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summer
12-27-2009, 01:52 PM
Hi,
I'm 16 weeks pregnant with twins & remember being told by my surgeon that I probably wouldn't be able to get a spinal or epidural since I'm fused to my sacrum. Did anyone find a way around this ? Otherwise they say I might have to be knocked out the old fashion way since I'll most likely get a C-section! Thanks.

LindaRacine
12-27-2009, 04:20 PM
Hi Jenn...

I remember hearing from women who have had fusions, but have received epidurals, but I don't think they were fused to the sacrum. It seems to me that if your entire lumbar spine is fused, there would be no way to get to the spinal cord without drilling through the bone.

Best of luck with your pregnancy and delivery.

Regards,
Linda

RitaR
12-27-2009, 06:00 PM
Hi Guys: Take it from me - I was told years ago when I was younger I would probably never be able to carry a child to full term. Well, of course, I didn't listen. My husband and I have a wonderful, straight-A 13-year-old son who is more than perfect! I could not have asked for more - a wonderful husband who is my brick, helps me all the time, more than he will ever know, and even a son who loves us both with all his heart! So, just remember, it CAN happen. I know you are wondering about after surgery -and I had not had surgery prior to delivering, but the heart of my story is that doctors don't know it all.... Ha! I did have a little problem with SI pain and left leg sometimes had some numbness because of the baby pressing on my SI joint - but that pain was well worth the outcome, if you know what I mean. I wouldn't have missed it for the world!!!! And, you know, if we have a loving family who supports us, like I do, we can achieve anything!!! I hope and pray you have that support - everyone needs that. It helps us endure the agonizing pain we have day after day, all day long.
Hope this helps some.

LindaRacine
12-27-2009, 06:05 PM
Hi Rita...

I don't think Summer was concerned about delivering, she was just asking if an epidural is possible.

Regards,
Linda

abhbarry
12-28-2009, 07:37 AM
I had a son 3 months ago and am fused from L3 to T4 - I was not allowed an epidural and I delivered naturally.

aweiker
01-08-2010, 09:11 PM
I had my spinal fusion when I was 18 and had my first baby at 30. I was able to have a spinal, thank God, as I had pitocin and the pain was awful!

With the second baby I had a different anethesiologist, and he said that I should have never gotten the spinal - the risks are too great. If an infection would get in there the fusion would have to come out. So, just nubane for that birth, was it was ok! Much, much easier delivery, it progressed on its own and I didn't need the pitocin.

I am due with our third baby in June. I pray that it goes as well as #2 and I don't need the pitocin!

good luck to you!

JamieR
01-22-2010, 08:54 PM
I was able to have an epidural only because I was not fused all the way down. My fusion actually stopped about two spots before the epidural. He said if I had been fused further, they would not have been able to give me an epidural because the needle would not be able to go through the bone graft!! I was so thankful. I am a sissy and I did not want to have nautural labor. Just knock me out!

loves to skate
01-23-2010, 10:16 AM
I was able to have an epidural only because I was not fused all the way down. My fusion actually stopped about two spots before the epidural. He said if I had been fused further, they would not have been able to give me an epidural because the needle would not be able to go through the bone graft!! I was so thankful. I am a sissy and I did not want to have nautural labor. Just knock me out!
Jamie,

That doesn't make a whole lot of sense to me since the bone graft is on either side of the spine. I was told I could have an epidural cortisone shot for lingering nerve pain in my leg and my fusion is a low fusion. Maybe Linda will jump in here to clarify this for us.

Sally

HGD24
02-04-2010, 10:29 AM
First of all - Congratulations!!!!!!

I am fused T3 to L4 and had a spinal both during regular delivery & my c-section when I had my DD 2 years ago. A spinal is different than an epidural. Here's a great description of the differences: http://www.brighamandwomens.org/painfreebirthing/csreg.aspx

The spinal is given as a single dose which wears off within 2-3 hours of being given whereas the epidural can stay in for up to 24 hours. With my spinal, I was able to walk, roll over & squat during regular delivery. They did something a little different with the 2nd one given before the c-section. That one numbed my legs & feet.

I met with an anesthesiologist about 1 month prior to my due date to discuss my options. I brought my x-rays to the meeting and she noted in my chart that the spinal was the best option and at what level would work best. You really should do the same.

Shari
02-04-2010, 11:39 AM
Oh Summer, Congratulations!!!:D

I'm so glad to hear that you are pregnant, and w/ twins. I am sooooo happy
for you!!!

All my best God blessings to you,
Shari

jrnyc
02-04-2010, 11:49 AM
i think the issue is the "fused to the sacrum"! i was told i wouldnt be able to have myleogram after fusion operation..so i assume...maybe i am wrong..that if fluid cant go in the spine for one purpose, it cant go in for any purpose...or come out either? no spinal taps after fusion to sacrum?
am i correct?

jess

txmarinemom
02-04-2010, 09:53 PM
I met with an anesthesiologist about 1 month prior to my due date to discuss my options. I brought my x-rays to the meeting and she noted in my chart that the spinal was the best option and at what level would work best. You really should do the same.

HGD24, this is actually a great plan for UNfused patients, as well.

With my rotation, I'd had *several* particularly miserable lumbar punctures as a kid because nothing was where it was supposed to be.

Both of my deliveries were pre-fusion. My first kiddo showed up in 2-1/2 hours (plus, I went from 3-8 cm in 15 minutes), and left no time for anesthesia. Personally, I had no interest in repeating that experience.

I met with the anesthesiologist in the few months before I had my 2nd kid so they could "map" my back. Highly advisable for anyone planning for an epidural.

Pam

Karen Ocker
02-06-2010, 02:18 PM
In order to do a spinal or an epidural the anesthetist needs a space between the appropriate vertebrae to place a needle. Common spaces used for delivery are between:L2 to L3, L-3 to L-4, L-4 to L-5, L-5 to S-1(Sacrum).

If any of these spaces are fused together then epidural or spinal are not possible. There is no place to place the needle for either spinal or epidural.

A spinal means anesthetic is placed in the cerebral spinal fluid which bathes the spinal cord. An epidural means anesthetic is placed in the epidural space which bathes the nerve roots with anesthetic. A caudal injection is near the tailbone and can also be used for delivery.

Some anesthesia providers are not comfortable doing this because scarring may be present and anesthetic effectiveness may be unreliable.

Before I had my revision I was fused to L-3. I needed a D & C but had a cold so the anesthesiologisrt said he would do a spinal. I mentioned I was fused but he said he was a pain doc and "did this all the time". The spinal did not work and I needed general anesthesia after all.

JamieR
02-18-2010, 08:49 PM
Karen you are right. I had forgotten. It was not the bone graft that would keep me from getting an epidural, it was where I was fused. An Pam is also right, I had to show them my xrays so they could see where I was fused to so they could decide if an epidural was possible or not. My memory sucks!

TiffanyK
02-18-2010, 09:37 PM
Summer,

I don't have any answers or stories to relate to like others do, but I'm glad you brought up the subject. I am not fused and had my daughter 3 years ago with an epidural, though I am looking at surgery in the future. The pregnancy/epidural issue had been weighing on my mind for a while. I've come to terms with the possibility of getting knocked out when I finally can have another baby (if I get fused of course!). I'd rather have a baby more than anything and not worry how the delivery happens. All that matters to me is having that baby to love. Cherish these months of pregnancy and I hope all goes well no matter how it happens!

HGD24
02-22-2010, 01:43 PM
HGD24, this is actually a great plan for UNfused patients, as well.

Pam

Great advice Pam! The dr I met with was so happy to see me in a relaxed, non-surgical, non-medical setting to discuss the options and review my x-rays. I think it really helps everyone involved to be able to make these decsions ahead of time rather than in the heat of the moment.


In order to do a spinal or an epidural the anesthetist needs a space between the appropriate vertebrae to place a needle. Common spaces used for delivery are between:L2 to L3, L-3 to L-4, L-4 to L-5, L-5 to S-1(Sacrum).

If any of these spaces are fused together then epidural or spinal are not possible. There is no place to place the needle for either spinal or epidural.

Karen - do you mean if ALL of these spaces are fused?

summer
05-13-2010, 02:29 PM
Thanks everyone! I'm due any day now & have to bring my x rays & operative notes to the hospital, but most likely can't have a spinal or an epidural. If both girls are head down, I will try to deliver naturally in order to avoid being knocked out with general anesthesia for a c section. I'd hate to miss the birth of my only children!

Doodles
05-13-2010, 10:30 PM
Summer--
How exciting! Good luck to you and let us know how it all goes. Janet

Back-out
05-13-2010, 10:57 PM
It's a bit late in the game if you haven't been practicing but I found Lamaze worked great for delivery. Maybe I was just lucky or something, but both my sons were delivered without anesthesia of any kind (except for a jolt of local before the episiotomy - standard then).

I still use the Lamaze breathing for anything uncomfortable! True, that the twins have to be in a good position (though I think a good OB or midwife can do a bit of manipulation) but it CAN work. The main thing is not to panic. I figure the special breathing gave me a feeling of control. Sheesh, compared to other pain I"ve felt, it was nothing - especially when the fear element was under control!

And best of all you get those babies at the end!! :D

Major congratulations. You must be so excited! Hope you're able to sleep OK and that your back isn't bothering you too much! (Didn't dare say "at all" as it seemed to much to expect) Seems to me at that stage I was getting up to go to the loo all night long, and mine weren't even twins! (But their heads were big, and number 2 weighed in over 9 lbs.)

Maybe someone can videotape the birth so even if they knock you out you can watch it later. Second time around, there was a big mirror opposite my pubis so I could see the birth but at the last minute the fat headed doctor thrust his head right between it and my line of vision. I couldn't see anything. Older son asked me later, "What did you think, Mommy, right when he was being born?"

In a flash I answered (the truth): "I wish Dr. Wengrowitz would move his head." :rolleyes:

All good wishes for a happy, easy, exciting delivery. :)