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Intrathecal Pump Insertion Gallery

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>> Intrathecal Pump Insertion

Introduction:
Intrathecal pain pump insertion is a procedure to help with pain management. A small pump will be inserted in your body. The pump will be able to deliver pain medicine to the area around your spinal cord.
What is Intrathecal Pump Insertion?
A spinal cord stimulator (SCS), also known as a dorsal column stimulator, is a device surgically placed under your skin to send a mild electric current to your spinal cord (Fig. 1). A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord. When turned on, the stimulation feels like a mild tingling in the area where pain is felt. Your pain is reduced because the electrical current interrupts the pain signal from reaching your brain.
Stimulation does not eliminate the source of pain, it simply interferes with the signal to the brain, and so the amount of pain relief varies for each person. Also, some patients find the tingling sensation unpleasant. For these reasons a trial stimulation is performed before the device is permanently implanted. The goal for spinal cord stimulation is a 50-70% reduction in pain. However, even a small amount of pain reduction can be significant if it helps you to perform your daily activities with less pain and reduces the amount of pain medication you take. Stimulation does not work for everyone. If unsuccessful, the implant can be removed and does not damage the spinal cord or nerves.

Intrathecal Pump Insertion
 

There are many types of stimulation systems. The most common is an internal pulse generator with a battery. A SCS system consists of (Fig. 2):
An implantable pulse generator with battery that creates electrical pulses.
A lead with a number of electrodes (4-16) that delivers electrical pulses to the spinal cord.
An extension wire that connects the pulse generator to the lead.
A hand-held remote control that turns the pulse generator on and off and adjusts the pulses.
The battery inside the pulse generator delivers low voltage and needs to be surgically replaced every 2 to 5 years if it is a standard battery. Rechargeable battery systems may last up to 10 years, depending on usage. Your doctor will select the best type of system for you during the trial stimulation.

The pulse generator is programmable by the doctor and has three settings:
Frequency (rate): number of times stimulation is delivered per second. Too few results in no sensation. Too many results in a washboard or bumpy effect.
Pulse width: determines size of area stimulation will cover.
Pulse amplitude: determines threshold of perception to pain.
Causes
This pain management technique is often only used if noninvasive pain management has failed or has negative side effects. An intrathecal pain pump can be used to manage long term pain problems caused by: Failed back or neck surgery syndrome Compression fractures Phantom limb pain Cancer Reflex sympathetic dystrophy nervous system disease Causalgia burning pain due to peripheral nerve injury Arachnoiditisinflammation of the spinal nerves Chronic pancreatitis inflammation of the pancreas Many people have a significant reduction in pain and are better able to function in daily life after having an intrathecal pain pump insertion.

How Do I Prepare for Intrathecal Pump Insertion

Your doctor may do the following: Physical exam Blood tests Electrocardiogram (ECG, EKG)a test that records the hearts activity by measuring electrical currents through the heart muscle Chest x-raya test that uses radiation to take a picture of structures inside the body Before the surgery, you will undergo a trial to see if the pump will actually decrease your pain. Pain medicine will be injected into the area around your spine one or more times. In some test trials, a catheter may be placed in the area around your spine. The catheter is then connected to an external pump. The proper placement of the catheter and ideal dose of medicine for you will also be found in the trial period. Cervical Injection Leading up to your procedure: Do not eat anything after midnight the night before your surgery, unless directed otherwise by your doctor. Arrange to have someone drive you to and from the procedure. Arrange for help at home after your procedure. Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like: Aspirin or other anti-inflammatory drugs Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

What Happens During the Surgery?
To place the catheter, a small incision will be made in your back. A small tube (called a spinal catheter) will be placed near your spinal cord. It will be secured with sutures. Your doctor will use an x-ray machine to help guide the catheter. The catheter will travel under your skin from your spine, around your torso, and into the abdomen. The doctor will make a pocket under the skin of your abdomen. The pump will be placed into this pocket.
Once the device is in place, you will be awakened. The pump will be tested. The incisions in your back and abdomen will be closed with sutures or staples. The area will be covered with bandages.

 
 
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