gms | German Medical Science

Objective: Spinal cord stimulation (SCS) in pregnancy is a rare discussed topic. In the literature there are only 9 studies, which deal with this theme. We report the case of a 32-year-old woman with spinal cord stimulation during pregnancy and compare our case to similar published cases.

Method: In literature search, we found 14 cases of spinal cord stimulation in pregnancy by 11 patients, which are reported in 9 published articles. We reviewed all these articles and compared them with our present case. We investigated the indication for operation, SCS-status during pregnancy, course of pregnancy, delivery, anaesthesia at delivery, pregnancy outcome, type of electrode, electrode location, generator location and technical complications.

Results: Most indications for SCS were complex regional pain syndrome (n=5; 45,45%) followed by failed back surgery syndrome (n=4; 36,36%). In 5 of 15 pregnancies (n=5, 33,33%) the stimulation was turned off as the pregnancy was diagnosed. A deformity of the fetus was not prominent in the cases were the SCS turn on during pregnancy. Further aspects were defined like location of generator implantation, technical complications and course of pregnancy.

Conclusions: On the one hand, the use of SCS by pregnant women offers a fairly good way to manage pain syndromes and avoid side effects of pain medication on the pregnant woman and her fetus. On the other hand, there are until now no well-controlled studies about possible side effects of SCS on the fetus and the pregnant. The decision, whether to turn the SCS on or off during pregnancy, have to be taken together with the patient und discussed individually in every case. By young women with a chronic pain syndrome and wish to have children, the pulse generator should be implanted on upper gluteal region to avoid technical complications.