This modality is usually offered to patients who have been tried on a variety of medical and minimally invasive treatments (e.g. epidurals) without significant success or when patients experience a lot of side effects with their current medical regimen. Usually patients who are candidates for this modality have been taking higher amounts of medications. However, patients who have good pain relief from their medicines but are experiencing significant side effects (e.g. sedation) are also good candidates. The pump is a wireless and programmable reservoir that is placed in the abdomen underneath the skin. A catheter from this pump is tunneled under the skin to the back where the medicine is delivered to the fluid the bathes the spinal cord. By doing so, superior pain relief is achieved by far less amount of medication. A lot of the side effects of medications taken by mouth are no longer an issue given the fact that a lot less medicine is required. This pump is usually filled every month or for some every couple of months or so.
Prior to implantation of the pump, every patient must have a trial. During this trial, usually you will be admitted to the hospital and an epidural catheter will be placed in your back. Through this catheter, an infusion of medication will be done through an external pump. There is no incision for this part and the catheter will be removed usually the next day or so. If you have a good response, you will be scheduled for the final phase which is performed at the surgery center.
The implantation is done some time after a successful trial. Usually, you will be under general anesthesia for this. In this phase, the pump will be placed under the skin in the abdomen and gets connected to the catheter that is placed in the back for medication delivery.