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Caesarean Section for Orthopedic Indications – Lumbar Fusion

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The article discusses the increasing number of late complications after cesarean sections in pregnant women, which has led to a reexamination of the indications for the procedure. It highlights the high percentage of cesarean sections performed for non-obstetric reasons, particularly related to orthopedic conditions. The article emphasizes the need for special attention to pregnant women with a history of orthopedic surgery. The lack of consensus in this area and physicians’ concerns about patient claims have prompted an analysis of existing knowledge in this field. The study reviewed references published in five databases, focusing on pubic symphysis diastasis, lumbar disc herniation, past hip arthroplasty, and fractures in the pelvic bones. The results suggest that orthopedic indications for cesarean section should not be treated as imperative, as natural delivery may be possible without an increased risk of complications. The article concludes that extra-obstetric indications for cesarean section should be determined on an individual basis in a multidisciplinary team

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established day surgery hospital in London

Published article

S: Orthopedic indications for cesarean section in many cases should not be treated imperatively, since natural delivery after correct fusion of a pelvic fracture, implantation of a hip endoprosthesis or a limited dissection of the pubic symphysis is possible and is not associated with a higher risk of obstetric or orthopedic complications. Extra-obstetric indications for cesarean section should be determined individually for each pregnant woman in a multidisciplinary team, since…

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Clin Med. 2023 Nov 27;12(23):7336. doi: 10.3390/jcm12237336.ABSTRACTBACKGROUND: The increasing number of late complications described after cesarean sections is prompting a reexamination of the indications for them in pregnant women. The high percentage of pregnancies terminated by preventive cesarean section for non-obstetric reasons also largely involves orthopedic conditions. A challenge for obstetricians is pregnant patients,

J Clin Med. 2023 Nov 27;12(23):7336. doi: 10.3390/jcm12237336.

ABSTRACT

BACKGROUND: The increasing number of late complications described after cesarean sections is prompting a reexamination of the indications for them in pregnant women. The high percentage of pregnancies terminated by preventive cesarean section for non-obstetric reasons also largely involves orthopedic conditions. A challenge for obstetricians is pregnant patients with orthopedic conditions both before and during pregnancy. Pregnant women with a history of orthopedic surgery require special attention. The lack of consensus in this area, physicians’ fear of patients’ claims and the skewing of patients’ requests for surgical termination of pregnancy have prompted an analysis and systematization of existing knowledge in this field.

METHODS: References published up to 30 June 2023 in five databases Pubmed, Embase are included. Keywords have been checked for the following: pubic symphysis diastasis, lumbar disc herniation, past hip arthroplasty and fractures in the pelvic bones. In the described conditions complicating pregnancy, the mode of delivery was taken into account.

RESULTS: All included studies were screened and reviewed by at least two authors until an overall consensus of 50 articles was reached.

S: Orthopedic indications for cesarean section in many cases should not be treated imperatively, since natural delivery after correct fusion of a pelvic fracture, implantation of a hip endoprosthesis or a limited dissection of the pubic symphysis is possible and is not associated with a higher risk of obstetric or orthopedic complications. Extra-obstetric indications for cesarean section should be determined individually for each pregnant woman in a multidisciplinary team, since orthopedic conditions may overlap with obstetric pathology in the pelvis.

PMID:38068388 | DOI:10.3390/jcm12237336

The London Spine Unit : most established day surgery hospital in London

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Caesarean Section for Orthopedic Indications

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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J Clin Med. 2023 Nov 27;12(23):7336. doi: 10.3390/jcm12237336.ABSTRACTBACKGROUND: The increasing number of late complications described after cesarean sections is prompting a reexamination of the indications for them in pregnant women. The high percentage of pregnancies terminated by preventive cesarean section for non-obstetric reasons also largely involves orthopedic conditions. A challenge for obstetricians is pregnant patients

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