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Intrathecal PumpImplanted intrathecal drug delivery systems that deliver pain medication directly to the spinal cord at a fraction of the oral dose — for patients with severe refractory pain, evaluated with a trial first at Remix Medical in Houston, TX.

Specialty
Pain Management
Type
Procedure
Body location
Intrathecal space, cerebrospinal fluid, lumbar spine, spinal cord dorsal horn, abdominal wall (pump pocket)
CPT code
62362 (implantation or replacement of programmable pump); 62350/62351 (implantation of intrathecal catheter); 62361 (non-programmable pump); 95990/95991 (refilling and maintenance of implantable pump); 62367-62370 (electronic analysis and reprogramming)

Also known as: Pain Pump, Intrathecal Drug Delivery System, IDDS, Morphine Pump, Targeted Drug Delivery, Baclofen Pump

Intrathecal Pain Pump in Houston, Texas

An oral opioid travels through the stomach, the liver, and the bloodstream, saturating the entire body in order to reach a small population of receptors in the spinal cord. Delivering the drug directly into the spinal fluid reaches those same receptors at roughly one three-hundredth of the oral dose.

Less drug. Less sedation. Less constipation. Less of everything the body did not need in the first place.

What is an Intrathecal Pump?

An intrathecal drug delivery system is a programmable pump implanted beneath the skin of the abdomen, connected to a fine catheter that delivers medication directly into the cerebrospinal fluid surrounding the spinal cord.

The pump is refilled in the office through a port, typically every one to six months, and the dose is adjusted by telemetry without any procedure at all.

Medications Used

  • Morphine and hydromorphone — opioids, the most common agents
  • Ziconotide — a non-opioid calcium channel blocker derived from cone snail venom, useful when opioids are unsuitable
  • Bupivacaine — a local anesthetic, usually combined with an opioid
  • Baclofen — for severe spasticity rather than pain

The Trial Comes First

As with spinal cord stimulation, no patient receives a permanent pump without a trial. A single intrathecal injection or a temporary catheter establishes whether the therapy delivers meaningful relief and whether the patient tolerates it.

Who It Helps

  • Chronic non-cancer pain refractory to all other management
  • Cancer pain , particularly when oral opioid side effects have become intolerable
  • Failed back surgery syndrome in patients unsuitable for, or failed by, spinal cord stimulation
  • CRPS with widespread involvement
  • Severe spasticity from multiple sclerosis, cerebral palsy, or spinal cord injury

What It Asks of You

This is a long-term commitment. Refills must not be missed — an empty pump can precipitate withdrawal. Catheter granulomas, though uncommon, are serious. Pumps require replacement roughly every five to seven years when the battery expires.

It is reserved for patients for whom other options have genuinely been exhausted, and it works well for exactly that group.

Careful Evaluation at Remix Medical

Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

How it's performed

After a successful trial, the patient is positioned laterally under fluoroscopy. A catheter is advanced into the intrathecal space at the desired spinal level and tunneled subcutaneously to a pocket created beneath the skin of the abdomen, where the programmable pump is placed and connected. The pump is filled and programmed by telemetry, and the dose is titrated over subsequent visits. Refills are performed in the office through a septum port.

How to prepare

Complete the required psychological evaluation and a successful intrathecal trial before scheduling. Nothing to eat or drink for 6 hours before the procedure. Arrange a driver and someone to stay with you overnight. Hold anticoagulants as directed. Confirm you can reliably attend refill appointments — this is a condition of candidacy, not a suggestion.

What to expect after

Keep the incision dry for 10 days. Avoid bending, lifting over 10 pounds, and twisting for 6 weeks. Carry the device identification card at all times. Never miss a refill appointment. Report fever, wound drainage, severe headache, new weakness, escalating pain, or any symptom of opioid withdrawal immediately. Sudden severe back pain or progressive weakness may indicate a catheter granuloma and requires urgent evaluation.

Outcome

In patients with refractory pain who pass a trial, intrathecal drug delivery typically produces substantial pain reduction with markedly lower systemic drug exposure, reduced sedation and constipation, and improved function. It is a long-term therapy requiring ongoing refills and periodic pump replacement.

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Raju Mantena, DO

    Pain Medicine Physician

    Medical Center — South Freeway · Montrose — Upper Kirby · Pearland

    Board certifiedAccepting newBook

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026.

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