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Patient Selection

  • Lucas W. Campos
Chapter

Abstract

Intrathecal therapy (IT) is used to treat a wide array of pain etiologies including nociceptive, neuropathic, or mixed, for both cancer-related and noncancer-related pain. IT is often considered when SCS fails and is an appropriate alternative to SCS in select patients with non-neuropathic pain or diffuse cancer pain. Common disease states and diagnoses for which IT has been successful in treating include diabetic neuropathy, radicular pain from failed back surgery syndrome, or severe rheumatoid or osteoarthritis pain throughout the body. Noncancer pain patients who need around-the-clock dosing of oral opioids or have failed oral opioid therapy due to intolerable side effects such as pruritus, constipation, or urinary retention are also excellent candidates for IT. Cancer patients with a life expectancy ≥3 months and cerebrospinal fluid (CSF) circulation which is not hampered by tumor burden are the patients most likely to benefit from this modality. Assessment of the patient when considering IT should include a complete physical, neurologic, radiologic, psychological, and social evaluation. In this chapter we will review the state of the literature concerning patient selection based on these assessments.

Keywords

Intrathecal therapy Patient selection Noncancer pain Cancer pain Neuropathic pain Nociceptive pain 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lucas W. Campos
    • 1
  1. 1.Interventional Pain PhysiciansChicoUSA

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