Intrathecal Infusion Pump for Pain Medications or Baclofen

An intrathecal pump, also known as a pain pump, is a surgically implanted device that delivers medication directly to the fluid surrounding the spinal cord. Medicine delivered in this way can interrupt irregular signals traveling through the nerves and spinal column to the brain. This information sheet will explain what it is, Dr. Singer can determine if it is for you.

What is a pain pump?
A pain pump is a small device, implanted with surgery, that allows direct delivery of medicine to the spinal cord and nerves. It consists of several parts, including a pump and reservoir placed in the abdomen (belly) and a catheter placed in the intrathecal space of the spinal cord.

The intrathecal space (sometimes called the subarachnoid space) is the area between the spinal cord and the thin, strong membranes that surround and protect it. The intrathecal space holds the cerebrospinal fluid that bathes the spinal cord. Infusing medication directly into this area helps it reach the spinal cord and nerves, where it can control pain or the abnormal muscle contractions that lead to spasticity.

Because the intrathecal pump delivers medication directly to this area, powerful relief can be achieved with a much lower dose (less than 1%) than what's found in pills or injections, which become diluted as they flow throughout the body in the digestive system or bloodstream. Using a pump may also reduce medication side effects common with long-term pill use.

In two studies looking at patients with cancer-related pain and pain from AIDS, researchers found that intrathecal pumps afforded greater pain control and more manageable side effects than traditional oral pills.

How does a pain pump work?
The parts of the intrathecal pump are placed in your body through a surgical procedure. There are several parts:

• A thin, flexible tube called a catheter is inserted in the intrathecal space surrounding the spinal cord.
• An extension catheter attaches to the catheter in the intrathecal space and goes around the torso.
• The extension catheter attaches to the pump, a round device that is about 1 inch thick and 3 inches across. The pump is implanted under the skin of the abdomen (belly). Dr. Singer will program the pump to deliver a measured dose of medication directly to the intrathecal space at specific times.
• Inside the pump is a hollow, refillable reservoir that holds the medication. When the reservoir is empty, it can be refilled with a needle.
• A personal therapy manager (PTM) device helps you give yourself an extra dose if you need it. Dr. Singer will program the PTM with the correct dosage amount so you can use it safely on your own. The PTM typically runs on two AA batteries: Make sure you have fresh batteries in the device, so it is ready to use if and when you need it.

What medications are used in an intrathecal pump?
An intrathecal pump may be used with opioid pain medications, anesthetics (numbing medications) or baclofen (a drug used to treat muscle contractions and ease spasticity).

Conditions Treated by an Intrathecal Pump
A pain pump may be recommended to address:

• Back or neck pain, including from compression fractures, disk pain, spinal stenosis or spondylosis.
• Pain that lingers after prior surgical procedures
• Abdominal or pelvic pain
• Extremity pain
• Complex regional pain syndrome
• Trunk pain, including postherpetic neuralgia (chronic pain that lingers after a shingles infection)
• Cancer pain, stemming from either the cancer itself or treatments such as chemotherapy
• Peripheral nerve injury pain
• Neuropathic pain
• Spasticity (muscle stiffening) due to stroke, multiple sclerosis, cerebral palsy or brain or spinal cord injury
• More rarely, other refractory (severe) chronic pain conditions, when more conservative pain therapies have failed

Who is a candidate for an intrathecal pump?
A pump may be appropriate for a person experiencing severe, long-term pain or spasticity that has not been relieved through other approaches such as pills, physical therapy or relaxation techniques.

Manufacturer's Information
Medtronic

This information is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.