Intraspinal Drug Infusion Therapy

Intraspinal Drug Infusion therapy (Implanted drug infusion therapy) is a technique that includes the permanent implantation of a pump that delivers medication at regular intervals, to a tube to painful areas of the spine. The procedure to put this system in place and then continue its use, is done in two stages. In the first stage, a temporary system is put in place where the pump itself is located outside the body. If after a short-term period the patient reports significant back pain or leg relief, the patient may elect for the second stage, where a permanent pump is inserted inside the body. The narcotic medication (typically morphine) delivered to the affected area of the spine via the pump and thin tube, is of a much lower dose than would be taken into the body via oral delivery (pill) but since it goes directly to the area of spine damage it may offer the same or better analgesic (pain reduction) benefit.

Why it's done: Typically, intraspinal drug infusion therapy is used as a last resort type of back pain treatment, after physical therapy and surgery have failed to produce benefits for the patient, or if the patient has had issues with drug dependence or narcotic medications. This treatment may work when other treatments, such as back surgery and radiofrequency radioblation, have failed. This type of treatment may be considered appropriate for patient's whose symptoms are restricted to the buttocks and lower back. Like spinal cord stimulation (SCS), patients who have finally arrived to the point where this procedure is being considered have usually had one or more failed back surgeries. The target of the medication is the spinal cord, and the medication is meant to block pain.



How it's done: The procedure to implant the device delivering the medication, as well as the tube, is similar to that used for SCS. Intraspinal drug infusion therapy is done in two stages: a first trial stage where a temporary external pump is installed, and a second stage where a permanent pump is inserted is the temporary pump is successful. The opening of the tube that feeds medication from the catheter terminates near the affected area of the spine thought to be causing the back pain. The first stage of intraspinal drug infusion therapy is usually done in a hospital. After the temporary system is implanted, the patient will be sent home for a few days and then will report back to the doctor as to the level of relief, if any, the device system provides. If the patient does report significant relief from back or leg pain, then a permanent pump will be inserted internally. Once the permanent device (the pump) is in place, it will remain in place as long as the patient elects to continue this type of therapy, and barring events such as infection related to the device in the body.

Prognosis: Though there are risks and side effects associated with this treatment system, it has helped patients to bring their pain down to tolerable levels when all other treatments options have failed. This is the only back pain treatment associated with narcotic medication that carries a low risk of drug dependence and addiction. This therapy system is more likely to be successful in bringing about significant pain relief when the patient remains committed to other forms of back pain treatments simultaneously, such as physical therapy, exercise, and lifestyle modifications.