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Lumbar fusion and pregnancy
Hi,
I posted this question on another forum, but I did not receive any responses. I had some questions about pregnancy and lumbar fusion. I am 27 years old, and I recently underwent a lumbar fusion from L4-S1. I also have two other herniated discs in my back, from L1-L3. My neurosurgeon stated that I will be able to have a child, have a c-section, and an epidural, if an anesthelogist would agree to it. My questions are, would I be able to have a natural childbirth, or would I have to have a c-section? I'm afraid that I will end up needing to be totally under general for birth if it's a c-section. My other question is should I find a high risk OB, or can I go with any OB? I also have a history of urinary reflux, and have had bladder surgery. I'm also looking into finding a back support brace. I'm also afraid that if I do get pregnant, I will spend most of my pregnancy on bed rest. My neurosurgeon stated I can start trying to conceive after 6 months from surgery, and we are looking to try in the fall. I would like to start looking for a new OB if needed before we get pregnant. Thanks very much for your input.
I posted this question on another forum, but I did not receive any responses. I had some questions about pregnancy and lumbar fusion. I am 27 years old, and I recently underwent a lumbar fusion from L4-S1. I also have two other herniated discs in my back, from L1-L3. My neurosurgeon stated that I will be able to have a child, have a c-section, and an epidural, if an anesthelogist would agree to it. My questions are, would I be able to have a natural childbirth, or would I have to have a c-section? I'm afraid that I will end up needing to be totally under general for birth if it's a c-section. My other question is should I find a high risk OB, or can I go with any OB? I also have a history of urinary reflux, and have had bladder surgery. I'm also looking into finding a back support brace. I'm also afraid that if I do get pregnant, I will spend most of my pregnancy on bed rest. My neurosurgeon stated I can start trying to conceive after 6 months from surgery, and we are looking to try in the fall. I would like to start looking for a new OB if needed before we get pregnant. Thanks very much for your input.
I am actually a patient of a spinal fusion myself. I had my surgery on February 18th, 2008 my second semester of my freshmen year of high school. I am 22 years old and my steel bars go from between my shoulders to about the top of my pelvis due to scoliosis. I am so scared of the complications that may arise from such a condition and I'm worried I may end up having a c-section and being put on bed rest longer than expected after delivery. Any suggestions?
Yup.. we're naming her Lillian (which of course will end up getting shortened to Lily). It's a little old fashioned I suppose, but my husband and I really liked it.
Do you know whether you're having a boy or a girl... or will it be a surprise?
Do you know whether you're having a boy or a girl... or will it be a surprise?
Wendy80 - thanks for the info! good luck with everything - i look forward to hearing from you in the next few weeks!-hope you have a safe and painfree birth!
have you a name picked out yet?
loopie
have you a name picked out yet?
loopie
From my understanding, it really will depend on the anesthesiologist who is present at the time of delivery. I met with the head anesthesiologist at our hospital and by telling him exactly what vertebrae were fused and by looking at the scar tissue on my back, he was able to tell me that they would at the very least give it a shot (giving me an epidural). It does seem that the most common place to administer an epidural is in the L4 region, however I think they might be able to work slightly above that area as well. For me, he said that since L4 and L5 are not fused, he has plenty of room to get the needle to the spinal cord, however the biggest problem will be whether the actual medicine works all the way (due to nerves being manipulated during the surgeries) and whether or not they'll be able to navigate correctly since they'll have to pass the needle through scar tissue. So your anesthesiologist might give you the same info... he'll try it, but it's not guaranteed to work. Oh, and he did tell me to bring my xrays with me when I go in to deliver (it just makes it easier for whoever is on call to use as a reference... they can see first hand what your back looks like).
And I'm doing well, thanks for asking. I'm almost 36 weeks and so far she's staying in there... I've had plenty of people tell me it looks like she might come early (just based on how big my belly is). I'm looking at the possibility of a c-section (which of course would require an epidural) b/c they're telling me my baby is measuring quite larger than "normal".. if she keeps up her weight gain from the past couple months, she might be close to 10 pounds at birth!
Good luck... your OB should be able to set you up with a consultation with the hospital's anesthesiologist.
And I'm doing well, thanks for asking. I'm almost 36 weeks and so far she's staying in there... I've had plenty of people tell me it looks like she might come early (just based on how big my belly is). I'm looking at the possibility of a c-section (which of course would require an epidural) b/c they're telling me my baby is measuring quite larger than "normal".. if she keeps up her weight gain from the past couple months, she might be close to 10 pounds at birth!
Good luck... your OB should be able to set you up with a consultation with the hospital's anesthesiologist.
Hi - I am new to this site, and have been looking for more information on lumbar fusion and pregnancy.
I had a successful fusion w/ instrumentation L4-L5-S1 Nov 2006. I am 39( 40 in Oct) and am now 29wks pregnant with my 1st. It was a long road to get here, but when we started, I really believed I would be on bedrest for the majority of my pregnancy- to my surprise, I have been feeling pretty great so far and usually just take a little rest each afternoon so I don't get to wiped out, and have been lucky to have gained just 10lbs so far. I rarely even take a tylenol, but am just now starting to feel a greater deal of pain than the "everyday pain" in my hips, and back - no big deal, but am beginning to think a lot about delivery.
My plan is to have as natural a birth as possible, but I know that things happen, and I want to be prepared, just in case I decide I want medication (epidural/spinal, etc) - or if there is a problem and I need CSec -so, question is...can we get the pain relief if we want it?
From what I've found out, the epidural goes in at the L4 region, thus with scar tissue, it may not be possible to put in the catheter which pumps medicine in as needed throughout the delivery. What may be more likely for anyone with previous back surgery is the spinal- which is a 1 time shot L4/L5 region but this only lasts for 1-2hrs, so you'd really have to wait until you really think you are close to ask for this-
So, I have spoken with my back surgeon, and will be discussing options "just in case" with my OB. It is also advisable that I bring any images post surgery (MRI/X-Ray) that I may have so OB and anesthesiologist are not having to figure it out in the delivery room under pressure. I know my situation is not unique, but I do want to be as educated about it as I can b/c when the time comes, there will be enough other variables not in my control!
Wendy80- how is everything going? you are about 36wks now? feeling ok? have you delivered?
the one thing I do know is that our bodies are pretty incredible - don't be too worried about bedrest or pain during pregnancy. If it is something you want- you can do it!!
best to you all!
loopie
I had a successful fusion w/ instrumentation L4-L5-S1 Nov 2006. I am 39( 40 in Oct) and am now 29wks pregnant with my 1st. It was a long road to get here, but when we started, I really believed I would be on bedrest for the majority of my pregnancy- to my surprise, I have been feeling pretty great so far and usually just take a little rest each afternoon so I don't get to wiped out, and have been lucky to have gained just 10lbs so far. I rarely even take a tylenol, but am just now starting to feel a greater deal of pain than the "everyday pain" in my hips, and back - no big deal, but am beginning to think a lot about delivery.
My plan is to have as natural a birth as possible, but I know that things happen, and I want to be prepared, just in case I decide I want medication (epidural/spinal, etc) - or if there is a problem and I need CSec -so, question is...can we get the pain relief if we want it?
From what I've found out, the epidural goes in at the L4 region, thus with scar tissue, it may not be possible to put in the catheter which pumps medicine in as needed throughout the delivery. What may be more likely for anyone with previous back surgery is the spinal- which is a 1 time shot L4/L5 region but this only lasts for 1-2hrs, so you'd really have to wait until you really think you are close to ask for this-
So, I have spoken with my back surgeon, and will be discussing options "just in case" with my OB. It is also advisable that I bring any images post surgery (MRI/X-Ray) that I may have so OB and anesthesiologist are not having to figure it out in the delivery room under pressure. I know my situation is not unique, but I do want to be as educated about it as I can b/c when the time comes, there will be enough other variables not in my control!
Wendy80- how is everything going? you are about 36wks now? feeling ok? have you delivered?
the one thing I do know is that our bodies are pretty incredible - don't be too worried about bedrest or pain during pregnancy. If it is something you want- you can do it!!
best to you all!
loopie
I would definitely try and look for a new GYN/OB... I'm no expert, but it doesn't seem healthy to only gain 10 pounds during your entire pregnancy (overweight or not). Like you said, you figure that the baby will weigh anywhere from 5-10 pounds (give or take) and you still have to account for the expanding uterus, the placenta, the amniotic fluid...etc. I would get a second opinion on that particular aspect.
I did have a pre-conception visit with my GYN. Lovely, he told me that he's no longer delivering babies. He did say that he will do my prelimilary tests and then transfer me to another OB. I might just decide to start with a different OB from the beginning. The GYN is about 40-45 minutes away, and I can see other ones in the area who deliver at the same hospital. He also instructed me that since I'm overweight, he would start me with a nutrionist and only wants me to gain 10 lbs in pregnancy. My older sister had a child last year, and the baby alone was almost 10 lbs. Trust me, I can't wait until the fall to take myself off of birth control, and see what happens.
Although not as recent, I have a similar situation. When I was 15-yrs-old I had a spinal fusion done from T2-L3. I had another surgery done 3 years ago to remove all of the hardware (due to infection of the metal). Granted your situation is a little different b/c you have 2 herniated discs and your fusion was done rather recently, but my back doctor and my OB both agreed that there was no reason why I couldn't try to get pregnant. I was told I can either deliver naturally or by c-section (assuming the anaesthesiologist says that they can get an epidural in there), but the only problem I might run into is obvious back pain (moreso than most pregnant women). I'm currently 26 weeks pregnant and so far so good... I do have some back pain already, but nothing that is keeping me from work (I just have to take it easy).
I didn't need to go with a special "high risk" OB... but it could be different for each specific case. And I'd say if your neurosurgeon told you that you can start trying in the fall, then go for it. He/she won't tell you to do something that might hurt you or cause you harm. You'll just have to take it easy, that's all. Good luck!
I didn't need to go with a special "high risk" OB... but it could be different for each specific case. And I'd say if your neurosurgeon told you that you can start trying in the fall, then go for it. He/she won't tell you to do something that might hurt you or cause you harm. You'll just have to take it easy, that's all. Good luck!
If I had those pre-existing conditions, it would probably make me feel better to have a preconception visit with an OB to see what they think before I got pregnant. That way you might have an idea what the complications might be. As far as the anesthesia during a c-section, I'm not sure if the situation would be different due to your medical history, but I asked if I ended up having to have a c-section if I could request general anesthesia and they told me no, that they don't like to do that unless it's absolutely necessary.
Hi there-
I'm in a similar boat- I had a discectomy last August at L4-L5 and am now about 14 weeks pregnant (it came as quite a surprise to us since it was so soon after the surgery). So far, I'm progressing, but I do have more back soreness than pre-pregnancy and have had some complications with the baby's progression that may or may not be surgery related. I was on bed rest from weeks 6-10 and am able to walk around slowly now.
I've spoken with my OB and she doesn't seem to want to do a c-section unless totally necessary, however, she plans on talking with my neurosurgeon just to be sure as the surgery was not long ago and due to it's location. My neurosurgeon, on the other hand, seems to be more open towards the c-section (I seem to trust his opinion more on this!) due to the type of surgery I had. My OB suggested I have a consult with the hospital anesth. in a few weeks to go over my options since epi's are usually placed at L4-L5.
One thing I would say is that as happy as I am to be pregnant, if we could have waited a little longer to get pregnant, I probably would have done that, to increase the strength in my back before starting to carry the baby weight. It is NOT fun at all.
I hope to keep checking this forum, maybe a knowledgeable person or doctor will respond to this important issue! Good luck to you and your family planning!
Gen
I'm in a similar boat- I had a discectomy last August at L4-L5 and am now about 14 weeks pregnant (it came as quite a surprise to us since it was so soon after the surgery). So far, I'm progressing, but I do have more back soreness than pre-pregnancy and have had some complications with the baby's progression that may or may not be surgery related. I was on bed rest from weeks 6-10 and am able to walk around slowly now.
I've spoken with my OB and she doesn't seem to want to do a c-section unless totally necessary, however, she plans on talking with my neurosurgeon just to be sure as the surgery was not long ago and due to it's location. My neurosurgeon, on the other hand, seems to be more open towards the c-section (I seem to trust his opinion more on this!) due to the type of surgery I had. My OB suggested I have a consult with the hospital anesth. in a few weeks to go over my options since epi's are usually placed at L4-L5.
One thing I would say is that as happy as I am to be pregnant, if we could have waited a little longer to get pregnant, I probably would have done that, to increase the strength in my back before starting to carry the baby weight. It is NOT fun at all.
I hope to keep checking this forum, maybe a knowledgeable person or doctor will respond to this important issue! Good luck to you and your family planning!
Gen
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