Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease
Abstract Pregnancy poses a special clinical challenge in surgical treatments for spinal diseases. Here we present the case of a 30-year-old woman with a ruptured lumbar disc on the right side of L5–S1. The patient was 18 weeks pregnant. Conservative managements for 3 weeks had failed to relieve her...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2016-02-01
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| Series: | Indian Journal of Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1572374 |
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| author | Byeong Sam Choi Il Choi Sungjoon Lee |
| author_facet | Byeong Sam Choi Il Choi Sungjoon Lee |
| author_sort | Byeong Sam Choi |
| collection | DOAJ |
| description | Abstract
Pregnancy poses a special clinical challenge in surgical treatments for spinal diseases. Here we present the case of a 30-year-old woman with a ruptured lumbar disc on the right side of L5–S1. The patient was 18 weeks pregnant. Conservative managements for 3 weeks had failed to relieve her pain. We performed interlaminar percutaneous endoscopic lumbar discectomy (PELD) using spinal anesthesia. The left lateral decubitus position was chosen to minimize abdominal compression. Preoperative magnetic resonance imaging (MRI) taken after attaching few fiducial markers at patient's mid-lower back was used to secure the correct surgical level without X-rays. The surgery was successful, and the patient's pain score on a visual analogue scale was reduced from 9/10 to 3/10. Ultrasonography was used to confirm that the baby was healthy postoperatively. PELD causes less pain, and dose not require general anesthesia, which imposes a higher risk of fetal distress than regional anesthesia. Combination of the interlaminar approach of accessing from the midline and a marking MRI permitted PELD without X-ray imaging. The relative ease of performing surgery on either side of the lateral decubitus position makes PELD more feasible for pregnant patients. |
| format | Article |
| id | doaj-art-0e2f973cf94f45d1b5a03d334f3094ae |
| institution | OA Journals |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2016-02-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-0e2f973cf94f45d1b5a03d334f3094ae2025-08-20T01:59:13ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672016-02-01050105105410.1055/s-0036-1572374Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc DiseaseByeong Sam Choi0Il Choi1Sungjoon Lee2Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, KoreaDepartment of Neurosurgery, Dongtan Sacred Heart Hospital, Hallym University, Gyeonggi-do, KoreaDepartment of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, KoreaAbstract Pregnancy poses a special clinical challenge in surgical treatments for spinal diseases. Here we present the case of a 30-year-old woman with a ruptured lumbar disc on the right side of L5–S1. The patient was 18 weeks pregnant. Conservative managements for 3 weeks had failed to relieve her pain. We performed interlaminar percutaneous endoscopic lumbar discectomy (PELD) using spinal anesthesia. The left lateral decubitus position was chosen to minimize abdominal compression. Preoperative magnetic resonance imaging (MRI) taken after attaching few fiducial markers at patient's mid-lower back was used to secure the correct surgical level without X-rays. The surgery was successful, and the patient's pain score on a visual analogue scale was reduced from 9/10 to 3/10. Ultrasonography was used to confirm that the baby was healthy postoperatively. PELD causes less pain, and dose not require general anesthesia, which imposes a higher risk of fetal distress than regional anesthesia. Combination of the interlaminar approach of accessing from the midline and a marking MRI permitted PELD without X-ray imaging. The relative ease of performing surgery on either side of the lateral decubitus position makes PELD more feasible for pregnant patients.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1572374endoscopic discectomypregnancylumbar disc herniation |
| spellingShingle | Byeong Sam Choi Il Choi Sungjoon Lee Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease Indian Journal of Neurosurgery endoscopic discectomy pregnancy lumbar disc herniation |
| title | Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease |
| title_full | Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease |
| title_fullStr | Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease |
| title_full_unstemmed | Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease |
| title_short | Surgical Strategy Using Endoscopy to Minimize Fetal Surgical Risks in Treating a Pregnant Woman with Herniated Lumbar Disc Disease |
| title_sort | surgical strategy using endoscopy to minimize fetal surgical risks in treating a pregnant woman with herniated lumbar disc disease |
| topic | endoscopic discectomy pregnancy lumbar disc herniation |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1572374 |
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