Successful Re-implantation of Intrathecal Delivery System after Removal Secondary to Infection or Wound Dehiscence

Abstract

1Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 2Department of Neurological Surgery, Jefferson University Physicians, Philadelphia, PA 3Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA An intrathecal delivery system allows direct infusion of analgesics and antispasmodic drugs into the cerebral spinal fluid in patients with chronic intractable pain or spasticity. Intrathecal therapy effective but any surgical intervention carries the risk of complications. Complications encountered with this therapy include wound dehiscence (spontaneous reopening) and infection, which often lead to explanation of the intrathecal pump. Later re-implanation is feasible, but there is limited information regarding successful retention of the device after re-implantation. A recurring problem with generating reliable guidelines in neurosurgery is that some situations occur too rarely for evidence to be much more than anecdotal.