Background Intrathecal analgesia plays a key role for patients suffering refractory cancer pain. Nevertheless, intrathecal drug delivery systems (IDDS), requiring a cervical catheter tip implantation, have been poorly described in medical literature.
Aims A monocentric retrospective follow-up study was designed to evaluate results of cervical IDDS for cancer pain.
Patients and methods From January 2010 to December 2022, all intrathecal-treated patients were prescribed a combined intrathecal analgesics regimen through a catheter placed in the cervical vertebral canal. Post-implant assessment of pain was determined using a numeric rating scale (NRS). Patients were followed via day-hospital visits and telephone calls at least monthly. Pain scores were compared using the Wilcoxon’s signed rank test.
Results Ninety-eight patients were included in this study; all received intrathecal treatments. Implanted patients suffered from severe pain (mean presurgical maximum numerical rating score 8.02±0.24 despite a mean 562.56±127.72 mg of oral morphine equivalent daily dose). Mean survival time after intrathecal treatment start was 208.48±67 days. Intrathecal drug delivery systems provided pain relief compared with initial pain score with a significant statistical difference after 1 week, 1 month, 2 and 3 months (p<0.01). A 50% reduction in initial pain level was achieved in 93% of cases during the first week of intrathecal implant.
Conclusions Results suggest that long-term intrathecal treatment using a multidrug regimen for cancer-related pain through cervical intrathecal catheters was suitable and safe in our study population. We demonstrated a clinically and statistically significant pain reduction in patients using mainly a percutaneous lumbar approach.
- cancer pain
- facial pain
- injections, spinal
- neck pain
Data availability statement
Data are available upon reasonable request.
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Contributors GC, TD, NR, VS, EN, NL, and DD participated in conceptualization and design, acquisition of data, analysis, interpretation of data and writing. AJ, FB, SJ-H, YMP and TD participated in conceptualization and analysis of data.
DD is guarantor of the study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests DD received consultations fees from Medtronic Esteve and Grunenthal.
Provenance and peer review Not commissioned; externally peer reviewed.
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