Intrathecal Pump Placement

Intrathecal pain pump is a drug delivery system employed for administering medication directly into the spinal cord. This system comprises of a small pump which is surgically implanted beneath the skin of the abdomen, and the medication is delivered through a catheter to the affected area, close to the spinal cord.

The space around the spinal cord is known as the intrathecal space or subarachnoid space which is filled with fluid called cerebrospinal fluid (CSF). CSF is involved in providing nutrition and protection to the brain and spinal cord. This intrathecal drug delivery system is more efficient then oral medication, as it directly supplies the medication into the CSF present around the spinal cord.

The surgically implanted pump is a metallic device connected to a small plastic tube called the catheter that supplies the medication into the intrathecal space. The space within the pump works as a reservoir for the medication. The pump can be adjusted based on the condition and requirement of the patient to continuously release the medication, at the specified rate and for a pre-determined period of time.

Intrathecal pain pump is employed in patients when conservative treatment fails to be effective and a surgical approach may not be feasible. Before implanting the pump, safety, efficacy and any allergy to the medications is evaluated.

The intrathecal pain pump has been useful in alleviating pain and spasticity due to the following conditions:

  • Cancer pain
  • Failed back surgery syndrome
  • Reflex sympathetic dystrophy
  • Causalgia
  • Cerebral palsy
  • Multiple sclerosis
  • Stroke
  • Brain injury
  • Spinal cord injury

Risks and complications

The possible complications associated with the implantation of intrathecal pain pump are:

  • Infection
  • Bleeding
  • Spinal headaches
  • Blockage in the catheter
  • Leakage of CSF
  • Fluid accumulation around pump
  • Conditions such as meningitis
  • Spinal nerve root injuries
  • Side effects of the medications


HARVARD MEDICAL SCHOOL ASHPP PENN SIS AMA NASS aaPM&R ISASS - The International Society for the Advancement of Spine Surgery