An intrathecal pump is a medication pump which delivers drugs directly into the intrathecal space, also known as the subarachnoid space, within the spinal canal. The drugs in the pump go immediately into the cerebrospinal fluid (CSF) which bathes the spinal cord. This type of medication pump is generally recommended for patients with severe pain which cannot be treated by other means and patients who experience spasticity as a result of conditions such as multiple sclerosis. A variety of medications can be delivered with the pump.
Before a neurosurgeon will agree to place an intrathecal pump, usually the patient must pursue a variety of treatment options for management of his or her condition. If these options are not effective, a temporary intrathecal pump can be implanted for the purpose of determining whether or not the patient experiences relief. If the patient feels better, a surgery for a permanent implant can be scheduled.
There are two components to an intrathecal pump. The pump itself is implanted in the muscles of the lower back and it is connected to a catheter which enters the spinal canal. For placement of the pump, regional or general anesthesia is used. The catheter can be placed under local anesthesia. Some pumps are programmable, allowing them to be periodically adjusted.
Once the pump is placed, it will start delivering medication. Because the pump delivers drugs directly into the spinal cord, very low doses can be used. This allows patients to avoid many harmful side effects associated with higher dosages. Periodically, the patient must return for follow-up appointments to check the position of the pump, confirm that the programming is correct, and to refill the reservoir in the pump with a fresh supply of medication.
This medical device can greatly assist with pain management. However, there are some risks. The surgery carries risks of infections, nerve damage, and adverse reactions to anesthesia. The pump itself can fail, requiring replacement, and it or the catheter may also move. Sometimes patients experience leakages of CSF as a result of intrathecal pump use, and they may also experience other complications related to the condition which led to the placement of a pump in the first place.
When discussing the intrathecal pump as a pain management option, patients should ask their physicians about what kind of outcome to expect. They should also familiarize themselves with post-surgical care instructions and the signs of complications so that they can take adequate care of their pain pumps.