An intrathecal drug delivery pump is an implantable device that delivers pain medication directly to the spinal fluid, providing effective pain relief at much lower doses than oral medication.
A thin catheter is inserted into the intrathecal space (around the spinal cord) through a needle in the back, and tunnelled under the skin to a programmable pump implanted in the abdomen. The pump delivers precise doses of medication (usually morphine or baclofen) directly to the spinal fluid. The operation takes one to two hours.
Intrathecal pumps are considered for severe chronic pain not adequately controlled by oral medications, cancer pain, severe spasticity (baclofen pump), and failed back surgery syndrome.
Oral or transdermal pain medication, nerve blocks, spinal cord stimulation, physiotherapy, and psychological pain management.
A trial injection of intrathecal medication is performed first to assess effectiveness. Psychological assessment. Multidisciplinary pain team review.
Effective pain relief at lower doses, reducing systemic side effects of oral medication. The pump can be adjusted and refilled without further surgery.
Discomfort over the abdominal pump.
Post-dural puncture headache after catheter insertion.
Even at low doses, opioids can cause nausea, drowsiness, and constipation.
Around the pump or catheter. Risk approximately 3-5%.
Kinking, migration, or disconnection of the catheter.
Spinal fluid leak causing headache.
Inflammatory mass at the catheter tip. Can cause neurological symptoms.
Pump malfunction or programming error. Safety features reduce this risk.
General or local anaesthesia with sedation.
Hospital stay one to three days. Avoid heavy lifting for six to eight weeks. The pump is refilled every one to six months depending on medication use, via a simple needle injection through the skin.
Pump programming and refill at regular intervals. Annual review of medication needs.
Every one to six months depending on the medication dose. Refilling is done in clinic with a needle through the skin — no surgery needed.
Five to seven years. Battery replacement requires a minor surgical procedure to exchange the pump.