The Spinal Infusion Pump

A spinal infusion pump is a device that delivers concentrated amounts of opioid medication via a small catheter directly into the spinal fluid where the pain receptors in the spinal cord originate. It does this by pumping medication from the reservoir through a catheter into the spinal canal.

An Option for Patients with Difficult Pain Diagnosis

This device may be appropriate for some people living with severe, long-term chronic pain or spasticity that has not responded to other methods, including medications, injections, physical therapy, chiropractic care, or surgery.

How Do They Work?

Spinal infusion pumps are similar to spinal cord stimulators in that they are surgically implanted under the skin, but they differ in that medication, rather than electrical signals, is used to ease pain.

Its parts include a pump, a medication reservoir and a catheter. The pump is programmed to deliver small amounts of medication directly to the central nervous system.

How effective is the Spinal Infusion Pump?

Patients report a reduction in pain scores after receiving targeted drug delivery.

• 51% of patients completely eliminated other opioids* at 12 months.
• 87% of patients rated their quality of life as fair to excellent.

Is it Safe?

Because the spinal infusion pump delivers medication directly to the origin of pain, powerful relief can be achieved with much lower doses (less than 1%) than required with oral or IV medications, which become diluted as they flow throughout the body and are metabolized in the liver. This makes the pump delivery much safer, reducing harmful side-effects such as stomach discomfort, nausea, constipation, cognitive impairment, and addiction.

Trial and Pump Implant Procedure

The procedure is completed in two stages. The first stage is the trial and the second involves implanting the permanent device. During the trial you will receive a single shot of medication in the spinal fluid that surrounds your spinal cord. This is a quick procedure, done in the doctor’s office. The diagnostic spinal injection is simple and causes minimal discomfort. You go home shortly after the injection.

If the trial is successful, you will be scheduled for spinal infusion pump implant. The pump implant procedure usually takes one to two hours. You are give either sedation or general anesthesia to make you comfortable during the procedure.

• During the procedure a catheter is precisely placed in the spinal space corresponding to the origin of your pain.
• A pump reservoir that holds the medication is placed under the skin of your flank or abdomen.
• Medication flow is started once the catheter is connected to the pump.

The surgery is an outpatient procedure and you go home the same day.

Spinal Infusion Pump Side Effects and Complications

Having a pain pump is safe and has significantly less side effects than oral or IV pain medication. Complications are rare, but can include:

• Infection
• Bleeding
• Cerebrospinal fluid leak—a temporary leak of spinal fluid that may result in a headache.
• Mechanical problems with the pump or shifting of the device after strenuous exercise that may require repositioning or replacement

How is a Spinal Infusion Pump Refilled?

Approximately every three months, you will return to your pain doctor to have the pump refilled with medication. Sometimes these refills can be performed at home through a skilled nursing service under the guidance of a physician. The provider will remove any remaining medicine from the pump’s reservoir with a needle and then inject new medicine into the reservoir.

What to Expect Once You Have a Pump?

• We will work closely with you to make adjustments and fine tune the medication dosage so its just right for you.
• You may receive an optional remote control which allows extra doses of pain medicine when needed.
• Follow-up visits about every 3 months, to refill your pump medications, and check pump function.
• Although most patients prefer to have a pump for the remainder of their life, a pump can be removed if your painful condition improves to the point you no longer need treatment.

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