Intrathecal Implants for Chronic Pain

Overview
Intrathecal implants are pumps that are surgically placed in the body to deliver small doses of analgesics (painkillers) directly into the spinal fluid. Doctors may consider intrathecal implants in cases where more conservative pain relief techniques such as oral or injected medications are not effective or large doses of drugs are required for pain relief, surgery has been ruled out, and there is no present or past addiction. Intrathecal implants may be considered for many different types of chronic pain, including failed low back surgery syndrome.

What does it involve?
An intrathecal implant consists of a small, battery-powered, programmable pump that is implanted in the abdomen. The pump is connected to a catheter (tube) that is introduced into the spinal column.

If you and your doctor decide to consider an intrathecal implant, you may be asked to complete a trial of spinally injected analgesics for two to three days.

Surgery is required to implant the intrathecal pump.

The intrathecal implant might be used to deliver medications including local anesthetics, opioids such as hydromorphone, alpha adrenergic agents, and baclofen.

Recovery
Your doctor will tell you how long you can expect to spend recovering in the hospital.

Results
There is weak clinical evidence supporting the use of intrathecal implants for the treatment of chronic pain.

Constraints
An intrathecal implant may not be successful at reducing pain.

Any surgery carries risks including blood clots, blood loss, infection, breathing problems, reactions to medication, and heart attack or stroke during the surgery.

Complications specific to intrathecal implants including leaking spinal fluid, neurological injury including paralysis, pump failure, and an inflammatory mass forming at the tip of the catheter.