What is Intrathecal Drug Delivery?
Intrathecal drug delivery, more commonly known as a “pain pump”, is a medical device developed by Medtronic. Pain pumps use a small, mechanic pumping device, implanted in the abdomen, to deliver pain medication directly to the spinal cord. By delivering medication directly to the spinal cord, medication is up to 300 times more effective than when taken orally. This treatment is typically recommended for patients that have experienced success with oral medication, however they are no longer able to control their pain.
What Does Intrathecal Drug Delivery Treat?
Intrathecal drug delivery systems treat chronic pain. The pain pump device slowly releasing pain medication directly into the intrathecal space of the spine over time, relief is much more consistent and effective. The device can be programmed to adjust throughout the day, as needs of the patient vary, allowing for customized pain relief.
How Does the Procedure Work?
For this minimally-invasive outpatient procedure, the patient is put under general anesthesia. The surgeon will make an incision in the lower back, and one end of the catheters is carefully guided into the intrathecal space of the spine using a fluoroscopy. During the whole procedure the patient is laying in a lateral position. While still in this position a second incision is made in the abdomen, where the mechanical device is inserted into place. The catheters are connected to the pump device, and the incisions are closed.
The incisions are closed by the surgeon, and the patient is monitored in a recovery room before being released. The patient will need someone to drive them home following the procedure. Patients may experience initial discomfort and limited movement, however and most patients may return to their normal routine within 24 hours, however any activity that can strain the spine, such as lifting heavy objects, should be avoided for up to 6 weeks.
The physician will be able to adjust medication received through the pain pump, based on feedback of the patient. The pain pump medication will need to be refilled approximately every 3 months, and an appointment will be made with your pain physician. The refill can be done in the medical office, rather than a surgical center.
What are the Risks?
Although the complication rate for the pain pump procedure is low, all surgical procedures have risk of infection, and procedures that uses general or local anesthesia have risks of anesthetic complications. The pain pump procedure is considered to be low risk, however complications including device malfunction, and a catheter moving or becoming blocked exist. The pain pump procedure is a minimally-invasive procedure, which has substantially lower risk of complications, including infection, when compared to open surgery. A battery replacement will be necessary every 5 to 7 years, depending on how much medication the pump delivers.
Benefits of Intrathecal Drug Delivery
Due to the effectiveness of drug delivery directly into the spinal cord, side effects from medication are minimized or eliminated fully. A trial epidural injection will be performed prior to implementing the pain pump, to verify that the pump will be effective for each eligible patient.
For more information about intrathecal drug delivery, visit Medtronic’s website at