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YOU are here : Home > Spinecare Topics > Intervention - Spinal Disorders > Minimally Invasive Intervention for Spine Pain
Spinecare Topics
Intervention - Spinal Disorders
Minimally Invasive Intervention for Spine Pain
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Minimally Invasive Intervention for Spine Pain
Implanted Drug Delivery Systems
Background: Opioid drugs administered into space around the spine can help reduce pain associated with malignant and nonmalignant disorders. The use of drug delivery assistance has become a standard form of intervention in the field of pain management. Numerous studies have documented the chemical basis for pain reduction and pain relief produced by intraspinal administration of pharmaceutical agents such as opioids. There are numerous methods for accessing the intrathecal space for drug administration. These methods include placement of epidural and intrathecal catheters. The catheter is then linked with an adjustable flow rate pump, which essentially serves as a drug reservoir. The rate of drug delivery is determined by the programmed rate of the pump motor. Generally this programming is activated through a microprocessor. Telemetry units provide an opportunity for communication with an external programming unit.
Direct Indications for the Procedure: The use of intrathecal medication therapy for the purpose of pain management should be considered for patients for whom treatment with all conservative methods including the use of oral opioids has failed due to a lack of response or due to the presence intolerable side effects. The candidate should have a life expectancy of greater than three months and should a have confirmed good cerebrospinal fluid circulation allowing for adequate pharmaceutical agent migration. The procedure should only be used on individuals with chronic pain.
Chronic pain is generally defined as pain, which lasts longer than 3 or 4 months and is unable to be managed. Patient selection should also include the category or type of pain. A psychological evaluation could be an important part of the initial screening for implanted drug delivery system consideration.
Procedure: The implantation procedure can be accomplished under general or local anesthesia with monitoring. Local anesthesia is generally preferred in an outpatient setting because of the rapid recovery and lesser risk of adverse side effects. Prior to implantation a considerable amount to time should be spent with the patient to develop optimize the site of the pump. Generally the pumps are placed in the right or left lower quadrant of the abdomen. The patient is generally positioned on the operating table in the lateral position. Implantation is performed under image guidance usually with c-arm fluoroscopy.
Goals of The Procedure: The primary goals of the procedure are to reduce pain and to provide access for drug delivery in an attempt to achieve this outcome. Novel intraspinal drug delivery systems have rendered the delivery of intrathecal medication more manageable and safe.
Background: Opioid drugs administered into space around the spine can help reduce pain associated with malignant and nonmalignant disorders. The use of drug delivery assistance has become a standard form of intervention in the field of pain management. Numerous studies have documented the chemical basis for pain reduction and pain relief produced by intraspinal administration of pharmaceutical agents such as opioids. There are numerous methods for accessing the intrathecal space for drug administration. These methods include placement of epidural and intrathecal catheters. The catheter is then linked with an adjustable flow rate pump, which essentially serves as a drug reservoir. The rate of drug delivery is determined by the programmed rate of the pump motor. Generally this programming is activated through a microprocessor. Telemetry units provide an opportunity for communication with an external programming unit.
Direct Indications for the Procedure: The use of intrathecal medication therapy for the purpose of pain management should be considered for patients for whom treatment with all conservative methods including the use of oral opioids has failed due to a lack of response or due to the presence intolerable side effects. The candidate should have a life expectancy of greater than three months and should a have confirmed good cerebrospinal fluid circulation allowing for adequate pharmaceutical agent migration. The procedure should only be used on individuals with chronic pain.
Chronic pain is generally defined as pain, which lasts longer than 3 or 4 months and is unable to be managed. Patient selection should also include the category or type of pain. A psychological evaluation could be an important part of the initial screening for implanted drug delivery system consideration.
Procedure: The implantation procedure can be accomplished under general or local anesthesia with monitoring. Local anesthesia is generally preferred in an outpatient setting because of the rapid recovery and lesser risk of adverse side effects. Prior to implantation a considerable amount to time should be spent with the patient to develop optimize the site of the pump. Generally the pumps are placed in the right or left lower quadrant of the abdomen. The patient is generally positioned on the operating table in the lateral position. Implantation is performed under image guidance usually with c-arm fluoroscopy.
Goals of The Procedure: The primary goals of the procedure are to reduce pain and to provide access for drug delivery in an attempt to achieve this outcome. Novel intraspinal drug delivery systems have rendered the delivery of intrathecal medication more manageable and safe.
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