Intrathecal Drug Delivery
The Center for Neuromodulation offers intrathecal drug delivery, sometimes referred to as a "pain pump," to patients with intractable cancer pain or severe pain from benign causes such as post-laminectomy syndrome (otherwise known as failed back syndrome) or complex regional pain syndrome. Common medications used in intrathecal delivery systems to treat pain are lidocaine, morphine, and phenol.
Intrathecal drug delivery is also used to treat certain neurological conditions, such as cerebral palsy or spinal cord injury that can cause spasticity of muscles in the body. Baclofin is the drug most commonly used in intrathecal delivery systems to treat spasticity.
How Does Intrathecal Drug Therapy Work?
Intrathecal is a medical term that denotes the space between a membrane covering the spinal cord and the spinal cord. It is in this space that drugs are often injected before surgery or to relieve severe pain. This targeted delivery of drugs directly into the fluid that bathes the spinal cord (cerebral spinal fluid) allows patients who suffer from severe pain to get pain relief at much lower doses of medication than if administered orally or by systemic (body wide) injection.
Intrathecal drug delivery systems require a pump to be implanted into the patient’s abdominal area under the skin. The pump is attached to a catheter (tiny tube) that is inserted into the intrathecal space and emits small doses of medication at timed intervals. A physician programs the amount of medication that is released and the times it is released. Re-programming can occur as needed, to either lessen or increase dosages and time between doses based upon an individual patient’s responses.
The medication reservoir within the pump can hold enough medication to last for several months and can easily be refilled with a simple needle injection through the skin on an outpatient basis.
Benefits of Drug Delivery
“When patients reach dosages of pain medications during standard medical therapy that increase the side effects to untenable levels, intrathecal drug delivery is considered because we can achieve high levels of the drug right where it is needed with systemic side effects,” says Dr. Brian Kopell, Director of the Center for Neuromodulation at Mount Sinai Hospital.
Side effects for high doses of pain medications that are taken orally or given intravenously and travel throughout the body can cause the following:
By contrast, drugs delivered directly to the intrathecal space come in doses so low these side effects are rare, while pain control is often greatly enhanced.
Studies generally show that well over half of patients that receive intrathecal drug delivery for pain report increased ability to carry out daily living tasks and experienced lower levels of disability one year out.
Center for Neuromodulation
5 East 98th Street
New York, NY 10029