Intrathecal Pump Implant ("Spinal Morphine Pump")
What is an Intrathecal Pump Implant ("Spinal Morphine Pump")?
An Intrathecal Pump is a specialized device, which delivers concentrated amounts of medication(s) into spinal cord area via a small catheter (tubing).
Am I a candidate for Intrathecal Pump Implant ("Spinal Morphine Pump")?
Currently at TPM, Intrathecal Pump is offered to patients with chronic and severe pain, who have not adequately responded to other treatment modalities. Some of the examples are failed back syndrome, cancer pain, and RSD. These patients receive infusion of painkillers such as Morphine or Dilaudid.
What is the purpose of it?
This device delivers concentrated amounts of medication into spinal cord area allowing the patient to decrease or eliminate the need for oral medications. It delivers medication around the clock, thus eliminating or minimizing breakthrough pain and/or other symptoms.
How long does the procedure take?
It is done in two stages. In the first stage, a single injection is made to assess effectiveness and screen for unwanted side effects. If this trial is successful in relieving symptoms, then the permanent device is placed under the skin. The patients have to meet certain other screening criteria before implanting the pump.
Will the procedure hurt?
The procedure involves inserting a needle through skin and deeper tissues (like a "tetanus shot"). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.
Will I be "put out" for this procedure?
The placement of the tubing is done under local anesthesia with patients mildly sedated. The amount of sedation given generally depends upon the patient tolerance.For the pump placement, patients are given stronger intravenous sedation and analgesia.
How is the procedure performed?
It is done with the patient lying on the side. Sometimes the tubing is placed with the patient sitting up. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needle for inserting the tubing.
Where is the tubing inserted? Where is the pump placed?
Tubing is inserted in the midline at the lower back. The pump is then placed on the side of the abdomen.
What should I expect after the procedure?
If the procedure is successful, you may feel that your pain may be controlled or quite less. The pump is adjusted electronically to deliver adequate amount of medication.
What should I do after the procedure?
This procedure is normally a day-procedure and patients are kept overnight for observation and pump adjustment.
How long will the pumps last?
The medication contained within the pump will last about one to three months depending upon the concentration and amount infused. It is then refilled via a tiny needle inserted into the pump chamber. This is done in the office or at your home and it takes only a few minutes.The batteries in the pump may last three to five years depending upon the usage.
Who should not have this procedure?
If you are on a blood thinning medication (e.g. Coumadin®), or if you have an active infection going on, you should not have the procedure. The patients also have to meet certain other screening criteria before implanting the pump.