Originally published by our sister publication Pain Medicine News
By Kenny Walter
Spinal targeted drug delivery (TDD) may be a viable option for pain relief, as a new study shows it could be safer and more effective than long-term opioid use, while increasing patient satisfaction.
In the study, a team of researchers conducted a survey to determine whether treatment variables are linked to patient satisfaction at a single pain clinic.
Each patient (N=973) was implanted with Medtronic pain pumps to relieve intractable pain and active TDD. Of the patients identified, 564 completed the 23-question survey comparing satisfaction with intrathecal (IT) medication dosages, pain relief, pain diagnosis, catheter tip location, side effects, mental clarity, physical functioning and healthcare utilization, and 560 were included in the final analysis.
In addition, 96.4% of patients had IT infusion admixtures containing bupivacaine and opioids.
The results show 63.8% of those surveyed reported good to excellent pain relief, while 80.7% reported high satisfaction with TDD. Moreover, 75% said there was an improvement in physical functioning and 89.7% said they had a better quality of life.
Finally, 78.5% of respondents reported complete discontinuation or substantial reductions in systemic opioid use.
Overall, the results demonstrate a statistically significant relationship between satisfaction and IT medication dose (P=0.02), with an average dose increasing with higher satisfaction groups and patients with higher doses of IT opioids not having more negative side effects (P=0.05).
The investigators believe the study shows evidence that IT drug delivery could be a viable option in the future.
“The results of this study confirm that intrathecal drug delivery can be a safe and effective alternative to long-term use of opioids for patients with refractory chronic pain who have exhausted other interventions,” said lead author David Schultz, MD, the chief medical officer of Nura Pain Clinics. “Our findings indicate that patients who received higher-dose intrathecal medication admixtures experienced better pain relief and higher satisfaction—without any increase in side effects, mental impairment or therapy complications.”
The study was published online in Neuromodulation (2025 Jan 4. doi:10.1016/j.neurom.2024.11.006).
