Background Patients taking oral medication sometimes suffer from side-effects, especially if they take high doses of medication. For some people, these same medications can be administered directly intrathecally (into the fluid around the spinal cord) using a pump implanted under the skin. This allows lower doses to be used, which results in fewer side-effects. You have previously had a successful trial of intrathecal medication and your doctor has agreed to implant a permanent intrathecal pump. What does the procedure involve? Your doctor will insert a catheter (small tube) through your back into the fluid around your spinal cord. The catheter is tunnelled under the skin around to the abdominal wall where it is connected to a pump which is implanted within the subcutaneous tissues of your abdominal wall. This system is then used to provide a constant supply of medication (this is called an infusion) into the fluid surrounding the spinal cord. What will happen during the procedure? On the day of the procedure, you will be admitted to hospital and the nurses will prepare you for theatre. In theatre, you will be asked to lie on the operating table. An anaesthetist will place an intravenous catheter and pump are placed surgically. What happens after the procedure? You will stay in the recovery room for 1-2 hours after your anaesthetic and surgery. You will then transfer back to the ward for overnight care, Medication has been put into your pump so the proceeded of replacing your oral medication with pump-based medication has already started. You can however still expect to take at least some of your oral medication for the next few weeks. What are the possible complications? This procedure has a very low risk of complication, but there are some that you should be aware of. Local discomfort: some patients may experience some discomfort in the surgical areas for a few days. This is the most common complication. Post -dural puncture headache: patients may develop a headache which is worse when the patient is standing up . This usually resolves by itself. However, should it persist, please let your specialist know. Bleeding or infection: these are very rare. Please tell the nursing staff or the doctor immediately if you develop a fever, worsening back pain or numbness and /or weakness in your legs after the procedure. If these symptoms occur outside of office hours, you should attend the nearest emergency department.