Our Summary

This research paper explains how changes in a woman’s body during pregnancy can affect the spine, leading to increased flexibility in the ligaments, a deeper curve in the lower back, and a change in the tilt of the pelvis. It specifically focuses on women who had a condition called adolescent idiopathic scoliosis (an abnormal curvature of the spine during adolescence) and who underwent spinal fusion surgery as a treatment. The study found that these women are at a greater risk of experiencing lower back pain during pregnancy if the surgery involved the third lumbar vertebra or below.

However, the research also shows that these women have a low risk of their spinal curve getting worse during pregnancy. The paper also discusses that these women can have anesthesia administered to the spine (neuraxial anesthesia) during childbirth, but it may be more difficult and require a more experienced medical professional to successfully place the epidural.

FAQs

  1. What changes occur in the spine during pregnancy?
  2. Is there a higher risk of developing low back pain during pregnancy for patients with adolescent idiopathic scoliosis who have undergone spinal fusion?
  3. Is neuraxial anesthesia possible for patients who have undergone spinal fusion for adolescent idiopathic scoliosis?

Doctor’s Tip

Tip: It is important to discuss your history of scoliosis surgery with your obstetrician and anesthesiologist if you are planning to become pregnant, as they can help ensure the safest and most comfortable experience during childbirth.

Suitable For

➢ Patients with severe scoliosis (curves greater than 50 degrees) that are progressing rapidly, causing significant pain and/or respiratory compromise, are typically recommended for scoliosis surgery. ➢ Patients with moderate scoliosis (curves between 30-50 degrees) that are causing significant pain and/or impacting their quality of life may also be recommended for surgery. ➢ Patients with scoliosis that is not responding to conservative treatments such as bracing or physical therapy may be considered for surgery. ➢ Patients with scoliosis that is causing neurological symptoms such as weakness, numbness, or tingling in the extremities may be recommended for surgery to prevent further nerve damage. ➢ Pediatric patients with early-onset scoliosis (scoliosis that presents before the age of 10) may be recommended for surgery to prevent progression and maintain growth potential.

Timeline

Before Scoliosis Surgery:

  • Patient undergoes diagnostic tests such as X-rays, MRI, and physical exams to determine the severity and progression of scoliosis.
  • Patient may undergo non-surgical treatments such as bracing, physical therapy, and pain management to manage symptoms and stabilize the spine.
  • Patient and their healthcare team discuss the risks and benefits of surgery, as well as the surgical procedure and recovery process.

After Scoliosis Surgery:

  • Patient is monitored closely in the hospital for pain management, wound healing, and complications.
  • Patient may need to wear a brace or use assistive devices during the initial recovery period to support the spine.
  • Physical therapy and rehabilitation are typically started soon after surgery to regain strength and mobility in the spine and surrounding muscles.
  • Patient will have follow-up appointments with their surgeon to monitor the healing process, assess spinal alignment, and address any concerns or complications.
  • Long-term follow-up care may include periodic X-rays and check-ups to monitor for any potential complications or recurrence of scoliosis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery, particularly during pregnancy?
  2. How will my pregnancy affect the healing process and long-term outcomes of the surgery?
  3. Will I be able to safely carry a pregnancy to full term after scoliosis surgery?
  4. How will the surgery impact my ability to care for a newborn and handle the physical demands of motherhood?
  5. Are there any specific precautions or considerations I should keep in mind during pregnancy as a result of the surgery?
  6. Will I need any special accommodations or monitoring during pregnancy due to the surgery?
  7. How will the surgery affect my ability to receive pain management during labor and delivery?
  8. Are there any restrictions on future pregnancies or childbirth methods as a result of the surgery?
  9. How soon after the surgery can I safely become pregnant?
  10. Are there any additional resources or support services available for pregnant women who have undergone scoliosis surgery?

Reference

Authors: Serhan KA, Abraham VM, Shirley ED. Journal: J Bone Joint Surg Am. 2025 Apr 2;107(7):771-777. doi: 10.2106/JBJS.24.00850. Epub 2025 Feb 24. PMID: 40172564