Fellow University of Arizona Buffalo, New York, United States
Introduction: Due to the predominance of females having spine surgeries for different pathologies, issues related to women’s health care, such as pregnancy, are a specific concern. There is little information about the effect of previous spine surgery (PSS) on pregnancy outcomes. Our objective was to address common questions related to pregnancy after spine surgery: Do patients with PSS have different pregnancy outcomes than women without PSS? Do patients with PSS have worse backpain during and after pregnancy?
Methods: A systematic review was performed. Manuscripts that related spine surgery with pregnancy were included. Review articles, case reports, and no surgical articles were excluded. A meta-analysis for new onset of back pain (NOBP) during and after pregnancy and type of delivery was performed. A random-effects model was used to calculate risk ratios (RR). Forest plots were used to display RR and 95% confidence intervals (CI).
Results: A total of 17 studies, 8 case series and 9 cohorts, were identified representing 704 patients who had PSS before pregnancy. Cohort’s studies also included 407 patients with a history of pregnancy without PSS. Outcome of interest were C-section rate, new onset of back pain (NOBP) and perinatal complications. Six studies reporting C-section rate and 3 studies reporting N0BP were selected for meta-analysis. The meta-analysis performed showed a summary RR of 1.48 [IC 95% 1.16-1.98] for C-section and 2.54 [IC 95% 0.86-7.50] for NOBP. Demonstrating that women with PSS have statistically significant increased C-section rate than women without, but not increased risk of NOBP. Perinatal complications were not observed.
Conclusion : A meta-analysis and comprehensive review of the literature show that women with PSS have higher rate of C-sections but no higher incidence of NOBP and perinatal complications than patients without PSS.
How to Improve Patient Care: This information is relevant in order to assess women in childbearing age prior to spine surgery.
