Spinal Drug Delivery Systems
Spinal Drug
Delivery Systems
POST-SURGERY | RECOVERY TIME | BENEFIT | CLOTHING | BATTERY |
ALARM | INTERFERENCE | DISLODGED
Spinal Drug Delivery Systems
A spinal drug delivery system, is also known as an Intrathecal drug delivery system or ‘pump’. It provides a method of delivering medication extremely close to the spine for maximum efficacy.
Why might it help?
Taking daily medication to ease pain or muscle spasms from persistent cancer pain or nerve pain such as MS, spinal injury, or brain damage can cause you to not gain as much benefit from the medication over time, or the adverse effects are too great to handle.
The drug is delivered directly to the (intrathecal) area in your spine by spinal drug delivery systems. The front of your spine is made up of bone supports, while the rear is built up of arches. The spinal cord is located in the centre of these arches. The spinal cord connects your brain to the rest of your body’s nerves. In the intrathecal area, the spinal cord floats in spinal fluid. The purpose of this fluid is to cushion the brain and spinal cord. It is produced in the brain.
Because your medicine is delivered so close to your nerves by your spinal drug delivery systems, you just need small dosages.
Spinal drug delivery systems are not a cure and may not be able to eliminate all of your pain or spasms completely. It’s possible that you’ll need to take more medications. It may, however, be a more effective strategy to manage your symptoms than your present medications. This may allow you to cut back on some of your oral drugs, resume more normal activities, and have better sleep.
Spinal Drug Delivery Systems are made up of three parts:
- The pump itself is a battery-powered gadget the size of a shoe polish tin that is implanted beneath the skin of your abdomen.
- A thin, flexible tube (catheter) is attached to the pump and inserted into the intrathecal space (figure 2), a fluid-filled region in your spine.
- During your refill and check-up sessions, your doctor or nurse will utilise an external programmer to communicate with and programme your pump.
The pump is filled with medicine that is delivered into your intrathecal area at a predetermined rate through the catheter. The pump is filled at the James Cook pain clinic on a regular basis, with intervals ranging from one to six months depending on the type of drug and dosage. A needle is inserted into the central port of the pump through the skin of the abdomen.
How long does the pump last?
A small internal battery powers the pump. Depending on the type of pump, this can last up to seven years. You will need to stay in the hospital overnight if the battery needs to be replaced, and you will almost certainly require anaesthesia, either spinal or general.
What are the risks and possible complications of a pump?
There are risks and hazards associated with any surgery. There may be negative effects from the medicine being administered once the pump is placed, such as nausea and vomiting, itching, and difficulty passing urine. All of these issues are transient and easily treatable.
Some of the drug’s negative effects, such as breathing issues and sedation, can be dangerous. The pain team will constantly monitor you for the first few days after the pump has been implanted so that any side effects can be treated swiftly.
Spinal fluid leaks, infection, meningitis, abscesses, bruising and injury to the spinal cord, scar tissue formation, catheter issues, and pump malfunction are all possible complications, but they are extremely infrequent.
A pump can be refilled with the wrong drug or programmed to deliver the wrong dose in extremely rare cases. Your treatment team, on the other hand, takes great care to avoid this. If you become ill after receiving your refill, contact your treatment centre right away.
How long does the refill take?
This can take anywhere from 30 to 45 minutes, depending on the circumstances. The pain clinic will schedule regular refill visits for your pump.
You will also receive a booklet that explains what medication is in your pump, the daily dose, and your next refill date. Please keep this document available and bring it with you to your refill visits.
What do I need to do when I go home after the surgery to implant the pump?
Until your wounds have healed, keep them dry and clean. There won’t be any stitches to take out. Examine your wounds on a daily basis for signs of infection, such as redness, swelling, or discharge. To inspect your wound, you do not need to remove the dressing.
Contact the pain clinic as soon as possible if you fear you have an infection, are feeling unwell, or your wounds are red, hot, or sensitive. Make sure you have the necessary contact information on hand.
How long is recovery
For several weeks, you may not see the benefits of having the spinal drug delivery system. During this period, your doctor may gradually lessen your pain or spasm medicine. If the pain does not improve contact your doctor.
How soon will I feel the benefit?
You will be able to complete the following tasks:
- Three weeks following surgery, modest lifting on occasion
- Four to six weeks after surgery, you can return to work and drive
- Twelve weeks following surgery, lifting heavier goods
These timelines are simply a guide and may vary depending on the individual.
Will it affect what I can wear
Spinal drug delivery systems are positioned to avoid getting in the way of belts and waistbands. Tight clothing may draw attention to the pump. Before the procedure, someone will go through this with you. The tiny swelling above the place where the pump is implanted may be visible to others.
When the specialist team decides where to put the pump, they will keep your comfort in mind. So far, there has been no evidence of a risk associated with wearing a seatbelt.
What happens when the battery runs out?
When the battery in the spinal drug delivery system needs to be replaced, you’ll have to stay in the hospital for a while. In most cases, an anaesthetic will be used.
I hear an alarm on my intrathecal drug delivery (ITDD)
There are alarms that sound when the drug level is low, the battery is low, or the spinal drug delivery systems are malfunctioning. These alarms differ from one device to the next. Before you leave the hospital with the pump in, your doctor and nurse will go over the alarms and what they mean to you.
Before the alarm goes off, you should replenish your pump. If you hear the low-battery alarm, make arrangements to have your battery replaced as soon as possible.
Will electrical equipment interfere with it?
Spinal drug delivery systems will not be harmed by most electrical devices such as cell phones, microwaves, or household tools. Large industrial machinery, on the other hand, may have an impact. As a result, you should stay away from industrial welding equipment and other equipment that generates a strong electromagnetic field.
Short-wave diathermy (heating deep tissue with electricity), radiation, therapeutic ultrasonography, and bone-growth stimulators are among the treatments that can interfere with your pump. As a result, it’s critical that you inform your dentist and physiotherapist that you’re using a pump.
Standard x-rays will not harm the pump, however, MRI scans may cause some pump types to malfunction, thus a check after the scan is recommended. Other pump models may need to be drained prior to the scan and refilled after the scan is completed. If you need an MRI, inform the radiologist ahead of time that you have a pump.
Can the catheter become dislodged or tear?
If you move quickly or aggressively, the catheter may become dislodged or tear. If you exercise or move quickly, you should be cautious. You can talk to your doctor or nurse about it.
If you have any further questions or concerns, you should speak with your doctor or nurse about them.