured to prevent dislodgment. The catheter will attach to the intrathecal pump device, similar to the size of a hockey puck. Your incision is closed with sutures. And, to prevent infection, a small pocket size device called a wound vac will be placed over your incision. This will be removed at your follow up visit.
After The Procedure
You can expect some soreness at the incision site. Your intrathecal therapy will be working when you wake up. You can expect to meet with an intrathecal therapy representative immediately following your surgery to discuss any concerns you may have. You will receive complete instructions and expectations from your physician following the procedure, along with a follow up appointment.