Pregnancy and Childbirth After Spinal Fusion for Adolescent Idiopathic Scoliosis

Matthew Landrum, Heidi R. Nocka, Leta Ashebo, Didja Hilmara, Elle MacAlpine, John M. Flynn, Michelle Ho, Peter O. Newton, Paul D. Sponseller, Baron S. Lonner, Patrick J. Cahill, Aaron Buckland, Amer Samdani, Amit Jain, Baron Lonner, Benjamin Roye, Burt Yaszay, Chris Reilly, Daniel Hedequist, Daniel SucatoDavid Clements, Firoz Miyanji, Harry Shufflebarger, Jack Flynn, John Asghar, Jean Marc Mac Thiong, Joshua Pahys, Juergen Harms, Keith Bachmann, Lawrence Lenke, Lori Karol, Mark Abel, Mark Erickson, Michael Glotzbecker, Michael Kelly, Michael Vitale, Michelle Marks, Munish Gupta, Nicholas Fletcher, Noelle Larson, Patrick Cahill, Peter Gabos, Peter Newton, Peter Sturm, Randal Betz, Stefan Parent, Stephen George, Steven Hwang, Suken Shah, Sumeet Garg, Tom Errico, Vidyadhar Upasani

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Little data exist on pregnancy and childbirth for adolescent idiopathic scoliosis (AIS) patients treated with a spinal fusion. The current literature relies on data from patients treated with spinal fusion techniques and instrumentation, such as Harrington rods, that are no longer in use. The objective of our study is to understand the effects of spinal fusion in adolescence on pregnancy and childbirth. Methods: Prospectively collected data of AIS patients undergoing posterior spinal fusion that were enrolled in a multicenter study who have had a pregnancy and childbirth were reviewed. Results were summarized using descriptive statistics and compared with national averages using χ2 test of independence. Results: A total of 78 babies were born to 53 AIS patients. As part of their pre-natal care, 24% of patients surveyed reported meeting with an anesthesiologist before delivery. The most common types of delivery were spontaneous vaginal delivery (46%, n=36/78) and planned cesarean section (20%, n=16/78). Compared with the national average, study patients had a higher rate of cesarean delivery (P=0.021). Of the women who had a spontaneous vaginal birth, 53% had no anesthesia (n=19/36), 19% received intravenous intermittent opioids (n=7/36), and 31% had regional spinal or epidural anesthesia (n=11/36). spontaneous vaginal delivery patients in our study cohort received epidural or spinal anesthesia less frequently than the national average (P<0.001). Of those (n=26 pregnancies) who did not have regional anesthesia (patients who had no anesthesia or utilized IV intermittent opioids), 19% (n=5 pregnancies) were told by their perinatal providers that it was precluded by previous spine surgery. Conclusion: The majority of AIS patients reported not meeting with an anesthesiologist before giving birth and those who had a planned C-section did so under obstetrician recommendation. The presence of instrumentation after spinal fusion should be avoided with attempted access to the spinal canal but should not dictate a delivery plan. A multidisciplinary team consisting of obstetrician, anesthesiologist, and orthopaedic surgeon can provide the most comprehensive information to empower a patient to make her decisions regarding birth experience anesthesia based on maternal rather than provider preference.

Original languageEnglish
Pages (from-to)620-625
Number of pages6
JournalJournal of Pediatric Orthopaedics
Volume43
Issue number10
DOIs
StatePublished - 1 Nov 2023

Keywords

  • Adolescent idiopathic scoliosis (AIS)
  • anesthesia
  • childbirth
  • delivery
  • pregnancy
  • spinal fusion

Fingerprint

Dive into the research topics of 'Pregnancy and Childbirth After Spinal Fusion for Adolescent Idiopathic Scoliosis'. Together they form a unique fingerprint.

Cite this