| Intraspinal Drug Delivery Systems |
Many medications that are normally given orally or intravenously can be delivered directly into
the spinal canal. The advantage of this delivery is that a much smaller dosages of medication
can be used, thereby minimizing many side effects associated with other oral or intravenous
use. Typically, the intraspinal administration is 300 times more effective than the oral dose.
Morphine (and other opioids or narcotics) interacts with opioid receptors in the spinal cord to
decrease pain impulses to the brain, thereby decreasing the brain's perception of painful
conditions. While developed for cancer pain, the intraspinal use of this medication has proven
very effective in chronic benign (non-cancer) pain as well. Intraspinal delivery may allow the
patient to significantly decrease the amount of oral medications ingested, thereby decreasing
side effects. Because the effectiveness of intraspinal morphine is many-times the effectiveness
of oral morphine, the patient's pain relief may allow resumption of a much more active lifestyle.
Baclofen is a medication that also works on the spine, interacting with GABA receptors to
decrease spasticity. As with morphine, the intraspinal administration is much more effective
than oral ingestion, thereby decreasing side effects and improving muscle relaxation.
Intraspinal baclofen therapy is used for spasticity that occurs from injuries to the brain or
spine. The therapy has proven effective for children with cerebral palsy or traumatic brain
injuries and for adults who have suffered cerebrovascular accidents (strokes) or spinal
injuries. Although morphine and baclofen are the most commonly used intraspinal medications,
clinical circumstances may require the use of other medications, either alone or in
combination. These medications include the opioids hydromorphone and fentanyl as well as
clonidine, bupivicaine and zinconotide. Prior to the implantation of the pump and catheter, a
trial procedure is performed which demonstrates the effectiveness of the medication for the
particular patient. The implantation requires a surgical operation and an anesthetic.
the spinal canal. The advantage of this delivery is that a much smaller dosages of medication
can be used, thereby minimizing many side effects associated with other oral or intravenous
use. Typically, the intraspinal administration is 300 times more effective than the oral dose.
Morphine (and other opioids or narcotics) interacts with opioid receptors in the spinal cord to
decrease pain impulses to the brain, thereby decreasing the brain's perception of painful
conditions. While developed for cancer pain, the intraspinal use of this medication has proven
very effective in chronic benign (non-cancer) pain as well. Intraspinal delivery may allow the
patient to significantly decrease the amount of oral medications ingested, thereby decreasing
side effects. Because the effectiveness of intraspinal morphine is many-times the effectiveness
of oral morphine, the patient's pain relief may allow resumption of a much more active lifestyle.
Baclofen is a medication that also works on the spine, interacting with GABA receptors to
decrease spasticity. As with morphine, the intraspinal administration is much more effective
than oral ingestion, thereby decreasing side effects and improving muscle relaxation.
Intraspinal baclofen therapy is used for spasticity that occurs from injuries to the brain or
spine. The therapy has proven effective for children with cerebral palsy or traumatic brain
injuries and for adults who have suffered cerebrovascular accidents (strokes) or spinal
injuries. Although morphine and baclofen are the most commonly used intraspinal medications,
clinical circumstances may require the use of other medications, either alone or in
combination. These medications include the opioids hydromorphone and fentanyl as well as
clonidine, bupivicaine and zinconotide. Prior to the implantation of the pump and catheter, a
trial procedure is performed which demonstrates the effectiveness of the medication for the
particular patient. The implantation requires a surgical operation and an anesthetic.
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