title: Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant.
abstract: A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th(10-11) in the epidural space, accessed via the L(2-3) interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant.
authors.affiliation: Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8602, Japan. sho2ito@yahoo.co.jp
authors.forename: Shoji
authors.initials: S
authors.lastname: Ito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugiura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Azami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sasano
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sobue
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001182:Arthroscopy; D002585:Cesarean Section; D020918:Complex Regional Pain Syndromes / Q000150:complications / Q000601:surgery / Q000628:therapy*; D036861:Delivery, Obstetric; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D004824:Epidural Space; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011859:Radiography; D013116:Spinal Cord / Q000000981:diagnostic imaging