Questions I asked yesterday: Epidurals after fusion (PCEA)

[txmarinemom]

A few topics have been bouncing around here lately, and I added them to my list of questions for Hanson yesterday. The topics will all start with the subject "Questions I asked yesterday:" ...

Let's try to get a collection of answers!

If you answer, please refrain from quoting PubMed articles anyone can pull - that aren't even necessarily peer-reviewed.

Also be sure to name your surgeon, his speciality, and whether he's an SRS member.

Mine, as many of you know is:

Darrell S. Hanson, MD
Baylor College of Medicine, Houston, TX (and, yes, he's SRS)

Specialties:

Adult Scoliosis
Aging Spine
Degenerative Conditions
Juvenile/Infantile Scoliosis

__________________________________________________ _

He doesn't do them.

When I asked why, he said he feels it increases the risk that post-op neurological damage can be masked.

He even went as far as to say the topic is raised every few years at SRS conferences: When the question is posed to 700 or so attendees ("How many of you have experienced masked neurological damage symptoms or deficits post-fusion with PCEA?"), he said ±100 hands are raised.

It'll be interesting the hear more on this ...

[SummerNC]

so he said no epidural after fusion?? just wanted to make sure that is what you were implying...that is a question I am asking at the next doc I see on Friday.....the last doc said childbirth will not be effected at all by the fusion...again, everyone has a different opinion...but this is kinda an important topic for me bc I don't think I can do the whole BIRTH thing without it

[txmarinemom]

so he said no epidural after fusion?? just wanted to make sure that is what you were implying...that is a question I am asking at the next doc I see on Friday.....the last doc said childbirth will not be effected at all by the fusion...again, everyone has a different opinion...but this is kinda an important topic for me bc I don't think I can do the whole BIRTH thing without it

No, the topic was U.S. frequency of PCEA (epidurals to control pain immediately after fusion surgery), LOL ... not epidurals for childbirth after fusion surgery has healed. I can easily see where that might scare someone counting on one before birth!

(I had one kid without ... one with. Take a guess which birth I preferred!)

If I'm not mistaken, only lower lumbar fusions even have the potential to affect epidurals for childbirth. I *think* I heard childbirth epidurals are placed mid-lumbar ... around L3, but I've slept since then ...

My concern PRE-fusion (my kids are 18 and 20 now) was the spinal rotation made the proper spot not where it should have been .

Regards,
Pam

[SummerNC]

Shhhheeesh.....can you hear my sigh of relief from here?? Sorry I misunderstood you....just wanted to clarify....this is all so new to me and so much info is swirlin around in my head right now

[txmarinemom]

Shhhheeesh.....can you hear my sigh of relief from here?? Sorry I misunderstood you....just wanted to clarify....this is all so new to me and so much info is swirlin around in my head right now

It's ok, hon ... and yes, I KNOW that sigh of relief - LOL.

My first labor went too quickly for an epidural (3-8 cm in 15 minutes) and I'd not even prepped with Lamaze. I think you could have heard me scream "WHAT???!" in the next county when they told me it was too late .

And, yeah ... lots of stuff *here* (outside of childbirth) to absorb.

Frequency of epidurals before fusion surgery for pain and the frequency of surgeon recommended dental pre-med (with antibiotics) were recent questions I just happened to ask my doctor yesterday during my visit.

That's all ... deeeeeeeeeeeeep breaths ;-).

Regards,
Pam

[CurvySAT05]

Does anyone know if an epidural for childbirth is possible with a fusion to the sacrum? I have a long time to go before thinking of children, but after my revision in December (T2-Ilium) I started wondering what birthing options I would have. Would I be limited to going au naturel or cessarian (and if I did need cessarian, would it have be with general anesthetic since fused to Sacrum)?
Thanks to anyone who has been through this and can answer this for me. This is something I forgot to ask the surgeon before surgery.
Curvy

[leahdragonfly]

epidurals for childbirth after lumbar fusion

Does anyone know if an epidural for childbirth is possible with a fusion to the sacrum? I have a long time to go before thinking of children, but after my revision in December (T2-Ilium) I started wondering what birthing options I would have. Would I be limited to going au naturel or cessarian (and if I did need cessarian, would it have be with general anesthetic since fused to Sacrum)?
Thanks to anyone who has been through this and can answer this for me. This is something I forgot to ask the surgeon before surgery.
Curvy

I had a fusion L4-S1 when I was 17 for spondylolisthesis, in 1984. I have a 3 y/o and a 6 y/o, both were c-sections. My birth canal was reportedly too narrow front to back due to the spondylo. Anyway, I had no problem receiving the spinal for the first C/S, the anesthesiologist just went one level higher. The second C/S, they had a little more trouble, tried the one place, then went one level above and to the side. Everything worked out fine, and when you're in hard labor as I was, getting the spinal is the least of your discomforts! A spinal is needed for a C/S, but usually epidurals are given for labor, so I don't know if this is possible. When I was pregnant I was told, "we'll just have to wait and see if it works."

I know Dr. Betz of Shriners Philly has a published article about the effects of scoliosis on pregnancy, and he discusses this, but I haven't personally read it--I'm happy with two kids.

Gayle

[dealornodeal]

epidurals for childbirth after lumbar fusions

SummerNC, just wanted to let you know that I am a witness that childbirth (ALL Natural) without an epidural CAN be done. My son is now 14yrs old and at the time I was working with 2 lumbar fusions and I was greatly apprehensive about anything being stuck in my back. So I prayed and prayed and prayed and asked God to handle the pain, which he did for the nurses even said that I did a great job and asked if I could "teach" the lady hollering down the hall what helped me keep my mind focused and my mouth quiet while bringing a wonderful new life into the world. NOW the other side of the story is that whenever I tell this story (TRUE STORY) all my friends ask me NOT to tell my story because they call this a freak of nature I call it a testimony to answered prayer!

So it can be done.....

LJ

[loves to skate]

loves to skate

Hi everyone,
I agree with dealornodeal. We didn't even have the option of epidurals back in the days when I gave birth. Natural childbirth was just coming into vogue and I had my baby with only a shot of demerol just before I delivered. I don't think I even needed it because I didn't get groggy until after she was born. I wasn't a believer at the time but I now believe in the power of prayer. Prayer I believe is what got me through my surgery of 12 hours with flying colors, since I didn't have the benefit of this forum to help me at the time.

[txmarinemom]

All interesting stuff, but can we get the post back on topic, please?