Intraspinal Pump Implantation and Management

What is an intraspinal catheter and pump implant, and when is it helpful?
Intraspinal catheters with subcutaneous pumps are typically used to manage chronic pain when more conservative pain management methods have failed or when the side effects of oral medication are severe. Intraspinal catheters bathe the sensory nerves of the spinal cord with a micro-dose opiate, anesthetic, or anti-spasmodic medication that relieves pain and/or muscle spasms. Further, by bypassing the organs through which an oral medication would pass, patients use less medication and avoid common side effects such as nausea, itching, and drowsiness.

What happens during the procedure?
We always perform a trial before implanting an intraspinal catheter and abdominal-wall pump. The trial is a simple outpatient procedure in which a temporary catheter is connected to a small external pump. The trial lasts about 7 days, during which we monitor the dosage of medication required to keep you comfortable and improve function. If the trial indicates that a pump will effectively reduce pain and muscle spasms, we proceed to implant a more permanent pump and catheter.

For an implant, an IV will be started to provide antibiotics and relaxation medication. Next, small incisions are made in the lower back and abdomen to place a flexible catheter into the spine and a programmable pump under the skin of the abdomen. We then insert the catheter into the epidural space of the spine. Once the pump and spinal are connected, the pump delivers anti-spasmodic or pain-relieving medication in a controlled fashion. We use the information gained during the trial to establish the dosage requirements. However, the amount of medication can be adjusted, and the pump reservoir will need to be refilled every several months.

What will happen after an intraspinal pump and catheter implant? 
An intraspinal pump and catheter implant will be an outpatient procedure. While you recover from the procedure, we will schedule a follow-up appointment and explain any limitations on your physical activity. Activity may be limited for a period of time after the procedure. For your own safety, you cannot drive the day of the procedure, so someone must drive you home. You should start feeling some relief in about 24-72 hours.