Kothari Ajay, Khurjekar Ketan, Hadgaonkar Shailesh, Kulkarni Himanshu, Sancheti Parag
Assistant Professor, Department of Spine Surgery, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
Chief Consultant, Department of Spine Surgery, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
J Clin Diagn Res. 2017 Aug;11(8):RD03-RD05. doi: 10.7860/JCDR/2017/27064.10494. Epub 2017 Aug 1.
Cauda equina syndrome is widely considered as a surgical emergency. The cause of cauda equina syndrome usually is a large central lumbar disc herniation, prolapse or sequestration. Decompression at the earliest has been suggested by many authors but the planning of surgical management becomes challenging when the patient is a breastfeeding mother. Fear of harmful effects of the drugs (administered in the mother) on the infant, always confuses clinicians regarding the treatment approach. So the multidisciplinary approach is necessary with involvement of anaesthetist, paediatrician and also a gynaecologist if necessary. Thorough knowledge of the safety of drugs to be used in operative and post operative period becomes a necessity keeping the baby into consideration. We present a case of one month postpartum female with cauda equina syndrome and present a stepwise multidisciplinary approach, which involves active contributions from surgeon, for safety of the mother and the infant.
马尾综合征被广泛认为是一种外科急症。马尾综合征的病因通常是巨大的中央腰椎间盘突出、脱垂或游离。许多作者都建议尽早进行减压,但当患者是一位哺乳期母亲时,手术管理的规划就变得具有挑战性。担心(母亲所使用的)药物对婴儿产生有害影响,这总是让临床医生在治疗方法上感到困惑。因此,多学科方法是必要的,需要麻醉师、儿科医生参与,如有必要还需妇科医生参与。考虑到婴儿,全面了解手术期和术后使用药物的安全性成为必需。我们报告一例产后1个月患有马尾综合征的女性病例,并提出一种逐步的多学科方法,其中外科医生要积极参与,以保障母亲和婴儿的安全。