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Lumbar fusion and pregnancy


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.
11 Responses
414635 tn?1272221293
I would  probably go for a high risk ob in your case but i really don't know
Avatar universal
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!

297280 tn?1226710005
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.  
276983 tn?1308577648
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!  
Avatar universal
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.  
276983 tn?1308577648
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.  
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