Intrathecal Drug Delivery Trialing
Bux A, and Chopra P. Intrathecal Drug Delivery Trialing. In: Medical Radiology. Elsevier B.V. 2022: 35-51.
Intrathecal Pump Drug Delivery
Intrathecal drug delivery has been used since the 1980s to treat spasticity as well as chronic malignant and nonmalignant pain symptoms. Patients that are considered for intrathecal drug delivery systems are those with chronic pain or severe spasticity that have failed all conservative treatments including interventional and non-interventional methods. Additionally, these patients have either failed previous surgery or they are not candidates for surgical intervention. Intrathecal drug delivery systems deliver medication to the CSF to provide better relief of pain or spasticity symptoms than systemic medications with less side effects than the other more conventional routes of administration. In order to qualify for implantation of an intrathecal drug delivery system, patients most often will undergo a psychological evaluation and should have successful intrathecal medication trial. This chapter will focus on trialing methods along with the different medications used for spasticity and chronic pain and their side effects and complications. In addition, we will examine patient risk factors and comorbidities and their effect on trialing techniques and medication administration location.