New Onset Lumbar Radicular Pain After Implantation of an Intrathecal Drug Delivery System: Imaging Catheter Migration

Patients with implanted drug delivery systems with positioning of the catheter tip into the lumbar cistern may develop new onset lumbar radicular pain as a result of catheter migration into an intervertebral foramen. Magnetic resonance imaging (MRI) is suggested as the initial imaging study to survey the spine and to evaluate for granuloma formation. Reimaging with computed tomography is essential to follow the course of the catheter and to delineate distal catheter tip location. It is suggested that positioning of the distal catheter tip at a location midway between the superior and inferior articular surfaces of the facet joint may minimize this complication.