Pregnancy and childbirth after microsurgery for lumbar disc herniation.
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.


METHODS
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.


RESULTS
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.
Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland. sven.berkmann@ksa.ch
Sven
S
Berkmann
Javier
J
Fandino
D000328:Adult; D036861:Delivery, Obstetric; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008866:Microsurgery / Q000009:adverse effects; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult