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Can Spondylolysthesis cause Complications During Pregnancy?

Sue in Dorset, UK asks:

"After suffering with back pain since my teens I was recently diagnosed with Grade III spondylolisthesis. My husband and I are thinking of starting a family. Could my injury cause any complications during the pregnancy?"

T J Salih, Senior Chartered Physiotherapist at the back2normal back and neck clinic, London replies:

"Spondylolisthesis is a fracture of the lumbar vertebra with a forward slippage of one of the fracture fragments - the front most aspect of the vertebra, the vertebral body. Apart from local low back pain this condition can cause referred pain in the legs, due to impingement of the spinal nerve roots.

"The answer to your specific query about pregnancy is yes on two counts.

"Firstly, if your Spondylolisthesis is a Grade III, it means that the forward slippage of the front part of the vertebra is 75% or above, relative to the normal spinal alignment. This can cause difficulty with vaginal birth. Your obstetrician should be consulted BEFORE you get pregnant. He or she will then be able to assess the shape and size of your pelvis, to see whether it would be possible to have a trail of labour, or whether it would be simply be best to opt for a caesarian section.

"One method of pain relief can be achieved when TENS acts as a physiological inhibitor of impulses from the pain receptor, in a process often referred to as the 'Pain Gate Mechanism'. This occurs because, when set at a higher frequency, the TENS unit stimulates different pain receptors which override the painful stimulus. This is the electrotherapy equivalent of rubbing your knee after you've fallen on it. The counter stimulation provides pain relief.

"Secondly, depending upon the level of pain that you have at present, it is likely that the level of pain during and after pregnancy will increase. You should be physically as well as you can be before becoming pregnant to minimize the potential risks to you and your baby.

"Always remember that planning BEFORE the event is the best option, and if you are in any doubt, your treating doctors should discuss things with you and ideally should discuss things between themselves at an early stage."

More about T J Salih >

Article published: 13th April 2004

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