Endoscopy-assisted intrathecal morphine pump implantation for severe cancer pain: a case report

This article presents a successful case of endoscopic-assisted intrathecal morphine pump implantation for the treatment of cancer pain associated with bone metastases. The patient was a 45-year-old female with severe cancer pain resulting from multiple bone metastases of rectal malignancy, which was poorly managed by the traditional three-step analgesic ladder. Preoperative intrathecal test puncture was attempted at multiple spinal levels but failed to access the intrathecal space. Subsequently, an endoscopic-assisted intrathecal morphine pump implantation was successfully performed at the L5-S1 level. Postoperatively, the patient achieved marked and sustained pain relief, accompanied by a dramatic improvement in her quality of life. No significant complications were observed during a 6-month follow-up. This technique provides a new therapeutic option for cancer pain patients who encounter difficulties with standard pump implantation procedures, demonstrating considerable potential for clinical application.