Spinal fusion-Spondylolithesis

[Pudding2014]

Hi,
Just wondering if anyone can offer me any advice. I had a posterior lumbar interbody fusion L5/S1 in Nov 2012 with a spinal realignment for Spondylolithesis grade 2 & have been left with nerve damage in my left foot.
I'm 31 weeks pregnant and starting to worry about labour and probably more so how I'm going to be afterwards as I still struggle when I've done too much.
If anyone has been/ is in a similar situation your advice would be greatly appreciated :)

[stressbucket1]

No real advice but I had a spinal fusion as a teenager I'm sure you will be fine afterwards do you have any help?

I had to see an anaethetist at 36 weeks last time because it may affect the pain relief you can have. I was told that an epidural might not work so if I needed a CS I would probably need a GA.

[Pudding2014]

Thanks so much for getting back :) I'm waiting for an appointment with the anaesthetist. ...really don't fancy an epidural even if they say I can have one plus would rather not have a c/s if possible. My boyfriend is taking 4-5 weeks off after the birth so will have help and support...guess I shall just go with the flow ;). Thank you again!

[Pudding2014]

Thanks so much for getting back :) I'm waiting for an appointment with the anaesthetist. ...really don't fancy an epidural even if they say I can have one plus would rather not have a c/s if possible. My boyfriend is taking 4-5 weeks off after the birth so will have help and support...guess I shall just go with the flow ;). Thank you again!

[stressbucket1]

I needed an emergency CS after a long labour as baby was getting distressed so I did need a GA its good to know all of your options before just in case.
I didn't want an epidural either but would have prefered it to a GA for CS unfortunately they didn't have time to try.

[Jcb77]

Hi pudding. Depending on what exactly was done, an epidural might still be possible. If you have scarring in your epidural space the anaesthetic solution might not spread fully so you might get a patchy block, but that'll be a 'suck it and see' kind of thing at the time - you can't see if or where any scarring has developed so don't know til you try. There are also some types of surgery where an epidural isn't a good idea anyway (depending on where metalwork is, what's been removed etc).
If your anaesthetist looks at the notes and thinks it's not appropriate, or you don't want one or it doesn't work well on the night, there are other options. A pca (where you press a button to deliver yourself a little dose of painkiller into a vein with each contraction) is often suggested. Different trusts have different protocols and drugs for this though so again be guided by the anaesthetist.
For a section, or other surgical input requiring anaesthetic, most women who've had back surgery can have a spinal. It's similar to, but in several crucial ways not the same as, an epidural. It goes in a different space so not affected by epidural scarring and is often still safe to put in when an epidural might not be.
Very unusually, neither are appropriate or possible (sometimes due to need for speed rather than your anatomy) and a GA is needed.
Hope the gas man can settle you mind but be assured that there are lots of options still.