Intrathecal Drug Delivery

What is intrathecal drug delivery?

Intrathecal drug delivery uses a pump to deliver small doses of pain medication directly to the fluid surrounding the spinal cord via a small catheter. A catheter is a small, soft tube.

What is the advantage of intrathecal drug delivery?

Intrathecal drug delivery has been shown to be effective for patients with chronic, intractable pain not controlled with common pain treatments. Pain signals travel along the spinal cord to the brain. This intervention delivers pain medication directly into the intrathecal space (the area surrounding the spinal cord) to block pain signals. Therefore, only a small quantity of pain medication is required and fewer side effects are experienced when compared to taking oral medication.

Clinical studies have shown that patients who do not obtain adequate pain relief with high doses of oral pain medication can achieve significant pain control with intrathecal drug delivery.

Where is this pump and catheter placed?

The pump is surgically placed under the skin of the abdomen. The catheter is also surgically placed under the skin in your back. One end of the catheter is connected to the pump and the other end lies in the intrathecal space. The intrathecal space contains spinal fluid that bathes the spinal cord. Pain medication is delivered from the pump through the catheter into the spinal fluid.

What does the pump contain?

The pump contains medications for treating pain. These medications may be local anaesthetic, opioids or a combination of both.

What happens when the pump runs out of medication?

The pump has to be refilled with medication every 2 or 3 months, depending on how much you require a day. It is refilled during an outpatient visit and the process takes about 10 minutes.

What are some pain conditions that may benefit from intrathecal drug delivery?

It is important to discuss with your pain specialist whether your pain condition will respond to intrathecal drug delivery. Some conditions that have been treated with this intervention include cancer pain, chronic arachnoiditis, intractable abdominal pain and back pain. If your pain specialist thinks that you are a suitable candidate, he or she may perform a trial using a temporary intrathecal catheter to infuse pain medication. If you have good pain control to this test, your doctor will talk to you about a procedure to permanently implant a pump and catheter.