"Sonology" of programmable intrathecal pumps

Area of Science:

• Medical Imaging
• Neurosurgery
• Pharmacology

Background:

• Intrathecal drug delivery systems (IDDS) are crucial for managing chronic pain and spasticity.
• Accurate identification of system components is vital for safe and effective device management.
• Sonography offers a non-invasive method for visualizing implanted medical devices.

Purpose of the Study:

• To characterize the distinct sonographic appearances of commercially available intrathecal drug delivery systems.
• To identify unique ultrasound features of the reservoir port (RP) and catheter access port (CAP) for each system.
• To assess the potential of ultrasound for localizing these critical components.

Main Methods:

• Three commercially available IDDS were evaluated using ultrasound.
• "Not-for-human-use" pumps were immersed in ultrasound gel.
• Sonographic scanning focused on the anterior pump surface to observe and record RP and CAP features.

Main Results:

• All systems displayed observable RP and CAP on ultrasound.
• SynchroMed II: RP as an anechoic depression; CAP as a peripheral conical depression.
• MedStream & Prometra: RP as dome-shaped; CAP as smaller, off-center dome or depression.

Conclusions:

• Ultrasound readily identifies the reservoir port in programmable intrathecal pumps.
• Distinct sonographic signatures exist for different IDDS, aiding in identification.
• Ultrasound may facilitate easier access to RPs, particularly for dome-shaped systems like MedStream and Prometra.