Intrathecal pump

From Wikipedia, the free encyclopedia

Intrathecal pump is a medical device used to delivery very small quantities of medications to the spinal fluid. Medications such as morphine, ziconotide, or baclofen may be delivered in this manner to minimize side effects associated with oral medications, since the amount of medication needed to achieve therapeutic efficacy is much less than that required by the oral route. Intractable pain and spasticity (such as spastic diplegia) in patients who cannot tolerate oral medications are potential candidates for an intrathecal pump.

The intrathecal pump consists of a metal pump, which stores and delives the medication, and a catheter, which delivers the medication from the pump to the intrathecal space where the medication takes effect. Two types of pumps are available: a constant rate pump delivers the medication at a constant rate, and a programmable pump delivers the medication according to a rate determined by a computer program which is changeable.

The implantable medical device requires a surgical procedure; a surgeon usually performs a trial intrathecal injection or a temporary intrathecal pump to determine if the medication works to begin with, and thus if a pump is appropriate. A permanent intrathecal pump is implanted if the patient derives at least 50% improvement in his or her symptoms. Complications include infection and bleeding during the surgery, spinal cord injury during the surgery, catheter fracture or migration, and in extremely rare cases, death during the surgery or from withdrawals or overdose from medication.

Currently only Medtronic manufactures programmable intrathecal pumps in the United States.