Clinical Approach and Surgical Strategy for Spinal Diseases in Pregnant Women

Han, In Ho; Kuh, Sung Uk; Kim, Jae Hoon; Chin, Dong Kyu; Kh, Kim; Yoon, Yong Soo; Jin, Byung Ho; Cho, Young-Eun

doi:10.1097/brs.0b013e31817c6c7d

Cited by 67 publications

(74 citation statements)

References 14 publications

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“…Absolute indications for surgery are cauda equina syndrome, and progressive loss of strength. In case of persistence of pain despite conservative medications, surgery is still an option (11,12,27) . Resistant back pain might trigger preterm delivery due to overstress (13,26) .…”

Section: Dıscussıonmentioning

confidence: 99%

“…Spinal or epidural anesthesia is suggested in lumbar disc surgeries for pregnant women (4,11,14) . Spinal anesthesia is a widely used technique throughout countries because it is easy to perform and its effects readily starts (7,15,20) .…”

Section: Dıscussıonmentioning

confidence: 99%

“…Nevertheless the incidence of lumbar disc herniation is very rare (1/10000) during pregnancy excepting preexisting hernias. Although conservative treatment is the first treatment of choice, surgical approach is indicated for selective cases (3,4,11,18) .…”

mentioning

confidence: 99%

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Surgical approach to lumbar disc herniation in pregnant women

Kıbıcı¹,

Kaya²,

Cücü

et al. 2015

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Objective: Our aim is to emphasize the importance of surgery along with the route of anesthesia and positioning of the patient during surgery when treating pregnant patients who present with progressive neurologic deficit and pain due to lomber disc herniation. Material and Method: Patients in this study were already followed up by our obstetric department. After a conservative medical approach with analgesics, symptoms did not resolve and contrarily worsened progressively so they were referred to neurosurgery department. Three pregnant patients with lomber disc herniation were operated during pregnancy. Two of the three patients presented in their second (n=2) or first trimester (n=1) of their pregnancies. Indications for surgery involved cauda equina syndrome, progressive loss of muscle strength and pain resistant to conservative medical treatment. Two of the three patients presented with primary herniation and the third patient had a recurrent herniation. All of the three patients were requested to sign an informed consent form. Results: Three pregnant patients were operated due to lumbar disc herniation and all the signs and symptoms of herniation resolved soon after surgery. conclusion: Surgical repair of lumbar herniation under spinal anesthesia is safe surgical treatment of choice in pregnant patients which prevents development of permanent neurological deficit and preterm delivery triggered by pain. Key words: Pregnancy, lomber disc herniation, microdiscectomy J Nervous Sys Surgery 2014; 4(3):127-133 Gebelerde Lomber Disk Hernisine Cerrahi YaklaşımAmaç: Gebelerde şiddetli ağrı ve nörolojik defisit nedeniyle cerrahi endikasyonu olan lomber disk hernisi olgularında uygulanacak anesteziyi, hasta pozisyonunu ve cerrahi yöntemin önemini vurgulamak istedik. Gereç ve yöntem: Çalışmadaki olgular kadın-doğum kliniğince takip edilmekteydi. Analjeziklerle ve konservatif tedaviye rağmen, semptomları düzelmeyen veya ilerleyen olgular nöroşirürji kliniğine sevk edildi. Lomber disk hernisi saptanan 3 olgu opere edildi. İki olgumuz, 3. trimesterde, 1 olgumuz ise 1. trimesterdeydi. Ameliyat için kesin endikasyonlarımız, kauda equina sendromu, ilerleyici motor güç kaybı ve konservatif tedaviye yanıt vermeyen ağrıydı. Opere edilen 3 olgumuzdan 2'si primer, 1'i ise nüks olguydu. Tüm olgularımıza spinal anestezi uygulandı. bulgular: Lomber disk hernisi nedeniyle opere edilen 3 olguda da semptom ve bulguların tamamı ameliyat sonrası düzeldi. Sonuç: Gebelerde lomber disk hernisinin spinal anestezi ile ameliyatı güvenli bir yöntemdir. Cerrahi, ağrı nedeniyle erken doğum riskini ortadan kaldırmak ve kalıcı nörolojik defisitleri önlemek için tercih edilecek tedavidir.

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Section: Dıscussıonmentioning

confidence: 99%

Section: Dıscussıonmentioning

confidence: 99%

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Surgical approach to lumbar disc herniation in pregnant women

Kıbıcı¹,

Kaya²,

Cücü

et al. 2015

sscd

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show abstract

“…Although lumbar disc herniation (LDH) accompanied by radiculopathy and low back pain occurs frequently, there are very few published cases of LDH surgery in pregnancy [1][2][3][4][5][6][7][8]. The most important reason for this disproportionality is the difficulty of surgical practice.…”

Section: Introductionmentioning

confidence: 99%

“…The most important reason for this disproportionality is the difficulty of surgical practice. Problems such as possible damages to the fetus, problems in selection of the appropriate surgery position and the effects of the anesthetic agents to the fetus lead to delays in decision-making for surgery [3][4][5]. Similarly, treatment may be delayed as far as possible as potential damage to the fetus would affect not only the newborn but also the parents.…”

Section: Introductionmentioning

confidence: 99%