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Intrathecal Drug Delivery

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A patient suffering intractable pain from cancer and other neuropathic conditions may often receive only limited relief with standard medication therapy. That’s because many pain medications have side effects – such as sedation or nausea – when they are taken in doses high enough to manage pain. But when the dose is limited, the pain is not controlled.  

Fortunately, we can now offer some pain medications in an intrathecal pump, which delivers the drug directly to the spinal fluid. When released into the spinal fluid, a drug is far more effective than it is when given other ways – in fact it would take 300 mg of intravenous morphine to equal the pain relief of just 1 mg of intrathecal morphine.

Intrathecal drug delivery provides medication directly to the spinal fluid from a pump implanted under the abdominal skin. The medication in the pump lasts from two to three months and can be refilled easily in the pain clinic.

A pump can help lessen chronic pain caused by:

  • Failed back surgery syndrome: Failure of one or more surgeries to control persistent leg pain (sciatica), but not technical failure of the original procedure.
  • Cancer pain: Constant pain caused by tumors compressing the spinal nerves, or scarring from previous radiation therapy.
  • Complex regional pain syndrome: A progressive disease of the nervous system in which patients feel constant chronic burning pain.
  • Peripheral neuropathy

A pump can also help lessen spasticity (muscle rigidity and spasms that make movement of the arms and legs difficult) caused by:

  • Cerebral palsy: A nervous disorder that impairs control of body movement.
  • Multiple sclerosis: A disorder of the brain and spinal cord caused by damage to the outer layer (myelin) of nerve cells.
  • Stroke: Damage to the brain fromlack of oxygen due to an interruption of the blood supply.
  • Brain injury
  • Spinal cord injury

Reviewed by: Neel Mehta, M.D.
Last reviewed/last updated: December 2013