The goal of implanting a medication pump is to deliver pain medication directly to the fluid around the spinal cord, known as intrathecal space, providing significant pain relief with smaller doses of medication compared to oral intake. This method is particularly beneficial for managing chronic pain conditions or severe spasticity. The pump, a small round device, is surgically placed under the skin of the abdomen. A catheter connected to the pump is positioned to release medication directly into the intrathecal space.

How is the procedure performed?

The implantation of a medication pump involves a surgical procedure performed under general anesthesia. Initially, a trial is conducted to ensure that the patient will respond positively to intrathecal medication delivery. If the trial is successful, the patient proceeds with the pump implantation.

During the actual implantation procedure, the patient is placed under general anesthesia. The surgeon makes a small incision in the back to insert the catheter into the intrathecal space of the spinal cord. Another incision is made in the abdomen, where a pocket under the skin is created to securely place the pump. The catheter from the spinal cord is then tunneled under the skin to the pump located in the abdomen. Once the pump and catheter are correctly positioned, the pump is filled with medication, and the incisions are closed.

The pump is programmed to deliver a specified amount of medication at set intervals directly into the intrathecal space. Post-surgery, the patient is closely monitored, and pump settings may be adjusted as needed for optimal pain management. The medication reservoir in the pump needs to be refilled periodically through a non-invasive procedure, which involves injecting medication through the skin into the pump’s reservoir. This procedure is typically done in a doctor’s office.

The use of fluoroscopy or real-time X-ray might be involved during the placement of the catheter to ensure accurate positioning in the intrathecal space, although the exposure to X-ray is minimal. The precise delivery of medication via the implanted pump allows for effective pain management with reduced medication side effects, significantly improving the quality of life for patients with chronic pain or severe spasticity.