 The primary objective of this study is to prospectively examine outcomes in 12 patients using ziconotide Intrathecal Drug TherapyIDT as first-line monotherapy with the use of an algorithm of slow titration for dosing. The use of Prialt has demonstrated fewer and less serious associated adverse effects as compared to IDT morphine, especially when titrated slowly. We will use an average Numerical Rating Scale as our primary outcome and the Oswestry Disability IndexODI, Beck Depression Inventory BDI, Pain Catastrophizing Scale PCS, Clinical Global Impression of Change Scale including binary satisfaction measuresCGIC, Lawton-Brody Instrumental Activities of Daily LivingIADL and Short Form-36 as secondary outcome measures. 