Intrathecal Pump and Catheter Troubleshooting

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Medical Radiology


Intrathecal drug delivery has been widely used for over four decades to treat symptoms of spasticity as well as those related to chronic malignant and nonmalignant pain. Intrathecal drug delivery systems safely and effectively deliver medication to the cerebrospinal fluid, allowing for better relief of pain or spasticity symptoms with less side effects than other routes of administration. Despite the safety of these pumps, there are complications that can occur, leading to serious morbidity and even mortality for the patient. The morbidity and mortality associated with pump therapy can result from several sources including complications from implant procedures, drug reactions or side effects, device malfunction, programming errors, or pump refill errors (Deer et al. 2012). Device registration and social security analyses from 2009 showed an intrathecal opioid mortality rate of 0.088% at 3 days after implantation, 0.39% at 1 month, and 3.89% at 1 year (Coffey et al. 2009). Physicians that are managing these pumps should be knowledgeable in the potential complications of this system and how to manage them. This chapter will focus on troubleshooting device-related complications and the appropriate management of catheter and pump-related issues.

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