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This article discusses the effectiveness of intrathecal morphine pump (ITMP) infusion therapy in managing chronic pain that does not respond to standard treatment. The study specifically focuses on the use of ITMP in patients who continue to experience pain after lumbar spinal fusion surgery and lumbar spinal decompression alone. The researchers retrospectively analyzed data from 43 chronic pain patients who received an ITMP between 2009 and 2019. They assessed pain intensity, quality of life, mental health, and morphine dosage over time. The results showed that ITMP had a significant long-term impact on pain relief, improving the quality of life and reducing psychological distress. There were no significant differences between patients who had spinal fusion surgery and those who had decompressive surgery alone. However, the initial morphine dosage was higher in the fusion group compared to the decompression-alone group. Overall, the study suggests that ITMP is an effective treatment option for chronic pain following spinal surgery
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated spinal hospital in the world
Published article
CONCLUSIONS: This retrospective study showed that ITMP have a major long-term impact on pain relief, improve the quality of life, psychological distress, as well as pain catastrophizing in patients with chronic pain following lumbar spinal surgery independent of the previous surgical procedure. After ITMP implantation initial median morphine dosage seems to be significantly higher after spinal fusion compared to decompressive surgery alone.
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Scand J Pain. 2023 Sep 6. doi: 10.1515/sjpain-2023-0042. Online ahead of print.ABSTRACTOBJECTIVES: Intrathecal morphine pump (ITMP) infusion therapy is efficient in managing chronic pain refractory to standard treatment. This study evaluates pain relief and improvement of quality of life in chronic pain patients after intrathecal morphine pump implantation for treatment of persistent pain after lumbar,
Scand J Pain. 2023 Sep 6. doi: 10.1515/sjpain-2023-0042. Online ahead of print.
ABSTRACT
OBJECTIVES: Intrathecal morphine pump (ITMP) infusion therapy is efficient in managing chronic pain refractory to standard treatment. This study evaluates pain relief and improvement of quality of life in chronic pain patients after intrathecal morphine pump implantation for treatment of persistent pain after lumbar spinal fusion surgery and lumbar spinal decompression alone.
METHODS: Forty three chronic pain patients that received an ITMP at our department between 2009 and 2019 were retrospectively analyzed divided into 2 cohorts (lumbar spinal fusion surgery and lumbar spinal decompression alone). Pain intensity was evaluated using the numeric rating scale (NRS), quality of life was assessed by EQ-5D-3L, mental health was assessed by Beck Depression Inventory (BDI-V), and Pain Catastrophizing Scale (PCS). Morphine dosage was assessed over time. Data was collected preoperatively, 6 and 24 months postoperatively. Statistical analysis was performed using Friedman’s analysis of variance to evaluate the development of NRS, PCS, BDI and EQ-5D-3L over time and Mann-Whitney-U-test for the differences between these parameters in the different cohorts. A two-sided p-value <0.05 was considered statistically significant.
RESULTS: Median age was 64 years (IQR25-75 56-71 years). NRS, EQ-5D-3L, BDI-V, and PCS showed a significant overall improvement after 6 and 24 months compared to baseline data (p<0.001). No statistically significant differences between patients with lumbar spinal fusion surgery and lumbar spinal decompression alone were seen. Furthermore, no statistically significant differences for age and gender were seen. The initially administered median morphine dosage was significantly higher in the fusion group (3.0 mg/day; IQR25-75 1.5-4.2 mg/day) compared to the decompression-alone group (1.5 mg/day; IQR25-75 1.0-2.6 mg/day); (p=0.027).
CONCLUSIONS: This retrospective study showed that ITMP have a major long-term impact on pain relief, improve the quality of life, psychological distress, as well as pain catastrophizing in patients with chronic pain following lumbar spinal surgery independent of the previous surgical procedure. After ITMP implantation initial median morphine dosage seems to be significantly higher after spinal fusion compared to decompressive surgery alone.
PMID:37667441 | DOI:10.1515/sjpain-2023-0042
The London Spine Unit : best situated spinal hospital in the world
Read the original publication:
Does lumbar spinal decompression or fusion surgery influence outcome parameters in patients with intrathecal morphine treatment for persistent spinal pain syndrome type 2 (PSPS-T2)
