What is an Intrathecal Pain Pump?
An intrathecal pain pump is an implanted device that automatically delivers a small dose of pain medication directly to the spinal fluid. This direct infusion of medication offers consistent relief, while significantly reducing side effects. It also reduces the need for opioid pain medication.
Twin Cities Pain Clinic offers the Syncromed Pump by Medtronic.
This pump is made up of two implantable components: A catheter and an infusion pump.
The pump is surgically implanted in the lower abdomen. One end of the catheter is carefully inserted into the correct space between your vertebrae, while the other end is connected to the pump.
The pump delivers a small dose of pain medication to the spinal fluid at either a constant or variable flow rate. Your TCPC provider will determine which is best for you. Dosage adjustments are non-invasive and can be completed during an office visit.
To determine the effectiveness of the treatment, a pain pump trial is performed prior to implantation.
What is required to try the device?
There are a few tasks you will have to complete prior to beginning the trial:
- A physical therapy regimen within the last 12 months
- A one-time psychological evaluation
- A pre-operative history and physical evaluation from your primary care provider
- A trial education appointment with your TCPC provider.
A prior authorization is also required by your insurance company prior to the trial. We will obtain this authorization for you.
Our clinic works with a third party to ensure that this procedure will be covered by your insurance. Once you have completed the psychological evaluation and physical therapy, our clinic will send the necessary records to the reimbursement department. The reimbursement department will contact your insurance company or refer to the coverage policies in order to reach a decision on coverage. Our clinic requires an approval from the reimbursement department before we can schedule a trial.
Who is a candidate for the Intrathecal Pain Pump?
Pain pump candidates are those who have often tried more conservative pain treatments and received little to no relief. One of our specially trained providers can help determine if a pain pump is right for you.
What can I expect during the trial?
You will receive sedation through an IV prior to the procedure. You will be brought into the procedure room and laid on your stomach on a special table. Your skin will be cleaned at the injection site and a local anesthetic will be used to numb your skin. The procedure is performed by a physician who will use an x-ray to place the catheter into the spine. The catheter will then be connected to a temporary, external pump.
You will be placed in an observation area for the rest of the day. During this time a nurse and your physician will slowly increase the amount of pain medication you will receive through the pain pump. Once pain relief is achieved, the catheter is removed by a nurse and you will be asked to lay flat for 1-2 hours in observation. You should expect to be at the Twin Cities Surgery Center for 6-8 hours.
The trial is considered a success if you begin to achieve pain relief and do not have any side effects to the medication. If you decided to pursue an implanted system, we will submit to your insurance company for authorization.
What can I expect during the implant surgery?
Prior to the implant surgery, you will need to obtain a pre-operative history and physical evaluation. You will also need to have an implant education appointment with your TCPC provider.
The surgery is performed by one of our physicians at Twin Cities Surgery Center or Fairview Southdale Hospital. You will receive sedation through an IV prior to the procedure. You will be brought into the operating room and laid on your stomach on a special table. Your skin will be prepped and cleaned prior to any incisions being made. Using x-ray and a small needle, the physician will place the permanent catheter for the pain pump into the intrathecal space of the spine. Once the catheter is placed, it will be connected to the pump internally. The surgery is an outpatient procedure and you should plan on being at the Twin Cities Surgery Center or hospital for 3-4 hours.
What can I expect after the surgery?
You will receive an antibiotic to prevent infection. There are certain activities that should be avoided for 6-8 weeks after the surgery to prevent movement of the implanted catheter including bending at the waist, twisting, reaching overhead, and lifting more than 5 pounds.
You will return to the clinic 3-4 days after the surgery for a visit with a nurse who will look at your incision site. At this time you will be cleared to shower. Two weeks after the implant, you will return to the clinic to have the pain pump filled and programmed. A nurse will fill your pump with pain medication through a needle, using ultrasound to verify proper placement. Your provider may ask you to come to the clinic more often as they fine tune your medication dose.
You will be given a personal therapy monitor (PTM) which will allow you to see the date your pain pump needs to be refilled. If you provider chooses, the PTM also allows you the ability to give yourself a bolus dose of medication. You will need to have your pain pump refilled by a nurse at TCPC about once a month.
What is life like with an intrathecal pain pump?
The purpose of a pain pump is to reduce your pain and improve your quality of life, and it delivers in so many ways! Patients who have a pain pump are able to reduce or eliminate the need for oral pain medications. Since the pump is implanted, it is not bulky or inconvenient to carry around. And of course, your reduced pain will open up a while new world of possibilities and opportunities, allowing you to get back to doing the things you love.
Request an appointment today and see if an intrathecal pain pump can give you back the quality of life you deserve.