Spine Group from Department of Orthopedics and Traumatology, Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, Brazil.
Department of Anesthesia, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Global Spine J. 2015 Apr;5(2):130-4. doi: 10.1055/s-0034-1387178. Epub 2014 Aug 6.
Study Design Case report. Objective The purpose of this report is to discuss the management of a disk herniation during pregnancy and the indication and particularities of surgery in this situation. Methods We describe a case of diskectomy performed in a 35-year-old woman at 18 weeks of gestation. After 4 weeks of trying to manage the disk herniation with rest and medications without success, the muscle strength of the L5 right root decreased to grade 4, and the patient was not responding to intravenous analgesia. After discussion with the patient and family, a decision was made to perform the diskectomy. Results After surgery, the patient's pain lessened, and the Lasegue test became negative. Two weeks after the procedure, the patient's muscle strength was normal. In the 40th week of pregnancy, the patient gave birth without any complications. Conclusion When necessary, diskectomy can be indicated and performed during pregnancy. However, appropriate precautions must be taken. Awareness of these precautions is important for the success of the procedure and for the well-being of the mother and the newborn.
病例报告。
本报告旨在讨论妊娠期间椎间盘突出症的处理方法,以及在这种情况下手术的适应证和特殊性。
我们描述了一位 35 岁女性在妊娠 18 周时行椎间盘切除术的病例。经过 4 周的休息和药物治疗来尝试治疗椎间盘突出症,但未能成功,右侧 L5 神经根的肌力下降至 4 级,且患者对静脉内镇痛无效。与患者和家属讨论后,决定行椎间盘切除术。
手术后,患者的疼痛减轻,Lasegue 试验转为阴性。术后 2 周,患者的肌力恢复正常。在妊娠第 40 周时,患者顺利分娩,无任何并发症。
必要时可在妊娠期间行椎间盘切除术,但必须采取适当的预防措施。了解这些预防措施对于手术的成功以及母婴的健康都非常重要。