Prevention of intrathecal drug delivery catheter-related complications

Kenneth A. Follett, Kim Burchiel, Timothy Deer, Stuart DuPen, Joshua Prager, Michael S. Turner, Robert J. Coffey

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

In an effort to improve the performance of implantable intrathecal drug delivery systems, a group of physicians experienced in the management of such devices reviewed surgical practices and principles that were associated with low catheter-related complication rates. Clinical study and postmarket data identified physicians whose patients experienced a relatively low rate of catheter-related complications. Six of those physicians (three anesthesiologists and three neurosurgeons) reviewed the number and types of intrathecal drug pumps and catheters they had implanted, with an emphasis on the specific details of successful catheter implantation techniques. The authors pooled their experiences to reach a consensus on implant techniques that are associated with a low rate of post-operative complications. The authors found that complications were minimized by the use of specific methods for catheter placement that included: a mid-to-upper lumbar dural entry level, a shallow-angle paramedian oblique insertion trajectory, and meticulous catheter anchoring and tunneling techniques. Systemic antibiotic prophylaxis, attention to pump pocket location, and surgical wound closure techniques also were important in reducing the incidence of postoperative devicerelated complications. Their experience indicates that specific implantation techniques using a variety of catheters and accessories can be expected to reduce the incidence of complications after implantation of intrathecal drug administration systems.

Original languageEnglish (US)
Pages (from-to)32-41
Number of pages10
JournalNeuromodulation
Volume6
Issue number1
DOIs
Publication statusPublished - Jan 1 2003

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Keywords

  • Drug administration system
  • Intrathecal catheter
  • Intrathecal drug delivery
  • Pain
  • Pump
  • Spasticity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Follett, K. A., Burchiel, K., Deer, T., DuPen, S., Prager, J., Turner, M. S., & Coffey, R. J. (2003). Prevention of intrathecal drug delivery catheter-related complications. Neuromodulation, 6(1), 32-41. https://doi.org/10.1046/j.1525-1403.2003.03005.x