Intraspinal Delivery System

In certain pain and spasticity conditions, it is advantageous to deliver medications directly into the spinal canal rather than orally (taking pills by mouth). This therapy is designed to increase the effectiveness of the medication and decrease potential side effects.

Not all patients suffering from chronic pain or spasticity will benefit from an intraspinal delivery system. To determine if you are a candidate, a trial procedure is necessary. This is accomplished in the operating room at Tallahassee Memorial Hospital. During the trial, you will be placed face down (prone) on the procedure table and given light sedation. You have to be awake enough to communicate with the surgeon. The surgeon will use an x-ray machine to visualize your spinal anatomy. Next, you will be given a local anesthetic to numb your skin and subcutaneous tissues. After that, a special needle will be placed into the spinal canal. The medication will then be injected into the spinal fluid. After the needle removed and the procedure is over, you will be admitted to the hospital overnight for observation.

You should feel significant pain relief or a decrease in spasticity during the trial. Based on the results of the trial, a decision will be made whether or not to proceed with implantation. Intraspinal delivery systems can significantly decrease pain or spasticity, but as with any surgical procedure, there are risks involved. These include infection, bleeding, injury to the spinal cord, equipment failure, or future lack of benefit.

Before the surgery, you will be made aware of the cosmetic changes from the implantation. The medication reservoir/pump has the same shape as a hockey puck, although slightly larger. This is implanted in your abdomen, just underneath your skin and on top of the abdominal musculature. Depending on the amount of fatty tissue present, the profile of the implant may range from relatively flat to a significant bulge.

In addition, you will be informed of the “maintenance” involved with intraspinal delivery systems. The electronic pump/reservoir only holds a limited amount of medication, and it will need to be refilled approximately every 4–8 weeks. For refills, the reservoir is accessed via a needle that’s placed through the skin. Any remaining old medication is removed and new medication is added.

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