If your screening test is successful, you and your doctor will likely decide to pursue long term ITB therapy, and the next step would be to implant the permanent infusion system pump and catheter. This is accomplished with a surgical procedure performed under general anesthesia that takes 1-3 hours and may require overnight hospitalization.
During this procedure the surgeon will form a “pocket” under the skin in the abdomen to hold the pump. There will then be a second incision in the back, where one end of the catheter will be placed in the spinal canal. The other end of the catheter will then be attached to the pump, resulting in a fully implanted infusion system. Then the incisions will be closed, and the surgery is complete. There may be some minor discomfort and tenderness where your pump and catheter are placed, but this should resolve within a few days.
You and your physician will be able adjust the pump using an external programming device to optimally manage your spasticity by delivering the appropriate dose of medication. It may take several weeks or months to reach the optimal dose. Some patients are sent for a brief period of inpatient rehabilitation including intense physical and occupational therapy and ongoing pump titration to help them better adapt to changes in function resulting from reduced spasticity.
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