Center for Pain Management

Intrathecal Pump Implant

Intrathecal pumps are mechanical devices that deliver medications directly into a particular area of the spinal cord. These devices consist of a computerized pump, a catheter, and a resevoir. The resevoir can be filled with any of a host of medications including opioids, Clonidine, Baclofen, Bupivocaine and Ziconatide.

Studies show that there can be fewer side effects with intrathecal opioids than with oral medication. Drowsiness is improved, as are constipation and nausea. Improvement in pain control is particularly effective with multiple medications aimed at different parts of the pain control system.

Intrathecal medication delivery also has its drawbacks. Implanting a pump is not an inocuous procedure. There are functional and aesthetic pitfalls to consider. Implanting a pump causes significant cosmetic alteration at the implant site, that is unacceptable to many patients. Also to be considered is the fact that a pump is a mechanical device that is prone to problems ranging from glitches and mechanical compromise, to total mechanical failure. If a patient with a pump is in an accident, the pump can stop working and the catheter can be displaced. Emergency room physicians and personnel are usually not well versed in how to deal with pump patients.

While statistically it appears that oral delivery is just as effective as intrathecal delivery, it appears that for patients who have failed oral opioid treatment or received only limited benefit, a pump may prove more effective. If so, then the use of intrathecal opioids may prove to be more effective for the individual patient.