What are the Known Complications of Having a Drug Pump Implanted for Back Pain?

Question: What are the Known Complications of Having a Drug Pump Implanted for Back Pain?

There are a number of potential problems associated with having a drug pump implanted, but thankfully, they are usually minor. While rare, major complications, when they do happen, can be fatal.

Answer:

Sometimes there are problems with the catheter or the pump, in other words, the equipment. Problems with the catheter occur in up to 25% of patients with the implant. The catheter can kink up or disconnect, or there may be a problem with the way the pump fills or delivers the medication. Any of these issues will require more surgery.

The procedure itself has a few risks. For example, the use of anesthetic can cause toxicity to your nerves. This is why having the procedure done in-hospital is necessary. Should neurotoxicity occur, it will be easy and quick to get the appropriate specialists (neuroradiologists and/or neurosurgeons) to treat you.

Also, infections at the pump area are possible, and the risk of contracting meningitis and MRSA are real. Beginning at around 6 months after the procedure, and infection known as inflammatory granuloma may develop where the catheter was inserted. Punctures of the outer layer of the spinal cord are another risk, and may lead to leakage of the cerebrospinal fluid, or CSF. Dural punctures, as they are called, may cause a headache, but will probably be okay within a few days.

After the implantation has been done and you are on your way, you will need to have a plan for pump, drug and catheter related emergencies, as they are possible. The surgeon who implants the device in you may or may not be available at the time a problem arises. So remind your primary care doctor and nurse that you’ve had the procedure, and ask your implanting surgeon for names of appropriate back up personnel. Also, it’s a good idea to carry the information about the make and model of your pump, the type of medication and most recent dosage, and how to contact your doctor.

_{Sources:
Dr. Sudhir Diwan, Director Pain Medicine Fellowship Program and Director of the Division of Pain Medicine at Weil-Cornell Medical College of Cornell University. Telephone Interview. May 2008.}

Gould, H., III, MD, PhD, Understanding Pain: What it is, Why it Happens and How It's Managed. American Academy of Neurology. 2007. New York.

British Pain Society. Intrathecal drug delivery for the management of pain and spasticity in adults; recommendations for best clinical practice.December 2006.