Intrathecal Therapy: Cased-Based Learning

Intrathecal drug delivery is a well-established intervention for chronic pain and severe spasticity with over 3 decades of clinical use. While there is proven efficacy with this treatment approach, there are critical decision points in the management of patients who are considering this intervention as well as patients who are already implanted. This course will describe approaches for patient selection, trialing, implantation, post-implantation management, troubleshooting, and therapy optimization. Additionally, this program will provide hands-on learning stations to review some of the technical aspects of this therapy. Multiple medical specialists would find this course beneficial including neurology, neurosurgery, anesthesiology, and physical medicine and rehabilitation. This course will also be of interest to many allied health professionals such as physical therapy, occupational therapy, nursing, pharmacy, case management, and bioengineering.

Learning Objectives

• Understand the indications and contraindications for intrathecal therapy
• Describe management strategies for intrathecal therapy optimization and troubleshooting
• Demonstrate technical skills that are commonly employed in the management of patients with intrathecal drug delivery systems

Introduction

Michael F. Saulino, MD PhD
Erik Shaw, DO

Should intrathecal therapy be considered in this patient?

Gladstone McDowall, MD

What steps should be undertaken before implant?

Jay S. Grider, DO PhD MBA

How do I manage a patient in the perioperative phase?

Yawar Qadri, MD PhD

How do I initiate therapy and manage the patient initially after implant?

Hemant Kalia, MD MPH

How do I optimize the therapy in the implanted patient?

Erik Shaw, DO

How do I set up practice to provide this therapy?

Mehul Desai, MD

What do I do if a patient has a medical emergency?

Daniel Moon, MD MS

How do I evaluate a patient who is no longer appreciating benefit with the therapy?

Michael Saulino, MD PhD