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Intrathecal Drug Delivery for Control of Pain

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Treatment of Chronic Pain by Interventional Approaches

Abstract

Over the last two decades, the use of intraspinal drug delivery (ISDD) systems for the treatment of chronic pain and spasticity has increased. The clinical practice varies from institution to institution as far as the utilization of different agents or routes of administration. The clinical approach for intraspinal drug delivery is influenced by the type of pain treated (e.g., chronic nociceptive vs. neuropathic). The choice depends on life expectancy as well as the planned time frame of treatment. Intraspinal catheter placement is frequently chosen for the treatment of cancer pain, spasticity (caused by cerebral palsy, multiple sclerosis, spinal cord injury, and other neurologic conditions), and intractable nonmalignant pain (severe post-laminectomy syndrome and arachnoiditis, vertebral compressive fractures resistant to other therapies, complex regional pain syndrome (CRPS), postherpetic neuralgia, and other types of neuralgias) and the administration of intrathecal chemotherapy and CSF drainage.

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Authors and Affiliations

  1. Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 409, Houston, TX, 77030, USA

    Brian M. Bruel M.D., MBA & Mitchell P. Engle M.D., Ph.D.

  2. Carolinas Pain Institute, Wake Forest University School of Medicine, 145 Kimel Park Drive Suite 330, Winston-Salem, NC, 27103, USA

    Richard L. Rauck M.D., FIPP, Thomas J. Weber DO & Leonardo Kapural M.D., Ph.D.

Authors
  1. Brian M. Bruel M.D., MBA
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  2. Mitchell P. Engle M.D., Ph.D.
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  3. Richard L. Rauck M.D., FIPP
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  4. Thomas J. Weber DO
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  5. Leonardo Kapural M.D., Ph.D.
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Correspondence to Brian M. Bruel M.D., MBA .

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Editors and Affiliations

  1. President and CEO, Clinical Professor of Anesthesiology, The Center for Pain Relief, West Virginia University School of Medicine, Charleston, West Virginia, USA

    Timothy R. Deer

  2. Clinic Chief, Clinical Associate Professor, Department of Anesthesiology, Stanford Pain Medicine Center, Redwood City, CA, USA, and Stanford University School of Medicine, Stanford, California, USA

    Michael S. Leong

  3. Department of Anesthesiology, Orthopedic Anesthesia, Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA

    Asokumar Buvanendran

  4. Center for Interventional Pain & Spine, DE and Bryn Mawr, Newark, Pennsylvania, USA

    Philip S. Kim

  5. President, National Institute of Pain, Tampa, Florida, USA

    Sunil J. Panchal

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Bruel, B.M., Engle, M.P., Rauck, R.L., Weber, T.J., Kapural, L. (2015). Intrathecal Drug Delivery for Control of Pain. In: Deer, T., Leong, M., Buvanendran, A., Kim, P., Panchal, S. (eds) Treatment of Chronic Pain by Interventional Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1824-9_42

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