disc herniation and future pregnancy?

[ctts]

Acta Neurochir (Wien). 2012 Feb;154(2):329-34. Epub 2011 Oct 26.
Pregnancy and childbirth after microsurgery for lumbar disc herniation.
Berkmann S, Fandino J.
Source
Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland. [email protected]
Abstract
BACKGROUND:
The influence of previous lumbar discectomy on pregnancy and childbirth has not been extensively studied. This study reports the course of pregnancies after lumbar discectomy.
METHOD:
Twenty-six 31.5 ± 3.6-year-old patients who had delivered 39 children were included. All patients underwent lumbar microsurgical discectomy prior to childbirth. Demographic and surgical data were collected from hospital records and patient questionnaires. The presence and course of low back pain (LBP) and radiculopathy signs were noted.
FINDINGS:
Mean latency between surgery and childbirth was 42.5 ± 34.8 months. Delivery was at gestational week 36 to 42, and the average weight of the newborn was 3,390 ± 0.490 g. Prevalence and new onset of symptoms during pregnancy was as follows: low back pain, 76% and 60%; leg pain 37% and 18%; motor deficits 13% and 6%; and sensory deficits 39% and 19%, respectively. No recurrent lumbar disc herniation was diagnosed within 6 months after pregnancy. Patients suffering from radicular pain during pregnancy were at risk of persistence of symptoms 6 months after delivery. Three patients had had surgery because of recurrent lumbar disc herniation during the follow-up of 7.73 ± 2.66 years.
CONCLUSIONS:
The incidence of radicular pain during pregnancy after microsurgical discectomy for lumbar disc herniation was 18%. The incidence and prevalence of LBP are among the highest reported in the literature. The incidence of low back pain and radiculopathy signs does not change significantly with subsequent pregnancies. The operation rate for recurrent lumbar disc herniation or adjacent level disease after pregnancy seems not to be higher than the overall rate reported in the literature.
PMID: 22037981 [PubMed - indexed for MEDLINE]

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[geauxg8rs]

The only cause I ever hear for low back pain after pregnancy was related to the epidural placement for labor pain

 

[PMR 4 MSK]

The only cause I ever hear for low back pain after pregnancy was related to the epidural placement for labor pain

And that amazes me. After thousands of ESIs, not one patient has ever complained of chronic pain from the injection, yet I've seen several dozen patients over the years who swear their back pain came from the epidural for childbirth.

I've also never seen a patient who had an epidural for other/non-OB surgeries complain of that as the etiology of their back pain.

 

[PinchandBurn]

And that amazes me. After thousands of ESIs, not one patient has ever complained of chronic pain from the injection, yet I've seen several dozen patients over the years who swear their back pain came from the epidural for childbirth.

I've also never seen a patient who had an epidural for other/non-OB surgeries complain of that as the etiology of their back pain.

I wonder if it has anything with :

1) palcement of a catheter for peri-labor pain
2) progesterone
3) larger gauged touhy needles used in OB

 

[ctts]

See my earlier post with the same thread title. Not sure what happened, but my post on this thread only has an abstract for an article, but missing the rest of my post. Sorry!

 

[drf]

The epidural back pain myth was put to rest years ago. I dont have the paper on hand as this was back in residency. The incidence of back pain is the same for patients who get epidural catheters and those who do not.

Plenty of reasons for back pain with 9 months of carrying an extra 30-50 lbs then having 5-9 lbs pass thru the pelvis.