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Spinal Pumps and Spinal Cord Stimulators

Pain Management Treatments for Chronic Pain

Peer Reviewed
Page: 1 of 2

After multiple spine surgeries, Michelle G. had so much back pain that she was taking 300 mgs of morphine per day to obtain relief. While the pain was finally bearable, Michelle suffered from loss of appetite, nausea, constipation, and severe lethargy. Ten years ago, Michelle had very little choice but to suffer with the side effects. Not so today. Michelle is a new person thanks to the amazing pain management technology now available to us. Michelle is taking only 1 mg of morphine per day with the improved pain relief, no side effects, and she leads a normal, happy life. Here's how: 

Intrathecal Spinal Pumps

Medicines taken orally get diffused throughout the entire body which means that a great deal of medication must be ingested in order to get the appropriate quantities to the place it is needed most to ease pain: the spinal cord. Now we have the ability to get that medicine to exactly where it's needed. By surgically implanting a pump under the skin of a person's abdomen, and running a catheter to the precise location in the spine where the pain is, we can pump medication directly into the spinal fluid, allowing for a much more potent effect on the spinal cord. This drastically cuts down the dose of medication that is needed, and the medication often provides even better pain relief with much fewer side effects.

Maintenance of the pump is fairly routine. The pump is refilled every 1 to 3 months by inserting a needle through the skin and through a diaphragm on the surface of the pump. Several medications can be administered this way, and even combinations of drugs might be used. Because the whole system is under the skin, the risk of infection is minimized and the patient can be fully mobile and active.

Obviously, a spinal pump should be considered only when more standard (and less expensive) treatments have not been effective or have caused intolerable side effects, but this is clearly a pain management advance that can directly improve the quality of life for chronic pain patients.

Updated on: 09/07/12
Iain Kalfas, MD
This article addresses the problem of intractable back pain and the role of intrathecal spinal pumps and dorsal column stimulators. Both options offer patients a reasonable degree of success at controlling severe back pain. However, they should be used only after all other approaches, both conservative and surgical have been considered.
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