Upper Antero-Medial Thigh as an Alternative Site for Implantation of Intrathecal Pumps: A Case Series

Alternative Implantation Site of Intrathecal Pump in the Submuscular Plane of the Pectoralis Major Muscle: A Case Report

“…Another nonconventional site of IT pump implantation is the anterior thigh. A case series by Narang et al 3 reported 9 successful implantations of IT pumps into the anteromedial thigh. Due to the close anatomic proximity of the neurovasculature in this region, the authors of this case series recommended remaining in the subcutaneous plane to avoid injury to the saphenous vein, femoral nerve, femoral vein, and femoral artery.…”

“…From its first implantation in 1981, IDDS has shown to be beneficial in the management of cancer pain, chronic noncancer pain, and spasticity. 1 Commonly, the IT pump is implanted into the abdominal region; however, other locations, including the gluteal, flank between the 12th rib and iliac crest, anterior thigh, and iliac fossa, [2][3][4] have been proposed when patients are not candidates for abdominal implantation. We propose the submuscular plane of the pectoralis major as a safe alternative implantation site for a pump.…”

Instituting an intrathecal baclofen pump program at an academic institution

“…8 If patients are unable to have abdominal pocket placement, gluteal or thigh positioning is also an option. 9 The catheter is then passed subcutaneously from the lumbar incision to the abdominal incision, attached to an extension catheter, and secured to the pump itself. All connection points are interrogated and secured as required.…”

Recurrent abdominal dislodgement of intrathecal pump and utility of infraclavicular site for patients with elevated body mass index: illustrative case

“…It is rare to encounter circumstances that dissuade abdominal placement of the device, and there are few such cases documented in the literature that describe alternative sites for pump placement. [11][12][13][14] Here we describe a patient with recurrent displacement of their abdominal ITB pump leading to catheter malfunctions who necessitated repositioning of the pump to an alternate site, and review the relevant literature in order to assist future practitioners faced with this unusual clinical scenario.ABBREVIATIONS CP 5 cerebral palsy; ITB 5 intrathecal baclofen; GABA 5 g-amino-butyric-acid.…”