Implantable intrathecal pumps for chronic pain: highlights and updates.
Management of chronic pain by intrathecal delivery is gaining increasing use. The aim of this article is to review the literature pertinent to implantable devices used for treatment of chronic pain, and to highlight what is known. Articles were obtained from Medline database and reviewed. Practical patient selection criteria, trial management, and surgical technique are described. Expert consensus guidelines for intrathecal medication use are also reviewed. Finally, an exhaustive description of known complications and future implications is discussed. We concluded that intrathecal pump seems to be overused, while there is still weak evidence to support its outcome. It is also recommended that future research focus on the outcome, measured by functional parameters rather than commonly used pain scores.
Knight
Karen H
KH
Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44108, USA. khknight@earthlink.net
Brand
Frances M
FM
Mchaourab
Ali S
AS
Veneziano
Giorgio
G
D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005544:Forecasting; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000592:standards / Q000639:trends*; D007278:Injections, Spinal; D008297:Male; D010147:Pain Measurement; D010148:Intractable Pain / Q000175:diagnosis / Q000188:drug therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000700:Analgesics; D000701:Analgesics, Opioid