Intrathecal Pain Pump Insertion

(Pain Pump Insertion)

Michael Jubinville, MPH

Definition

Intrathecal pain pump insertion is a procedure to help you control pain. A small pump will be inserted in your body. The pump will be able to deliver pain medicine to the area around your spinal cord.

Reasons for Procedure

This pain management technique is used if other ways of easing pain hasn’t worked or has caused problems. The pump can be used to manage long-term pain problems caused by:

Many people have much lower pain after the pump is placed. They can also function better.

Compression Fracture

Compression fracture lumbar
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Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding
  • Infection
  • Headaches
  • Problems from the pain medicine
  • Problems with the catheter or pump
  • Nerve injury

Your chances of problems are higher for:

  • Having an infection
  • Allergies
  • You can't take certain medcines
  • Bleeding problems
  • Psychological problems

What to Expect

Prior to Procedure

Your doctor may do the following:

You will be tested to see if the pump will lower your pain. Pain medicine will be injected into the area around your spine one or more times. In some tests, a catheter may be placed in the area around your spine. The catheter is then connected to a pump outside of the body. The test will also let the doctor find the right place for the pump and dose of medicine.

Cervical Injection

Cervical epidural injection
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Leading up to your procedure:

  • Don't eat anything after midnight the night before your surgery.
  • Arrange for a ride.
  • Arrange for help at home.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week in advance.

Anesthesia

General anesthesia may be used.

Description of the Procedure

A small cut will be made in the middle of the back. The catheter is placed in a space near the spinal cord. It's then secured with stitches. X-rays are used to make sure the catheter is in the right place. The catheter is run from the spine to the belly where the pump is placed. The catheter is under the skin.

The belly is opened with a small cut. The pump is put in place below the waistline. The pump will sit in a pocket that is made between the skin and muscles. The catheter will be attached to the pump. The pump is secured. The cuts are closed and bandaged.

After Procedure

You will be taken to a recovery area. Your blood pressure, heart rate, and breathing will be watched. The staff also will watch for :

  • Slow breathing
  • Constipation
  • Itching
  • Nausea or vomiting
  • Headache
  • Agitation

How Long Will It Take?

About 3-4 hours.

Will It Hurt?

Anesthesia will keep you pain free. After the procedure, it can be controlled with medicines.

Post-procedure Care

To help you get better faster:

  • Take care of the wound to prevent infection.
  • Follow any limits on your activities.

Your healthcare team will teach you how to use your medicines safely.

You will need to carry an Implanted Device identification card because the pump will set off metal detectors. The battery in your pump will need to be replaced every 5 to 7 years. You will need to go for regular visits to your doctor to have the pump reservoir refilled with medicine at regular intervals.

Call Your Doctor

Call your doctor if any of these occur:

  • Redness, swelling, pain, or pus draining from the wounds
  • Fever or chills
  • Pain you can't control with the medicines you were given
  • Sudden back pain
  • Loss of bowel or bladder function
  • Headache lasting longer than 48 hours
  • Beeping noises from pump
  • New leg weakness and spasm
  • New numbness or tingling
  • Nausea or vomiting
  • Cough, breathing problems, or chest pain
  • Side effects from the medicines

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Chronic Pain Association
http://www.theacpa.org
American Academy of Craniofacial Pain
https://www.aacfp.org

CANADIAN RESOURCES:

Canadian Pain Society
https://www.canadianpainsociety.ca
Health Canada
https://www.canada.ca

References:

Intrathecal drug pump. Mayfield Brain & Spine website. Available at:
...(Click grey area to select URL)
Updated April 2016. Accessed August 23, 2018.
Intrathecal drug pump implant. UPMC website. Available at:
...(Click grey area to select URL)
Accessed August 23, 2018.
Knight KH, Brand FM. Implantable intrathecal pumps for chronic pain: highlights and updates. Croat Med J. 2007;48(1):22-34.
Last reviewed May 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 8/23/2018

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