Spinal Infusion System (Intrathecal Drug Therapy or ITD)

A spinal infusion system is a special pump that can be implanted to deliver pain-relief medication right into the spinal fluid through a catheter. This is a treatment method for patients experiencing chronic, intractable pain that has not been alleviated through more conservative methods. The spinal infusion system reduces a patient‘s reliance on oral medications because it can provide strong pain relievers directly to the pain receptors of the spinal cord to achieve substantial relief. The medication delivery is continuous, discontinuous, and augmented for each patient according to how the pain waxes and wanes.

Candidates for the Spinal Infusion System

Patients who may benefit from this pain medication delivery system include those with pain from cancer, post-laminectomy syndrome, reflex sympathetic dystrophy syndrome or severe osteoporosis. Typically, these patients cannot control their pain adequately with oral pain medication. The continuous infusion of pain medication into their spinal fluid is a more efficient pain-medication-delivery system.

The Spinal Infusion System Insertion Procedure

The spinal infusion system requires surgery for its insertion. The procedure is done as an outpatient and takes a few hours to complete. Sedation with local anesthesia is the preferred anesthetic to allow for return home that same day.

The patient‘s skin is cleaned with an antiseptic. X-ray imaging then guides the doctor to the precise location along the lower spine into which the needle with the catheter will be inserted. Once the catheter is inserted, it is anchored to the spinal ligaments. A tunneling tool is then used to create a path to the lower abdomen, where a pouch is created in the skin to hold the infusion pump. The pump is filled with the appropriate pain medication, placed within the pouch and connected to the catheter. The patient‘s surgical incisions are then closed and bandaged.

Risks of the Spinal Infusion System Insertion

The pump is filled with saline water initially until seen in the office for follow-up after surgery. It is then filled with the therapy drug that will produce pain relief.  Post-operative pain is adequately treated with ice and tylenol until seen in the office.

Other side effects may include:

  • Bruising
  • Headaches
  • Tingling
  • Temporary numbness or weakness

Uncommon side effects that are more serious may include bleeding or infection.

Results of the Spinal Infusion System Insertion

The medication in the pump typically lasts a couple of months. The pump can be easily refilled with a needle that is inserted into the pump chamber. The pump batteries usually last between 3 and 5 years, at which point the pump must be replaced.

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