Intrathecal Pump Implant
WHAT IS INTRATHECAL PUMP IMPLANT?
An intrathecal pump is an implanted device used to deliver medication directly into the spinal canal. The pump is surgically placed under the skin of the abdomen, and a catheter is inserted into the intrathecal space surrounding the spinal cord. This treatment option is usually considered when other conservative treatments have been ineffective. It can be beneficial for patients experiencing post-surgery back pain, cancer pain, or neuropathic pain. Typically, the pump requires replacement every 5 to 7 years.
HOW IS THE PROCEDURE PERFORMED?
The intrathecal pump (ITP) implantation procedure is performed in a hospital theatre under specialised imaging guidance. You will receive intravenous sedation from an anaesthetist to help you relax during the procedure. A small incision is made in the back, and a flexible catheter is inserted into the spinal canal. This catheter is connected to a battery-operated pump placed under the skin of the abdomen. The pump is filled with the appropriate medication during the procedure, and its capacity can be either 20 ml or 40 ml, depending on your doctor’s recommendation.
WHAT SHOULD BE DONE BEFORE THE PROCEDURE?
Prior to the procedure, you may need to stop blood thinning products as directed by your doctor. Other regular medications can be taken with a sip of water on the morning of the procedure. Insulin-dependent diabetics will likely be prioritised on the list and should bring their insulin for potential administration after the procedure. Hospital staff will call you the day before the procedure to provide fasting and admission times. DO NOT eat, drink, smoke, or chew gum before the procedure. Arrange for someone to drive you home afterward, as you won’t be able to drive for 24 hours due to the received anaesthesia.
WHAT IS THE NEXT STEP AFTER THE PROCEDURE?
After the Intrathecal Pump (ITP) implantation, you will stay in the hospital for 1 to 2 nights, depending on your pain level. It’s essential to arrange for someone to drive you home after the procedure as you won’t be able to drive immediately following it. For the first 3 days post procedure, avoid showering. After day 3, you can shower as the dressings are waterproof, but leave all dressings on until your week 1 appointment with the nurses. Be cautious not to lift anything heavier than 2kg, bend, twist, or reach above your shoulders for 6 to 8 weeks post-op to allow your body to heal and prevent the catheter from moving out of place in your epidural space.
WHAT ARE THE RISKS AND SIDE EFFECTS?
Serious side effects and complications are rare. The most common problem after the procedure is having pain in the area of the procedure for 1 to 3 weeks. Please contact your local GP or the rooms if you have any allergic reaction to the medication administered in hospital, signs of infection at your procedure site.