Since the problems with neuralgia are quite frequently created by blood vessel compression of the Trigeminal nerve, the goal of this microvascular treatment is to stop that compression. The surgeon will begin the procedure by shaving an area of hair behind the patient’s ear on the side where the pain exists. Next, a small hole will be drilled into the skull using a special device that is designed to stop once the skull is penetrated, then the dura (brain covering) will be cut with a scalpel to gain access to the trigeminal nerve and its root. Upon location of the problem, the surgeon will either put a pad in place that will act as a barrier between the nerve and the blood vessel, or he will transpose the vessel, which is actually compressing the nerve.
Implantation of an Intrathecal Pump
An intrathecal pump is an effective way to deliver pain medication directly to the spinal cord area. By distributing the medication straight into the cerebrospinal fluid (CSF), the patient is able to benefit from significantly lower amounts of medicine than with traditional oral medications. This is an option of treatment for candidates who have not had success with traditional methods or procedures. Some examples of patients who may benefit from intrathecal pump implant include those suffering from the following conditions: failed back surgery , cancerous tumors that are compressing the spinal column, chronic pancreatitis, or other progressive diseases that result in sciatica or peripheral nerve pain.
The system uses a small pump that is surgically placed under the skin of the patient’s abdomen along with a catheter that is also surgically placed in the intrathecal, fluid-filled space around the spinal cord that contains CSF, area. The two devices are connected through a flexible, silicone tube that delivers the pain medication to the spine. A space inside the pump called the reservoir holds the medication, and it is programmed to slowly release it over a period of time. The pump can also be programmed to release different amounts of medication at different times of the day, depending upon changing needs. When the reservoir is empty, the doctor or nurse refills the pump by inserting a needle through the patient’s skin and into the fill port on top of the reservoir.