What is an intra-thecal pain pump?

An intra-thecal pain pump is a type of implantable device that is used to deliver very small doses of concentrated medication directly to the nerves in the spinal cord.  Intra-thecal pain pumps are a consideration for people who have chronic pain or cancer related pain that has not responded well to other types of therapy.

A small catheter is placed inside the spine where the nerves and spinal cord sit (intra-thecal space).  This catheter is then placed under the skin, and then connects to a small, round device called a pain pump.  The pain pump is placed under the skin of the belly.  The pain pump can be programed to each patient’s needs, delivering one or more concentrated medications directly to the nerves that are feeling pain.  Because this medication is delivered directly to the nerves that are hurting, the amount of pain medication needed to control your pain is drastically decreased compared to what would be needed if the same medicine was taken by mouth.  This helps the patient both have better pain control, and also helps reduce the risk of bad side effects strong oral or IV narcotics may have.

Who would benefit from an intra-thecal pain pump?

The most common reason a patient will have a pain pump would be because of chronic pain or cancer related pain.  Pain pumps are an FDA approved alternative when other chronic pain treatments have failed.

Patients who have pain that is not related to a cancer diagnosis must undergo a “pain pump trial” first.  During this 10 minutes procedure, a tiny needle is placed into the region of the nerves and morphine is injected.  The patient is then monitored to see the effects of the medication.  If the trial was very helpful to the patient, then an implanted pain pump would likely also give the same relief (or better).  Patients who have cancer related pain do not have to undergo the trial first.

Risks Involved

Our ability to use imaging guidance and cutting-edge technology minimizes patient risk.  Prior to your procedure, your physician will discuss any potential risks with you.

Conditions to let us know about

Let your doctor know if you currently are pregnant or breast feeding, feeling ill, have a fever, or are taking any blood thinners.

Insurance coverage

The placement of an intra-thecal pain pump is covered by most private insurance providers as well as Medicare. We will seek authorization from your insurance company prior to your procedure. A psychological assessment is a requirement by most insurance companies before authorization will be given for the trial or the implant itself.  This is easy to do, generally conducted by phone, and usually takes about an hour.

Preparing for your procedure

If you are on blood thinners your doctor will instruct you if you need to stop these medications prior to the procedure. If your procedure requires sedation, then you will need a responsible adult to give you a ride home.

Recovering from your procedure

You will receive moderate sedation during your procedure.  You will stay in the recovery area until you are ready for discharge. You will be given written post procedure discharge instructions that will advise you about return to normal physical activity. If you have any questions after your procedure, please call the RIA Endovascular Clinic at 303-930-2849, or the McKee IR nurses at 970-820-6178.

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