If you have been in pain for more than 6 months and your current treatment has not provided adequate relief, or you’re experiencing intolerable side effects, don’t lose hope. A Medtronic pain pump may be an option for you.

What Patients Have to Say About Targeted Drug Delivery

Caroline

Targeted Drug Delivery Since 2001
"The first day of my screening test, I had immediate pain relief."

What Can I Expect From the Screening Test?

If you are considering a drug pump to control your pain, think about having a screening test. With a screening test, you‘ll have a reasonable idea of what your results might be before you have the device implanted.

The screening test is important for a variety of reasons. During the screening test you can:

  • Assess how well targeted drug delivery relieves your pain
  • Feel what it is like to receive pain medications intrathecally into the fluid-filled space surrounding your spinal cord
  • Decide if you want to go on to have the targeted drug delivery system implanted

Before the screening test begins, your doctor will answer any questions you have and make sure you are familiar with the risks.

You may experience significant improvement in your pain symptoms during the screening test. However, realistic expectations are essential to satisfaction with any pain treatment. Discuss treatment goals with your doctor. Keep in mind that targeted drug delivery will not eliminate the primary source of your back pain or cure underlying disease, but it may help you better manage your chronic pain.

What Happens During the Screening Test?

The screening test will take place in either the hospital or a surgery center. After the screening test, you and your doctor will discuss your experience and decide if an implantable targeted drug delivery system is right for you.

The Two Types of Screening Tests

Dr. David Provenzano

Pain Management Specialist, Pennsylvania
"When you are contemplating which type of trial to undergo or discussing with your healthcare provider, again there are two types of trials. There’s the bolus or single shot trial where we inject medication into the spinal canal. Or there is a continuous trial where we put a catheter into your spinal canal and we infuse small amounts of drugs very close to the spinal cord and in the spinal fluid."

There are two screening test methods. Your doctor will recommend the method that makes the most sense for your situation and discuss the risks of the screening procedure with you.

Injection Method

This procedure consists of a single injection or multiple injections of a small amount of medication into the intrathecal space.

Generally, these are the steps your doctor may take during the injection method:

  • You will be placed on a surgical table.
  • You may be given medication to help you relax.
  • Your back will be cleaned with a solution.
  • Your heartbeat and breathing rate will be monitored.
  • A special needle filled with pain medication will be used. It will be placed in the intrathecal space of your spinal cord and medication will be injected.
  • After the injection, you will be monitored for up to 24 hours.

Continuous Infusion Method
This type of screening test takes place over a few days and closely resembles the therapy delivered by the implanted drug pump.

Generally, these are the steps your doctor may take during the continuous infusion method:

  • You will be placed on your stomach on a surgical table.
  • You may be given medication to help you relax.
  • Your back will be cleaned with a solution.
  • Your heartbeat and breathing rate will be monitored.
  • A small incision will be made in your back for the catheter.
  • The temporary catheter will be placed in your back and attached to an external pain pump.
  • A continuous flow of medication will then be delivered intrathecally to the fluid-filled space surrounding your spinal cord.
  • After receiving the medication, your response will be monitored.
  • You may be in the procedure room for up to two hours and then monitored for up to 24 hours. The rest of the test period may take place at home or in the hospital, depending on your doctor’s preference.

Complications can occur with the screening test, including bleeding, infection, and drug side effects. The catheter also may need to be replaced. You should not undergo a screening test if you have an active infection at the time of the test, have a body size too small to accommodate an implanted pump, or if you are allergic to the screening medication.

About the Screening Test Procedure

Dr. David Provenzano

Pain Management Specialist, Pennsylvania
"If you and your doctor have decided to progress forward to an intrathecal drug delivery trial, you’re clearly going to ask what’s going to happen that day."

What Can I Expect After the Screening Test Procedure?

After the procedure, you will be taken to a recovery room. You may experience some discomfort in the area of your back where the incision(s) was made. This is temporary and will resolve in the hours and days following the procedure.

If your screening test involved the injection method, you will:

  • Discuss your response to the screening test with your doctor before going home. Your doctor will want to know:
    • Did your pain decrease?
    • Did you experience any discomfort?

If your screening test involved the continuous infusion method, your doctor will discuss the following regarding your temporary system:

  • How to use the external drug pump
  • How to care for the area around the catheter while you’re at home
  • What activities and movements to avoid during the screening test period

If you are uncomfortable during the continuous infusion screening test, you can have the temporary catheter removed.

What Can I Expect At the End of the Screening Test?

At the end of your screening test period, your doctor will:

  • Remove the temporary catheter (if your test involved continuous infusion)
  • Discuss your experience during the screening test
  • Ask you if you were satisfied with your experience
  • Help you determine if you should proceed with the implant procedure

One way to think about your experience with a pain pump is to compare your ability to do things before and during the screening test.

If you decide to proceed with targeted drug delivery, there will be a waiting period after the screening test and before your implant procedure. This will give the incision in your back time to heal and allow time for your insurance provider to be notified, and for the surgery to be scheduled.

How to Get a Screening Test

If you think Medtronic targeted drug delivery might help you relieve your chronic pain and get back to a fuller life, the first step is to talk with your doctor or a pain management specialist.

Your pain management specialist can help you schedule a test for the therapy that is most appropriate for your needs. Be sure to discuss the risks and benefits of the screening test and long-term therapy.

If you need help finding a pain management specialist, use our Find a Specialist tool to find one near you.

Talk With Someone Who Is Receiving Drug Delivery Therapy

Before or during your screening test, it can be helpful to talk with someone who has been living with drug delivery therapy. The Medtronic Ambassador Program puts you in touch with a volunteer who is interested in sharing their experience with a pain pump with you.