Intrathecal Drug Delivery for Treatment of Chronic Low Back Pain: Report from the National Outcomes Registry for Low Back Pain

Abstract

Current clinical practices related to trialing of drug-delivery systems resulted in the majority of patients successfully trialed. At 12-month follow-ups, implanted patients experienced reductions in numeric back and leg pain ratings, improved Oswestry scores, and high satisfaction with the therapy.

Transdermal power transfer for recharging implanted drug delivery devices via the refill port

“…Chronic pain arises from a variety of causes including traumatic injury, various diseases (like arthritis), surgery, or nerve damage (Phillips 2003). One treatment method for severe chronic pain or spasticity is to implant an intrathecal pump that delivers medication directly into the spinal canal (Erdine and De Andres 2006;Winkelmuller and Winkelmuller 1996;Wermeling 2005;Schug et al 2006;Rauck et al 2003;Deer et al 2004). These pumps are highly effective because they have a direct path into the cerebrospinal fluid (CSF).…”

Programmable Intrathecal Opioid Delivery Systems for Chronic Noncancer Pain: A Systematic Review of Effectiveness and Complications

“…Two investigators were authors on 2 articles included in the effectiveness and complications reviews, 88,89 but the studies were of different patients enrolled during different time periods. Two patients may have been enrolled in 2 studies included in both the effectiveness and complications reviews 85,89 (Valerie Anderson, personal communication), but the other patients differed between studies and the articles reported different outcome measures. Finally, another 2 articles 7,86 that were included in both the effectiveness and the complications reviews had the same first author, but reported on independent patient samples (Krishna Kumar, personal communication).…”

“…One article 85 reported that such supplementation increased over time. Relative to baseline, at 6 months, 65% of the patients had decreased or discontinued systemic opioids, but at 12 months, only 42.5% had.…”

Minimally Invasive Procedures for the Treatment of Failed Back Surgery Syndrome

“…The national outcomes registry for low back pain collected prospective data on 136 patients with chronic low back pain treated using intraspinal infusion via implanted devices, 81% of whom received morphine. Oswestry Low Back pain disability scale ratings after 12 months improved by 47% in patients with back pain and in 31% in patients with leg pain (Deer T et al, 2004).…”