Intrathecal Pain Pump Insertion
(Pain Pump Insertion)
Definition
Intrathecal pain pump insertion places a small pump in the body to deliver pain medicine around the spinal cord.
Reasons for Procedure
This procedure is done to manage long-term pain from problems such as:
- Failed back or neck surgery
- Vertebral compression fracture
- Phantom limb pain
- Cancer
- Complex regional pain syndrome (CRPS)
- Arachnoiditis—inflammation of a space around the spinal cord
- Chronic pancreatitis
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Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Problems from the pain medicine
- Problems with the catheter or pump
- Nerve injury
Things that may raise the risk of problems are:
- Smoking
- Alcohol use disorder
- Chronic diseases, such as diabetes or obesity
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging tests
A test will also be done to see if the pump will lower pain. Pain medicine will be injected into the area around the spine one or more times. A catheter may be placed in the area around the spine. The catheter is then connected to a pump outside of the body. The test will also let the doctor find the right place for the pump and dose of medicine.
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
A small cut will be made in the middle of the back. A catheter (tube) is placed in a space near the spinal cord. It is secured with stitches. X-rays are used to make sure the catheter is in the right place. The catheter is guided to the belly.
A small incision is made in the belly. The pump is placed below the waistline in a pocket that is made between the skin and muscles. The catheter will be attached to the pump. The pump is secured. The incisions are closed with stitches. Bandages are placed over the area.
How Long Will It Take?
About 3 to 4 hours.
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicine
- Teach you how to use the pain pump
- Give you an implanted medical device identification card to show when going through medical detectors
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It will take 6 to 8 weeks to recover. Physical activity may need to be limited during this time. You may need to ask for help with daily activities and delay return to work for a few weeks.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, or discharge from the incision
- Pain that you cannot control with medicine
- Leg numbness or weakness
- Beeping noises from the pump
- New or worsening symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Chronic Pain Association
https://www.theacpa.org
American Academy of Craniofacial Pain
https://www.aacfp.org
CANADIAN RESOURCES:
Canadian Pain Society
https://www.canadianpainsociety.ca
Health Canada
https://www.canada.ca
REFERENCES:
Cancer pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cancer-pain. Accessed November 23, 2020.
Swarm RA, Anghelescu DL, et al. Adult Cancer Pain. Version 1.2015. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2015 Mar.
Understanding an intrathecal pain pump implant. Saint Luke's website. Available at: https://www.saintlukeskc.org/health-library/understanding-intrathecal-pain-pump-implant. Accessed November 23, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 4/21/2021