Spinal Cord Stimulation during pregnancy

Many women who have a spinal cord stimulator (SCS) implanted are considering (or certainly have not ruled out) a pregnancy at some point in the future. But does spinal cord stimulation pose a risk to a pregnancy and unborn child? What advice is given by the medical profession?

What is spinal cord stimulation?

Spinal cord stimulation is a form of (and is sometimes referred to as) neuromodulation. Neuromodulation is defined as “the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body”.

A SCS is made up of a battery which is attached to leads. It’s implanted under the skin, with the leads sited precisely to deliver a mild electrical current (most often) to the spinal cord. It is hoped that this electric current will mask pain signals before they reach the brain. Spinal cord stimulation is used increasingly as a treatment for chronic neuropathic pain which has not responded to more conventional forms of treatment. Once implanted, the SCS is controlled by the recipient using a hand held remote control. Over the years, many of our clients suffering CRPS have had them implanted.

Although spinal cord stimulation has been around in one form or another for several decades, it’s only in more recent years as the technology has improved that it has become a staple in the treatment arsenal for chronic pain. Understandably, as a SCS delivers a constant electrical stimulus to the body, questions have been asked as to whether the use of spinal cord stimulation during pregnancy might adversely affect the pregnancy and/or the developing child. In particular, there is uncertainty as to whether the Electromagnetic Field (EMF) force generated by a SCS may have some effect on the child. Some have even questioned whether the EMF may hamper the ability to conceive in the first place.

Literature

A review of the limited literature that is available reveals that:

SCS is contraindicated during pregnancy – ie the medical advice given to women is to deactivate their SCS during pregnancy;
The reason for that advice is that the effect (if any) of spinal cord stimulation on pregnancy and the developing child is, as a result of the lack of research, currently unknown;
However, the same literature is also peppered with references to women who have chosen to keep their SCS activated during pregnancy and have nevertheless delivered healthy babies without any life threatening complications.

Spinal Cord Stimulation during pregnancy

Spinal cord stimulation is becoming a more routine procedure. Added to that, newer high frequency SCSs and dorsal root ganglion stimulators (DRG) can be even more effective at reducing levels of pain. Understandably, those are gaining in popularity.

Growing numbers of women who may potentially wish to have children or further children are having devices implanted. At present, it must be assumed that the majority of them would follow medical advice and deactivate them for the duration of their pregnancy. But remember, it’s not just the loss of spinal cord stimulation that a pregnant woman with chronic pain has to contend with. As a result of their pregnancy they cannot fall back on most prescription drugs, which leaves them to deal with the full onslaught of their underlying chronic pain, in addition to any pregnancy-related issues, without pain relief. It is understandable that some resort back to their SCS.

Research

Of course, spinal cord stimulation may be entirely safe during pregnancy. Then again there may be risks, low or high. However, this is one of those scenarios where, as a layman, it is difficult to imagine exactly how reliable research might be accomplished safely for both mother and unborn child.