Effect of MRI on intrathecal pump What effect does a magnetic resonance imaging have on an intrathecal pump? Except for the Codman3000 system, the intense magnetic field produced by an MRI can have profound effects on intrathecal drug delivery systems. For example, the Medtronic Synchromed II system will temporarily suspend drug delivery until the patient …
Complications of intrathecal therapy What type of complications can occur with intrathecal therapy? Aside from drug side effects and surgical complications, intrathecal drug delivery systems are complicated devices that can fail in several ways. The pump itself can break free from securing sutures and flip within the pump pocket such that the reservoir cannot be …
Does intrathecal analgesic drug delivery place patients at higher risk of serious adverse events than other interventional pain procedures? Recent observational studies suggest that patients who undergo permanent implantation of intrathecal drug delivery systems for the treatment of pain have a significantly higher risk of mortality than patients who receive other invasive interventions for their …
How can a diagnosis of granuloma be confirmed, and what is the treatment for it? The primary method to confirm the presence of a granuloma is with imaging, either magnetic resonance imaging (MRI) or computed tomography myelography, focusing on the area around the catheter tip that can reveal a mass or filling defect, respectively, confirming …
Catheter tip associated inflammatory mass What is a catheter tip associated inflammatory mass or granuloma, and what is their clinical presentation? Granulomas are an inflammatory mass that can develop on the catheter tip as a result of intrathecal drug administration. They are most commonly associated with continuous infusion of high concentrations of opioid medications—particularly morphine. …
What side effects can occur from intrathecal analgesics? Intrathecal delivery of analgesic medications carries with it the potential for all side effects of systemic administration, with a few additional risks specific to the intrathecal route. For example, intrathecal opioids can cause pruritus, urinary retention, and respiratory depression, while intrathecal local anesthetics can cause weakness, numbness, …
Does location of the catheter tip within the intrathecal space or mode of delivery affect the efficacy of intrathecal therapy? There is no definitive evidence supporting close proximity of the catheter tip to the spinal level corresponding to the patient’s painful area or one method of drug delivery over another. However, research studies and clinical …