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Lumbar disk herniation during pregnancy: a review on general management and timing of surgery

  • Review Article - Spine
  • Published:
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Abstract

Study design

Narrative review with case illustration.

Objective

Provide an overview of existing management strategies to suggest a guideline for surgical management of lumbar disk herniation in pregnant women based on time of presentation.

Methods

We performed a narrative review on the topic using the PubMed database. A total of 63 relevant articles published after 1992 were identified, of which 17 fulfilled selection criteria.

Results

A total of 22 published cases of spine surgery for disk herniation during pregnancy were found in 17 studies on the topic. Prone positioning was reported in the majority of cases during the first and early second trimester. C-sections were performed prior to spine surgery in the prone position for the majority of patients operated during the third trimester. The left lateral position with continued pregnancy was preferred during the latter half of the second trimester when delivery of the fetus cannot yet be performed but surgery is indicated.

Conclusion

Spine surgery during pregnancy is a rare scenario but can be performed safely when needed if providers adhere to general guidelines. Surgical approaches and overall management are influenced by the stage of pregnancy.

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Author information

Authors and Affiliations

  1. Lyon-Sud School of Medicine, University Claude-Bernard Lyon-1, Chemin du Grand Revoyet, 69310, Pierre-Bénite, France

    Hugo Ardaillon

  2. Department of Neurosurgery, Beth Israel Deaconess Medical Center, One Deaconess Road, Boston, MA, 02215, USA

    Yosef Laviv, Jeffrey E. Arle & Ekkehard M. Kasper

Authors
  1. Hugo Ardaillon
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  2. Yosef Laviv
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  3. Jeffrey E. Arle
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  4. Ekkehard M. Kasper
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Corresponding author

Correspondence to Ekkehard M. Kasper.

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No funding was received for this research.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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This article does not contain any studies with human participants performed by any of the authors.

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Ardaillon, H., Laviv, Y., Arle, J.E. et al. Lumbar disk herniation during pregnancy: a review on general management and timing of surgery. Acta Neurochir 160, 1361–1370 (2018). https://doi.org/10.1007/s00701-017-3098-z

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  • DOI: https://doi.org/10.1007/s00701-017-3098-z

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