Implantable Spinal Infusion Systems
Doctors have been experiencing the power of delivering medicine right onto and around the spinal cord for many years. Pain medicines given in this way can be used in much lower doses, and with a much greater beneficial effect. The side effects of these pain medications such as nausea and constipation are frequently minimized or eliminated, because the doses needed are so much lower.
Riverside Spine is recommending this therapy as a treatment for you to consider. Many of our patients with the most difficult pain problems, who are either not surgical candidates or who have failed surgery, can be offered hope and help with this technology. Please read on and prepare to discuss this therapy with your doctors and staff.
The Morphine Pump Trial
Initially, we perform a test infusion of pain medicine into the spinal fluid, to see if this therapy will be effective for your pain problem and if you can tolerate the medicine without allergy or side effects. This is only a short trial (less than a week) to give you an idea of what living with an infusion system might be like. For the trial, nothing permanent is installed, and there are no incisions. Initially a very thin catheter is placed under fluoroscopic (x-ray) guidance into the space around the spinal cord. This is done through a needle, and there is no incision necessary.
For complete sterility, we usually do this in the operating room. The procedure is done under local anesthesia with IV sedation if necessary, and is usually not painful.
It takes about 15 minutes to place the catheter successfully and secure it in place. The solution of medications, which is customized for you, will be started before we leave the operating room.
With the infusion system in place, we are ready to begin monitoring you for pain relief, and for resumption of gentle activity. Because this is strong medicine given in a powerful way, it will require ongoing medical attention. Side effects of therapy can include itching, problems with heart rate and blood pressure, problems with urination, problems with breathing, nausea, severe headache and others.
During your time in the hospital, you will remain with the tiny catheter and external pump system in place, continuously and slowly dripping pain medicine onto the spinal cord. The trial pump and medicine are carried externally in a waist pack, and you will be encouraged to walk around the hospital. You will be seen daily by Riverside Spine staff, and we will inspect the system for problems or infection, and make medication adjustments as necessary.
You will also be on a course of oral antibiotics. After a short time of therapy, you may notice that your ability to stand, walk and perform other activities is generally improved and that you have less reliance on your pain medicines. You should be keeping an accurate pain diary at this time. When the trial of spinal narcotics is finished, the catheter is easily and painlessly removed, and there is no incision scar. We will all have a good idea of whether or not this will be a helpful therapy for you on a permanent basis.
A Permanent Implant
If you’ve had a successful trial, and want to know more about what might lay ahead for you, read on. The permanent version of the spinal infusion system is an implanted pump, which is placed under the belly fat, connected to a small catheter which travels under the skin to the lower spine, and slowly releases your custom medication onto the spinal cord.
The entire system is under the skin, and once it is healed you can swim and do other activities. The pump can be easily refilled with medication using a small needle through the skin.
Spinal Administration of Narcotic Drugs
- Puts the medicine right where it is needed, and where it is most effective
- By minimizing the dose, minimizes the unwanted side effects of medications
- A variety of medications and combinations can be used to treat different pain qualities
- Offers you the latest technology available in a completely customized drug-delivery system
- Is a completely reversible therapy
- Provides you with better pain control, and usually the use of less oral pain medication!
More information, patient testimonials and images are available by visiting Medtronic drug pumps for pain.
Note: This information is intended as an educational supplement to a complete discussion with your physicians about this therapy, expected benefits and potential risks. A separate statement of informed consent is required.