title: Intrathecal drug delivery for chronic pain management-scope, limitations and future.
abstract: Intrathecal drug delivery system (IDDS) is a targeted therapy system for treating pain and muscle spasm. IDDS is recommended for the treatment of chronic pain which does not respond to optimal medical management. The aim of this review article is to give an up to date and concise account of the use of IDDS. It will explore the main indications, pre-implantation trials and different implantation techniques, the licensing of drugs for intrathecal use and the adverse effects and benefits of this therapy. IDDS is an invasive technique, which can result in severe morbidity and mortality. The up to date knowledge gained from this article along with the recommendations for improving safety in patients receiving IDDS, makes it a valuable resource for healthcare practitioners. Continued research, including outcome studies of this therapy continues to be necessary.
authors.affiliation: Department of Pain Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK, mczernicki@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Czernicki
authors.forename: G
authors.initials: G
authors.lastname: Sinovich
authors.forename: I
authors.initials: I
authors.lastname: Mihaylov
authors.forename: B
authors.initials: B
authors.lastname: Nejad
authors.forename: S
authors.initials: S
authors.lastname: Kunnumpurath
authors.forename: G
authors.initials: G
authors.lastname: Kodumudi
authors.forename: N
authors.initials: N
authors.lastname: Vadivelu
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007278:Injections, Spinal / Q000009:adverse effects / Q000295:instrumentation; D010147:Pain Measurement / Q000187:drug effects; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000517:prevention & control; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000700:Analgesics