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Acta Neurochirurgica

, Volume 160, Issue 7, pp 1361–1370 | Cite as

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

  • Hugo Ardaillon
  • Yosef Laviv
  • Jeffrey E. Arle
  • Ekkehard M. Kasper
Review Article - Spine

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.

Keywords

Lumbar disc herniation Pregnancy Discectomy Radiculopathy Low back pain Cauda equina syndrome 

Notes

Compliance with ethical standards

Funding

No funding was received for this research.

Conflict of Interest

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.

Ethical approval

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

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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Hugo Ardaillon
    • 1
  • Yosef Laviv
    • 2
  • Jeffrey E. Arle
    • 2
  • Ekkehard M. Kasper
    • 2
  1. 1.Lyon-Sud School of MedicineUniversity Claude-Bernard Lyon-1Pierre-BéniteFrance
  2. 2.Department of NeurosurgeryBeth Israel Deaconess Medical CenterBostonUSA

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