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Related Concept Videos

Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Related Experiment Video

Updated: Jun 27, 2026

Accessing the Subdural Space of the Rodent Spinal Cord for Treatment Delivery
07:54

Accessing the Subdural Space of the Rodent Spinal Cord for Treatment Delivery

Published on: August 8, 2025

Intrathecal Drug Delivery as a Rescue Strategy in Patients with Spinal Cord Stimulation: A Single-Center Case Series.

Nicolás Cordero-Tous1, Marcos Salmerón-Martín2, Bernardino Alcazar-Navarrete3,4

  • 1Functional Neurosurgery Unit, Department of Neurosurgery, Hospital Universitario Virgen de las Nieves, Juan Pablo II Avenue, S/N, 4th Floor, 18013 Granada, Spain.

Journal of Clinical Medicine
|June 26, 2026
PubMed
Summary

Combined spinal cord stimulation (SCS) and intrathecal drug delivery (IDD) offers a rescue strategy for chronic pain patients with inadequate relief. This neuromodulation approach significantly reduces pain and opioid use, improving patient satisfaction.

Keywords:
chronic low back painchronic non-cancer painhealth related quality of lifeintrathecal infusionspinal cord stimulationspinal pain

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Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs

Published on: December 7, 2012

Area of Science:

  • Neurology
  • Pain Management
  • Neurosurgery

Background:

  • Chronic pain, particularly low back pain, is a global health issue causing significant disability.
  • Spinal cord stimulation (SCS) and intrathecal drug delivery (IDD) are established treatments for refractory chronic pain.
  • Some patients do not achieve sufficient relief from SCS or IDD alone, necessitating alternative strategies.

Purpose of the Study:

  • To evaluate the efficacy and safety of combined SCS and IDD therapy in patients with refractory chronic pain.
  • To assess the impact of combined therapy on pain intensity, opioid consumption, quality of life, and patient satisfaction.

Main Methods:

  • A retrospective case series was conducted at a single center.
  • Patients previously implanted with SCS who subsequently required IDD were included.
  • Validated instruments assessed pain, opioid use, quality of life, and satisfaction.

Main Results:

  • Twelve patients with persistent low back pain were included.
  • Combined therapy resulted in a 40% average reduction in pain intensity (3.5 points on NRS).
  • Over 50% of patients discontinued systemic opioids; most complications were hardware-related.

Conclusions:

  • Combined SCS and IDD therapy provides clinically meaningful pain reduction and decreases opioid reliance.
  • While quality of life scores did not normalize, patients reported subjective improvements.
  • This combined neuromodulation approach may be a viable rescue option for select patients unresponsive to SCS alone.