Neuromodulation, how does it work?

Neuromodulation is technology that acts directly upon nerves. It is the alteration, or modulation, of nerve activity by delivering electrical or pharmaceutical agents directly to a target area. Neuromodulation devices and treatments are life-changing. They affect every area of the body and treat nearly every disease or symptom from headaches to tremors to spinal cord damage to urinary incontinence. Neuromodulation works by either actively stimulating nerves to produce a natural biological response or by applying targeted pharmaceutical agents in tiny doses directly to a site of action.

In the case of pharmacological agents delivered through implanted pumps, the drug can be administered in smaller doses because it does not have to be metabolised and pass through the body before reaching the target area. Smaller doses, in the range of 1/300 of an oral dose, can mean fewer side effects, increased patient comfort and improved quality of life.

Merlin Med (Pty) Ltd has partnered with Flowonix, a medical device company with a dedication to helping those who suffer from chronic disorders. Flowonix is a leader in healthcare innovation, and the company continues to advance medical technology to help patients return to normal lives.

Flowonix has developed a cutting-edge implantable drug delivery system that efficiently delivers medication when a patient needs it most. The 3rd Generation Prometra® Programmable Pump features a number of innovative technological developments that represent a significant advancement in intrathecal therapy. Through intentional design, the programmable infusion system has several components that guard against common complications including tissue ingrowth, suture complications, weakened connection, and possible issues with refills.

How is Prometra® different from a peristaltic pump?

The Prometra® drug delivery system is a valve gated pump. Instead of rollers and plastic tubing, it uses valves to isolate a titanium dosing chamber from the reservoir and catheter. This results in two principle effects: better control over dosing reliability and longer battery life. Separating the dosing chamber from the reservoir prevents the increase in pressure in the reservoir at refill, decrease in pressure over the weeks as the drug is emptied from the reservoir, and from having an impact on the amount of drug delivered. With this design, temperature and pressure effects, like getting into a hot tub or travelling by plane are minimised. Additionally, decreasing the number of moving parts from a long list of complex gears, rotors, and pliable tubing to just the two valves results in a nearly 50% increase in service life.

How does Prometra® work?

The Prometra® system has incredibly high dependability standards due to the advanced technology used to develop it. Because no medicine is being absorbed by the body on the way to the spinal cord, the amount of drug typically being delivered by intrathecal pumps per day is very low – often about seven drops of medicine a day. To provide high levels of dosing reliability without significant battery power, Prometra® uses a simple micro-valve mechanism to control the flow of medicines from the reservoir to the catheter. By controlling the flow of medicine with valves in a precision dosing system, Prometra® minimises weather, atmospheric pressure, reservoir fill level, and medicine flow rate from affecting the accuracy of delivery.