Expert: Ronald Levy, M.D. - 4/25/2008

Question
QUESTION: I had a triple fusion with hardware(4 cages, rods and screws) at L3-4, L4-5 and L5-S1. I am pregnant and wanted to know what you thought of an epidural during the labor.  If it is possible?  My doctor suggested a c-section..not sure what I am going to do?

ANSWER: It is certainly possible although it is more difficult and you are more likely to have a patchy block. IF you are going to have a c-section, then they would likely do a spinal which should be easier and give you a better block.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: What is the difference between a spinal and an epidural?  Is the spinal the one that you have to lay on your back for 8 hours after?  I have had one in the past for a procedure and then ended up with the headache after. I really do not want that to happen again.

Answer
You don't need to lay on your back for 8 hours after either but some people have you do it any way. If the anesthesiologist uses a small gauge needle, you don't have to lay flat. You are more likely to get a headache if they use a large bore needle for the spinal or if the epidural needle goes into the spinal space. Other than that, the difference between the two is that a spinal give you a denser block so you are less likely to be able to move or feel your legs, etc., but it is more reliablew for a c-section.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston