Permanent Epidural / Spinal Port - Pump Systemis a method that provides continuous drug infusion around the spine, used in cases where long-term pain management or drug therapy is required. This system allows drugs to be delivered directly to the epidural or intrathecal (spinal) area and is a highly effective option for controlling chronic pain.

What is Permanent Epidural / Spinal Port and Pump System?

This system is a device that allows medication to be delivered to areas around the spine (epidural or intrathecal space). It has two main components:

1. Catheter:
   • A thin tube is inserted into the epidural or intrathecal space.
   • Through this tube, the medication reaches the targeted area.
2. Pump System:
   • Outer Port It is placed under the skin and, if necessary, filled with medication with a needle.
   • Implantable Pump: It is a device that is completely implanted under the skin and delivers medication in a programmable way.

In which cases is it used?

1. Chronic Pain Management:
   • Cancer pain
   • Pain due to spinal degeneration or disc disease.
   • Neuropathic pain due to nerve damage.
2. Muscle Spasm and Spasticity:
   • Muscle spasms in multiple sclerosis (MS), cerebral palsy or spinal cord injuries.
3. Palliative Care:
   • Improving quality of life in advanced stage diseases.
4. Surgical Pain Management:
   • Long-term pain control in the postoperative period.

How is the Procedure Performed?

1. Evaluation and Preparation:

• The patient undergoes a detailed assessment.
• The area of application (epidural or intrathecal) is determined.
• The drugs and the type of device to be used are selected according to the patient's needs.

2. Catheter Placement:

• In a sterile environment, a thin catheter is inserted into the spine under local or general anaesthesia.
• The tip of the catheter is inserted into the epidural or intrathecal space.

3. Pump or Port Placement:

• Port: The other end of the catheter is placed under the skin and can be filled with medication if necessary.
• Pump In more advanced systems, a small pump device is placed under the skin. This pump delivers medication on a regular or programmed basis.

4. Test and Adjustment:

• The system is tested and the drug dosage and infusion rates are programmed according to the patient's needs.

Advantages

• Direct Impact: Systemic side effects are reduced as the drugs are administered directly to the target area.
• Less Need for Medication: The direct contact of the medication with the nervous system allows effective pain control with lower doses.
• Targeted Treatment: It acts directly on the source of pain.
• Improves Quality of Life: It facilitates the daily life of patients by effectively controlling chronic pain.

Who is it suitable for?

• Patients who cannot control chronic pain with medication.
• Cancer patients requiring long-term pain management.
• Individuals who are disturbed by the side effects of oral or intravenous drugs.
• Patients who are not suitable for surgical or invasive methods.

Risks and Side Effects

1. Infection: Infection may occur in the area where the device is implanted.
2. Catheter Problems: Blockage, dislodgement or damage to the catheter.
3. Pump Malfunction: Mechanical problems or improper operation of the device.
4. Nerve Damage Rarely, nerve damage may occur during catheter insertion.
5. Drug Side Effects: Despite low doses, some medicines may cause drowsiness, nausea or low blood pressure.

Post Procedure Care

• Regular Check: The port or pump should be filled, cleaned and adjusted regularly.
• Hygiene Cleanliness of the port area is important to reduce the risk of infection.
• Medication Settings: The dose of the drug can be adjusted by the doctor according to the level of pain and the patient's condition.
• Possible Symptoms: If signs of infection (redness, swelling, fever) appear, consult a doctor immediately.

Treatment Effectiveness

• Permanent epidural or spinal port-pump system is a highly effective method in the control of chronic pain when the right patient is selected.
• It is one of the gold standard treatment methods for pain management in cancer patients.
• It provides effective application of muscle relaxants in the treatment of spasticity.

Conclusion

Permanent Epidural/Spinal Port - Pump Systemis an effective, safe and quality of life-enhancing method in the treatment of chronic pain and spasticity. Thanks to its minimally invasive structure and direct mechanism of action, it offers a powerful treatment option, especially in cases resistant to drugs. However, the suitability and success rate of this method should be determined by a detailed evaluation by a specialist physician.