Abstract
Drug infusion into the CSF by implanted drug pump systems represents a solution to the general problem of site specific delivery of medications to the brain. The success of selective perfusion of the spinal cord for pain and spasticity illustrates how powerful this technique can be if applied to the appropriate problem. Progress has been rapid for spinal applications because the anatomy is straightforward, the pharmacokinetics are simple and the devices for delivery are available and reliable. Other applications which require intraparenchymal delivery are much more complex, such as delivery of antibodies to control tumor growth, inhibitory drugs to control movement disorders, anti-seizure medications for epilepsy, or neurotrophins for Parkinson’s disease. These possible treatments are much more difficult and are still experimental.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kroin JS, Ali A, et al. The distribution of medication along the spinal canal after chronic intrathecal administration. Neurosurgery 1993; 33(2):226–30; discussion 230.
Muller ZK, Penn R. Local-spinal therapy of spasticity. Berlin: Springer; 1988. p. 270.
Penn RD, Paice JA. Adverse effects associated with the intrathecal administration of ziconotide. Pain 2000;85(1–2):291–6.
Rigoli G, Terrini G, et al. Intrathecal baclofen withdrawal syndrome caused by low residual volume in the pump reservoir: a report of 2 cases. Arch Phys Med Rehabil 2004;85(12):2064–6.
Coffey RJ, Burchiel K. Inflammatory mass lesions associated with intrathecal drug infusion catheters: report and observations on 41 patients. Neurosurgery 2002;50(1): 78–86; discussion 86-7.
Deer TR, Raso LJ, et al. Inflammatory mass of an intrathecal catheter in patients receiving baclofen as a sole agent: a report of two cases and a review of the identification and treatment of the complication. Pain Med 2007;8(3):259–62.
Murphy PM, Skouvaklis DE, et al. Intrathecal catheter granuloma associated with isolated baclofen infusion. Anesth Analg 2006;102(3):848–52.
Narouze SN, Mekhail NA. Intrathecal catheter granuloma with baclofen infusion. Anesth Analg 2007;104(1):209; author reply 209–10.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer-Verlag Berlin Heidelberg
About this entry
Cite this entry
Penn, R.D. (2009). The Future of Infusion Systems in Neurosurgery. In: Lozano, A.M., Gildenberg, P.L., Tasker, R.R. (eds) Textbook of Stereotactic and Functional Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69960-6_191
Download citation
DOI: https://doi.org/10.1007/978-3-540-69960-6_191
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-69959-0
Online ISBN: 978-3-540-69960-6
eBook Packages: MedicineReference Module Medicine