Neurostimulation for Chronic Low Back Pain during Pregnancy: Implications for Child and Mother Safety

Massimo Antonio Innamorato (), Marco Cascella, Elena Giovanna Bignami, Paolo Perna, Emiliano Petrucci, Franco Marinangeli and Alessandro Vittori
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Massimo Antonio Innamorato: Department of Neuroscience, Pain Unit, Santa Maria delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, 48121 Ravenna, Italy
Marco Cascella: Department of Anesthesia and Critical Care, Istituto Nazionale Tumori—IRCCS, Fondazione Pascale, Via Mariano Semmola 53, 80131 Naples, Italy
Elena Giovanna Bignami: Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
Paolo Perna: Department of Neuroscience, Pain Unit, Santa Maria delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, 48121 Ravenna, Italy
Emiliano Petrucci: Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L’Aquila, Via Vetoio 48, 67100 L’Aquila, Italy
Franco Marinangeli: Department of Anesthesiology, Intensive Care and Pain Treatment, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 Coppito, Italy
Alessandro Vittori: Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy

IJERPH, 2022, vol. 19, issue 23, 1-8

Abstract: Pain therapy for low back pain in pregnancy is a very topical issue. In fact, it is necessary to balance the patient’s needs to control pain with the need to manage a pregnancy without negative effects on the fetus. We report a case of a 37-year-old woman with low back pain treated with neurostimulation before pregnancy. She described severe chronic low back pain unresponsive to pharmacologic treatments. We first implanted a subcutaneous stimulator into the patient, and then a definitive stimulator resulting in excellent pain control. The improvement in her quality of life allowed the woman to become pregnant. We decided to stop neurostimulation with the patient during pregnancy. The patient completed her pregnancy without complications and the baby was born healthy. During the pregnancy, the woman took only paracetamol when needed. However, this painful symptomatology, completely anecdotal, is not attributable solely to the previous spine problem but probably also to the changes occurring during pregnancy. At the end of pregnancy, the neurostimulator was reactivated without any discomfort for the patient, who is now pain free. This case report provides a first line of evidence of a possible treatment of low back pain in women intending to become pregnant, with risk-free management for both the patient and the child.

Keywords: pain; chronic pain; low back pain; child; mother; pregnancy; spinal cord stimulation; implantable pulse generator; pediatrics; neurostimulation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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