Intrathecal drug delivery 2002.
BACKGROUND
Intrathecal drug delivery has been used clinically since the 1970's. Significant clinical advances have been made combining new technology with pharmacology and surgery. Continuous infusion of medication for both analgesia and spasticity has become a part of the armamentarium for specialists in these areas. Significant recent advances in technology promise further enhancements and improvements for intrathecal therapy.


METHODS
A review of the literature combined with 20 years personal experience with intrathecal drug delivery.


RESULTS
Intrathecal therapy has established a role in the treatment of malignant pain, benign pain and severe spasticity. Significant literature and the current state of practice in the United States are reviewed. Recent therapeutic enhancements are discussed, and a wish list of future technological enhancements presented.
D001418:Baclofen / Q000008:administration & dosage / Q000493:pharmacokinetics; D017277:Drug Approval; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods* / Q000639:trends*; D009020:Morphine / Q000008:administration & dosage / Q000493:pharmacokinetics; D009069:Movement Disorders / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D013116:Spinal Cord / Q000187:drug effects / Q000378:metabolism; D014481:United States
D009020:Morphine; D001418:Baclofen