Talk to your doctor about what you would like to achieve with your treatment. Your doctor will do a trial to determine whether a drug pump will provide adequate pain relief or help you meet your goals.
A trial is a way for you and your doctor to evaluate your response to the medication delivered into your spinal region, to see if you are a candidate for a drug pump.
This will vary depending on the type of trial your doctor feels would be best for you. The trial could take as little as one day, and up to 4 days. Depending on the type of trial, you may undergo a procedure that takes approximately 1 to 2 hours plus additional time to be monitored in the hospital after the procedure. Consult your doctor to understand the details for the type of trial he or she thinks would be best for you.
Before you are given the trial injection or the catheter is placed, your doctor may numb a small region of your lower back with a local anaesthetic.
This will depend on your doctor and your pain level. Your doctor may gradually reduce or withdraw your oral medication(s) 1 to 2 weeks prior to the trial.
If the trial has been successful and you go on to receive the implanted system, your pain relief may differ slightly. Be sure to tell your clinician about the way you feel so that changes can be made that will give you the best pain relief possible.
If you decide to proceed with targeted drug delivery, there will be a waiting period after the trial and before your implant procedure. This will give the incision in your back time to heal and for the surgery to be scheduled.
Typically, the implant is performed under general anaesthesia. However, you may wish to talk with your doctor about other options.
Depending on your doctor's preference and hospital policy, a 1- to 2-night hospital stay may be recommended.
On average, the procedure takes about 1 to 3 hours from start to finish. Talk with your doctor about the specifics and duration of your procedure.
There are two incisions. One is for the pump and is located in your abdomen. The size of the incision depends on the size of the device and could be up to 6 inches long. The other incision, made on your back, is 2 to 3 inches long.
Spinal cord injury may occur from surgical placement of the catheter.
Usually not. The incision needs to be made where the pump will be implanted to help properly anchor the pump. Proper anchoring helps keep the drug pump in place. This may help minimize your discomfort and speed recovery.
You will begin receiving treatment as soon as your pump is filled and programmed to deliver the prescribed amount of pain medication through the catheter into the intrathecal space. Keep in mind, however, that it takes time to achieve an appropriate balance between pain relief, progress toward goals, and managing side effects.
The medication in your pump needs to be refilled every 6 weeks to 6 months. The frequency of refills depends on the drug concentration and the amount of pain medication you receive every day. A higher dosage requires more frequent filling. The pump is refilled by a needle injection in your designated refill centre. During these appointments your doctor can adjust your dose of medication to address your pain relief needs.
Because your pump is placed near the surface of your skin for refill access, on occasion someone might notice a slight bump if you are wearing fitted clothes. However, depending on your size and shape, where the pump is implanted, and the size of your pump, it may not show under your clothes at all.
Yes. After implantation, your doctor can make changes in dosage requirements.
If you no longer need the pump or change your mind about the treatment, your doctor can turn it off or surgically remove the system.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.