Scoliosis fusion and pregnancy

[mamasky]

Hi ladies, so I had a spinal fusion t3-l4 in december last year and I am currently 24 weeks pregnant and I'm worried about what options I'll be given for labour, I'm happy with a c section and I'm expecting I wont be able to get an epidural due to being fused at that point in my spine. I'm also worried I wont be able to push properly during labour due to my muscles in my back being so weak still. All the advice and help I can get is welcome

Didnt want to just read and run. I have no experience of this. Have you tried a support group?

Have you an appointment to see an obstetrician and an anaesthetist yet ?
Did you mean a fusion at T3/T4 ? That’s above the level at which they site a spinal or an epidural so in the basis of what you’ve told us should be ok . Your back muscle strength is irrelevant for pushing a baby out . Ask your midwife for a referral if not already booked .

If you were going for a vaginal delivery would you definitely want an epidural? I went in thinking that I didn't but I also wouldn't rule it out and fortunately never got to the stage where I wanted to change my mind.

Have you spoken to midwife/gp/consultant about your spine issues? I don't think the muscles would affect anything but would probably be nice to have the professional reassurance. Also to discuss delivery options.

COI: Im an anæsthesist with an interest in obstetric anæsthesia. Obviously I cannot comment on your individual circumstances or give you medical advice but would like to complement you on being really sensible in thinking about the options and planning for the birth now. Its much easier to choose what you want and think about risks when you are not actively labouring.

Ask your midwife if you can speak to an anæsthetist about options during your labour and birth, due to your spinal surgery history. Most obstetric services run a clinic for these sorts of situations where they will be able to examine and discuss the right options for you, both in regards to pain management in labour and in case you need any operative procedures during or after the birth.

In certain circumstances it is possible to have either epidural or spinal anæsthesia after spinal surgery (and your fusion at a higher thoracic level may make this possible) but it very dependant on your exact history. There are also many possibilities for pain management at various stages of labour from gas & air, to opiate injections and patient controlled type medications but it really depends what your local hospital can offer you, so its best to ask for a direct referral.

Best wishes for the rest of pregnancy and the birth.

I have T3-L4 fusion. Had the surgery in 1998.

Emcs under GA in 2015. Vbac this year with episiotomy repair under GA

No issues in pregnancy, labour or delivery except :
Pg1, consultant anaesthetist appt in pregnancy to confirm no possibility of epidural.
Pg2, declined to repeat the appt with consultant anaesthetist. Delivered on my back as ventouse required- that bit was sore as no time to put any lumbar support in place.

Hope this is useful. Let me know 8f you want to know anything else.

I had fusion surgery in my teens for a 75+ degree curve.

I have had 2 elective sections. Took a long time for the spinal to take but we got there in the end. I would have preferred a section under GA than to risk a vaginal birth.

There is a Facebook page called Scoliosis Association UK I'm sure there was a thread a while ago asking a similar question. Maybe helpful for you. They also have an online forum.

Yes, I'm in a couple of closed groups on Facebook. One for adults and one for parents - my kids have Scoliosis too.

Also, there's the forum on SAUK.

To reply to fluffyjumper, I'm in plenty but I'm just hoping theres more people out there not in the groups who may understand what's going on

Hi, I have congenital fusion between my L4 and L5, which is where they usually put the epidural in. I saw a consultant anaesthetist during pregnancy after I mentioned it to my midwife. He reviewed my x rays and said they’d be able to insert it a bit higher if I needed one. Which I did and it was fine.

Obviously that’s not as large as your fusion and as I’ve had it since birth I don’t have the same concerns about muscle strength.

Discuss it with your midwife and they’ll be able to refer you to the necessary specialists who can advise you on your options.