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妊娠晚期腰麻下椎间盘切除术:一例病例报告及文献综述

Discectomy with spinal anesthesia in the third trimester of pregnancy: A case report and literature review.

作者信息

Mehrafshan Ali, Hajilo Parisa, Samiee Fateme

机构信息

Department of Neurosurgery, Nekuii Forghani Hospital, Qom University of Medical Sciences, Iran.

Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Iran.

出版信息

SAGE Open Med Case Rep. 2025 Aug 30;13:2050313X251370506. doi: 10.1177/2050313X251370506. eCollection 2025.

Abstract

Low back pain is common during pregnancy, but symptomatic lumbar disc herniation in this period is particularly rare. We report a case of lumbar disc herniation in a 35-year-old woman at 32 weeks of pregnancy, who experienced persistent symptoms despite 6 weeks of rest and medication. Muscle strength in the right L5 nerve root declined to grade 4, and intravenous analgesia was ineffective. After thorough discussions with the patient and her family, a discectomy was performed under spinal anesthesia. Following surgery, the patient's pain decreased, the Lasegue test became negative, and muscular strength returned to normal 2 weeks post-operation. At 39 weeks of gestation, a cesarean section was performed due to functional dystocia.

摘要

下背痛在孕期很常见,但在此期间出现症状性腰椎间盘突出症则尤为罕见。我们报告一例35岁女性在妊娠32周时发生腰椎间盘突出症的病例,该患者尽管经过6周的休息和药物治疗仍有持续症状。右侧L5神经根的肌力降至4级,静脉镇痛无效。在与患者及其家属进行充分讨论后,在脊髓麻醉下进行了椎间盘切除术。术后,患者疼痛减轻,直腿抬高试验转为阴性,术后2周肌力恢复正常。妊娠39周时,因功能性难产行剖宫产术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c6/12399815/79d3677d4043/10.1177_2050313X251370506-fig1.jpg

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