Our Summary

This study analyzed the occurrence of a specific type of back surgery, called a lumbar discectomy, during pregnancy and in the first year after giving birth in women in Finland from 1999 to 2017. The researchers found that this surgery is not common during pregnancy, but women who smoke are at a greater risk. They also found that the surgery appears to be safe for the baby, as there were no recorded instances of baby deaths related to the surgery. In the first year after giving birth, the rate of this surgery increased, but was still lower than the rate in the general population. However, these women were at a higher risk of needing another operation within 90 days.

FAQs

  1. How common is the occurrence of lumbar discectomy during pregnancy and in the first year after giving birth?
  2. Are there any risks associated with lumbar discectomy during pregnancy, particularly for the baby?
  3. What is the risk of needing another operation within 90 days after giving birth in women who have had a lumbar discectomy?

Doctor’s Tip

A doctor might tell a patient about discectomy that it is important to follow post-operative instructions carefully, including proper wound care, physical therapy exercises, and avoiding heavy lifting or strenuous activity to allow for proper healing and prevent complications. They may also advise the patient to quit smoking if they are a smoker, as smoking can increase the risk of complications during and after surgery. It is important to follow up with your doctor regularly to monitor your progress and address any concerns.

Suitable For

Patients who are typically recommended for a discectomy are those who have not responded to conservative treatments such as physical therapy, medication, and injections for a herniated disc in the lumbar spine. If a patient is experiencing severe and persistent symptoms such as leg pain, weakness, or numbness that is not improving with non-surgical treatments, they may be a candidate for a discectomy. Additionally, patients who have a large disc herniation that is pressing on a nerve and causing significant neurological symptoms may also be recommended for a discectomy.

Timeline

Before discectomy:

  1. Patient experiences back pain, leg pain, and/or numbness due to a herniated disc in the spine.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis.
  3. Patient may try conservative treatments such as physical therapy, medications, and epidural injections to manage symptoms.
  4. If symptoms persist or worsen, surgery may be recommended as a last resort.

After discectomy:

  1. Patient undergoes pre-operative evaluations and preparation for surgery.
  2. Surgery is performed to remove the herniated disc material pressing on the spinal nerves.
  3. Patient stays in the hospital for a few days for monitoring and recovery.
  4. Patient may experience pain, stiffness, and limited mobility in the immediate post-operative period.
  5. Patient starts physical therapy and rehabilitation to strengthen the back muscles and improve flexibility.
  6. Over time, patient gradually resumes normal activities and experiences relief from back and leg pain.
  7. Follow-up appointments with the surgeon are scheduled to monitor recovery and address any concerns.
  8. Patient may need to continue with maintenance exercises and lifestyle modifications to prevent future disc herniation.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a lumbar discectomy surgery during pregnancy or in the first year after giving birth?

  2. How will the surgery impact my pregnancy and delivery, if scheduled during pregnancy?

  3. How will the surgery impact my ability to care for my newborn in the immediate postpartum period?

  4. Are there any specific precautions or limitations I should follow after the surgery to ensure a successful recovery?

  5. What are the chances of needing another operation within 90 days after the initial surgery, especially in the context of being a new mother?

  6. How will the surgery impact my ability to breastfeed, if applicable?

  7. Are there any alternative treatment options that may be more suitable for my situation, considering the risks associated with surgery during pregnancy or in the postpartum period?

  8. How long is the recovery period following a lumbar discectomy surgery, and what kind of post-operative care will be necessary?

  9. How will the surgery impact my overall health and well-being as a new mother, and what can I do to ensure a smooth recovery process?

  10. Are there any specific lifestyle changes or modifications that I should consider to reduce the risk of needing another operation after giving birth?

Reference

Authors: Nyrhi L, Kuitunen I, Ponkilainen V, Mäntymäki H, Huttunen TT, Mattila VM. Journal: Spine J. 2023 Feb;23(2):287-294. doi: 10.1016/j.spinee.2022.10.015. Epub 2022 Nov 5. PMID: 36343912