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Anesthesia

Spinal & Tailbone

04/28/2009

Question:

I`ve had two c-sections. With my first, the spinal was inserted in the middle of my back around T6-T7. I didn`t have any issues. My second spinal was inserted very low in the lumbar region. The sacrum and upper buttocks were numb for several weeks. Now, nine months later, I have sacrum and tailbone pain. When the needle was inserted, first they hit bone. Then only my right hip/buttock went numb. Eventually they got it right. I asked both my OB and the anesthesiologist and neither seem to think this pain could be caused by the spinal and suggested I see a chiropractor. The chiro says nothing is out of place. Any suggestions?

Answer:

It is unlikely that your first spinal anesthetic was inserted at T6-7. This is in the middle of the thoracic spine, whereas spinal anesthesia for a cesarean section is typically performed in the lumbar area: L2-3 or L3-4.

Unfortunately this is not a diagnostic service and I cannot say what is causing your pain. Pain in the buttock and leg can arise from spinal problems such as disc herniation, vascular (blood vessel) problems, spinal stenosis (narrowing), nerve entrapment outside the spinal column, and from a host of other rare causes, such as infection. So called mechanical back pain is probably the commonest of all, and does not involve large nerve structures. Assessment requires a full and careful history, and physical examination, aided by appropriate blood tests and imaging, such as x-rays or MRI.

Nerve injury from spinal and epidural anesthesia does occur occasionally. In almost all cases, the nerve function recovers within weeks to months, so symptoms that are prolonged for nine months or more are unlikely due to this cause. After childbirth, neurological complaints are far more likely to be due to compression of nerve structures in the birth canal by the baby's heard, or to some unrelated spinal or neurological condition.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University