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One of the advanced techniques for chronic pain or chronic spasticity uses the infusion of medication directly into the spinal sac. Medication is placed into a pump that is implanted under the skin and is infused through a tiny catheter into the spinal sac or epidural space. Like Spinal Cord Stimulation �pump therapy� is not for everyone or for every type of pain syndrome. Before a spinal infusion device is implanted, all less invasive pain management techniques have been exhausted.
Spinal infusion involves placing a tiny catheter into the spinal sac or epidural space. These spaces around the spinal sac are separated only by a thin membrane called the dura mater which includes a layer called the arachnoid membrane. Spinal or subarachnoid infusions place medicine inside the spinal sac (inside the dura mater) where the medicine can spread out in the cerebral spinal fluid (CSF) and affect wide areas of pain. Epidural (�above the dura�) medicines flow into the epidural space where the fluid spread is much more restricted by the epidural contents (epidural fat and blood vessels). Where the catheter is placed, and the kind of medicine infused depends on the patient, the type of pain, the duration of infusion, and many other factors.
Rarely does any type of implanted device relieve 100% of pain. However, when chronic pain is unresponsive to any other therapy, partial relief may allow resumption of function. Our goal of 50% pain relief from any invasive therapy often makes the difference between going to work, resuming daily tasks or inactivity. Like all drug therapy for chronic pain, ultimate success is measure by improvement in function.
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