Spinal Catheters: A specific device

Within the medical field, a catheter refers to a tiny, flexible tube that can perform a variety of tasks. Medical devices called catheters can be implanted within the body to treat illnesses or perform surgeries. Depending on the specific purpose, the catheter is slightly different. Specific catheters are needed for cardiovascular, urological, gastrointestinal, neurovascular, and ophthalmic uses by changing the material or production methods.

Catheters can be implanted into the brain, skin, adipose tissue, bodily cavity, duct, or artery. Depending on the kind of catheter, they can perform various jobs, including drainage, administering fluids or gasses, access to surgical tools, and much more.

With one of the most common causes of disability being chronic spinal pain, Dr. Schneiderhan developed an effective method of spinal catheter therapy to help treat back pain. Chronic spinal pain can result in a wide range of issues including issues with joints, nerves, muscles, ligaments, and central pain processing. Treating chronic spinal pain through qualified professionals can improve a patient’s quality of life. Dr. Schneiderhan’s team has performed the highest number of spinal catheter procedures in Europe allowing them to efficiently assess a patient’s condition and provide treatment to maximize therapeutic results.

What is a Spinal Catheter?

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Dr. Schneiderhan shows how the pain catheter is inserted

A spinal catheter is a tiny, flexible tube inserted into the spine and passed through a skin tunnel. From a spinal catheter, regular doses of medicine that prevent pain perception can be administered into your spinal cord. 

One very thin plastic catheter (tube) called a spinal catheter gets inserted through the skin into the epidural space of your spinal canal. Doctors will leave a catheter in place for a specified amount of time—a few days for most surgical pain aids and up to six weeks for some chronic pain types.

Spinal catheters give access to the epidural space for the administration of pain killers or local anaesthetics. Temporary epidural catheters are utilized as a short-term pain management strategy for complex disorders requiring joint movement or vigorous physical therapy. 

What is a Pain Catheter?

A pain catheter is a minimally-invasive method of reducing discomfort following surgery. Spinal catheters are one type of pain catheter. 

Who Can Benefit From the Therapy?

Based on several variables, including the type of surgery and at-home care available, a patient’s surgeon typically determines whether or not the patient is an appropriate candidate to receive a pain or spinal catheter. Pain catheters provide a variety of benefits to appropriate patients, including:

  • Reduced discomfort following surgery
  • Decreased usage of opioids
  • Fewer chances of opioid dependency
  • Quicker mobility and function recovery
  • Increased possibility of sooner hospital discharge

It’s crucial to realize that the medication administered via the catheter is weaker than the medication in the nerve block received during surgery. As the first nerve block wears off, some patients can feel discomfort as a result.

Typically, pain catheters are not recommended if:

  • Any of the drugs that the doctor inject can cause known allergies.
  • The patient uses a blood thinner, such as aspirin, Coumadin, or Plavix.
  • The patient has an active infection.

Procedures for the Placement

In a typical pain catheter procedure, an outpatient procedure room with a fluoroscope—a specialized x-ray machine—is used to carry out the treatment. The nurse or physician inserts an IV line in the pre-procedure location. This IV line provides sedation and fluids.

Most patients will be placed on their stomach in the operation room and attached to monitoring equipment, such as an EKG monitor, a blood pressure cuff, and a blood oxygen monitoring device to manage the safety and comfort of the patient.

After washing the patient’s back and buttocks with antiseptic soap, the doctor injects a numbing medication into the skin, which can cause a brief burning sensation.

The physician finds a small hole near the tailbone’s base (sacrum) that the physician inserts a needle into. Then, the needle is used to Inject contrast dye to highlight the locations where scar tissue is present.

After that, the pain catheter is inserted through the needle and aimed toward the scarring region. Then, a mixture of steroids and anesthetic is administered.

Possible Risks Associated with the Procedure

The medication in a spinal catheter can cause a patient’s arm or leg to feel flimsy, heavy, tingling, or numb. After the numbing medication wears off, the sensation typically disappears as well. In more extreme cases, the patient might be unable to move the affected region for one or two days.

On top of this, spinal catheters can carry a few risks. These risks can include:

  • Medication-induced allergic response
  • Nerve injury (spinal cord and nerve roots)
  • Bruising and bleeding at the injection site
  • Discomfort during or at the injection location
  • Infection
  • Puncture of the spinal cord’s protective sac
  • Medicine injection into a spinal fluid or blood vessel
  • In certain circumstances, there will be no change or a worsening of your pain
  • Steroid injections, especially in diabetics, may temporarily raise blood sugar levels.

What Should I Do After Receiving Spinal Catheter Therapy?

Before a patient is released from the hospital, the patient’s nursel goes through post-procedure instructions for spinal catheter therapy in detail. The spinal catheter will get removed, and the catheter insertion site will be gauze-dressed before the patient returns home.

If the patient is returned with the catheter still in situ, the spinal catheter insertion site will be covered with a transparent plastic bandage. This type of bandaging allows the patient to check for any infection-related symptoms like redness or swelling. The patient’s home care organization usually does the requested dressing change for a spinal catheter and evaluates the area for any signs of infection or other issues.

Typically, patients need 20 to 30 minutes in the recovery area following spinal catheter therapy. Although, the majority of individuals feel better directly after receiving the injection. Even in these cases, most doctors still advise the patient to relax as much as possible for the rest of the day. Patients can slowly stand up and stroll inside the recovery room after the treatment.

In addition, patients may notice a significant reduction in discomfort caused by the administration of a local anaesthetic. In addition, our patients also receive statonary treatment for two and a half days. After pain catheter therapy, no heavy objects should be carried for the time being either, including children or shopping.

What is the Difference Between normal and Racz Catheters ?

A Racz catheter operation is utilized to release nerves from scar tissue in the spine (sometimes referred to as epidural adhesiolysis). The doctor Gabor Racz invented the Racz Catheter procedure. He discovered its efficacy for reducing scar tissue caused by back discomfort. This scar tissue (also known as adhesions) may form due to irritation, chronic inflammation (ongoing swelling), or after surgery. Scar tissue can then aggravate neighboring spinal nerve roots, resulting in discomfort that travels down the legs from the back. By releasing the nerves, one may lessen pain and enable the delivery of medication to inflamed nerves.

Surgery with the Racz Catheter entirely prevents soft tissue harm. It enters the epidural space through the spine’s natural holes. It is, therefore, the least intrusive type of surgical pain treatment currently available.

This therapy is especially beneficial following poor microsurgical outcomes. Depending on the situation, up to 50% of patients who have microsurgery do not get enough pain relief, even when the underlying issue is resolved.

Compared to the more straightforward epidural procedures, the Racz Catheter approach frequently overcomes the first barrier to catheter passage and injectates flow with the process, giving the doctor more confidence that the target region gets treated. Highly diseased areas, including previous surgery levels, may be targeted using this method, which is sometimes impossible to do with straightforward epidural procedures.

When targeting particular cervical spine epidural sites, a Racz catheter is also the method of choice. The upper thoracic spine can get used to securely and quickly entering the catheter, which you can then guide upward and towards the head to the required areas. Simple cervical epidural injections and transforaminal cervical epidural injections have a higher risk of complications and provide less flexibility in injectate targeting. Many articles support the Racz Catheter’s use as a safe procedure with better results than simple epidural injection procedures for patients with radicular pain and a history suggesting epidural fibrosis.

Conclusion

Whether a patient is seeking treatment for a spinal cord injury or chronic back pain, a doctor can examine them to identify the issue then recommend a course of action such as a spinal catheter. The optimal therapy for severe back pain occasionally involves an interdisciplinary approach that allows professionals to suggest appropriate solutions and implement and coordinate various treatment alternatives.

Dr. Schneider’s team has completed the highest number of spinal catheter procedures with the majority of patients avoiding open surgery. This highly qualified team can help determine the right treatment for spinal cord injuries or chronic back pain seeking out the least invasive and most effective treatment options.

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Orthopaedics
from Taufkirchen on jameda

jameda review from 12/2018

Wiltrud Rakel, OP spinal canal stenosis, 2018.

"A competent and very confident statement at diagnosis, "golden hands" at surgery WS canal stenosis. Thank you Dr. Hadi for a new pain free life.

Your Wiltrud Rakel"