Name of the Procedure:

Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming

Summary

This procedure involves checking and adjusting a special pump implanted in the patient’s body that delivers medication directly to the spinal cord area. The electronic analysis ensures the pump is functioning correctly and the medication levels and settings are appropriate.

Purpose

This procedure addresses chronic pain or severe spasticity issues that are not controlled by oral medications. The goal is to ensure the implanted pump is delivering the correct dose of medication, preventing any potential complications or inefficacies.

Indications

• Severe chronic pain unresponsive to oral medications
• Spasticity management in conditions such as multiple sclerosis or spinal cord injury
• Patients with an existing intrathecal or epidural pump system in place

Preparation

• The patient may need to fast for a few hours before the procedure.
• Any current medications should be discussed with the healthcare provider to determine if adjustments are necessary.
• Pre-procedure imaging or tests might be required to assess the pump and catheter system.

Procedure Description

1. The patient is positioned appropriately, often lying on their side or stomach.
2. The medical team accesses the pump via a small incision or through the skin.
3. A special electronic device communicates with the pump to gather information about the reservoir status, alarm status, and current drug prescription settings.
4. Based on the findings, the pump may be reprogrammed to adjust the medication dosage or timing.
5. The incision is closed and dressed if it was made.

Tools used include an electronic programmer device and standard surgical instruments. Local or minimal sedation may be used.

Duration

The procedure typically takes about 30-60 minutes.

Setting

This procedure is performed in a hospital or outpatient clinic setting.

Personnel

• Pain specialist or neurosurgeon
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Infection at the incision site
• Pump malfunction
• Over or under-dosing of medication
• Minor discomfort or pain during the procedure

Benefits

• Accurate medication delivery directly to the target area
• Improved pain or spasticity management
• Enhanced quality of life through better symptom control Results can be felt relatively quickly after the pump is reprogrammed.

Recovery

• The patient may need to rest for a short period after the procedure.
• Normal activities can often be resumed the same day or the day after.
• Follow-up appointments are usually scheduled to monitor the pump and patient response.

Alternatives

• Oral or topical medications
• Physical therapy or other non-invasive treatments
• Other surgical options for pain management Each alternative has its own risks and benefits, often involving less direct drug delivery but also potentially without the risks associated with an implanted device.

Patient Experience

The patient might feel slight discomfort during the procedure. Post-procedure, patients typically experience minimal pain, easily manageable with over-the-counter pain relievers. Most patients are able to return to their regular activities within a day.