Intrathecal Pain Pump Insertion

Compression Fracture

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Prior to Procedure

Your doctor may do the following:

• Physical exam
• Blood tests
• Electrocardiogram (ECG, EKG)
• Chest x-ray
• MRI of the spine

Before the surgery, you will undergo a trial to see if the pump will actually decrease your pain. Pain medicine will be injected into the area around your spine one or more times. In some test trials, a catheter may be placed in the area around your spine. The catheter is then connected to an external pump. The proper placement of the catheter and ideal dose of medicine for you will also be found in the trial period.

Cervical Injection

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Leading up to your procedure:

• Do not eat anything after midnight the night before your surgery, unless directed otherwise by your doctor.
• Arrange to have someone drive you to and from the procedure.
• Arrange for help at home after your procedure.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel or warfarin

Anesthesia

Local, spinal, or general anesthesia may be used.

Description of the Procedure

To place the catheter, a small incision will be made in your back. A small tube (called a spinal catheter) will be placed near your spinal cord. It will be secured with sutures. An x-ray machine will be used to help guide the catheter. The catheter will travel under your skin from your spine, around your torso, and into the abdomen. A pocket will be made under the skin of your abdomen. The pump will be placed into this pocket.

After the device is in place, you will be woken. The pump will be tested. The incisions in your back and abdomen will be closed with sutures or staples. The area will be covered with bandages.

After Procedure

After the procedure, you will be taken to a recovery area. Your blood pressure, heart rate, and breathing will be monitored, as well as any potential side effects, like:

• Sedation
• Slow breathing
• Constipation
• Itching
• Nausea and vomiting
• Headache
• Agitation

How Long Will It Take?

About 3-4 hours.

Will It Hurt?

You will be under anesthesia for the procedure. You should not feel pain. You will experience some pain after the surgery. It will be managed with medicines.

Post-procedure Care

After returning home, you should do the following:

• Avoid bending, twisting, stretching, lifting objects over five pounds, raising your arms above your head, sleeping on your stomach, climbing a lot of stairs, or sitting for long periods of time for 6-8 weeks.
• Avoid driving for 2-4 weeks after surgery.
• Do not do housework or yard work or resume sexual activity until you have had your follow-up appointment with your doctor.
• Gradually return to your normal activities.
• Walk short distances at first, and after 2 weeks, gradually increase to 1-2 miles daily.
• Ask your doctor about when it is safe to shower, bathe, or soak in water.
• Be sure to follow your doctor's instructions.