Pregnancy and the herniated lumbar disc.

During the last decade, five pregnant patients with symptoms and signs of a herniated lumbar disc were identified among a series of 48,760 consecutive deliveries at William Beaumont Hospital, an incidence of 1:10,000. In all cases, clinical evaluation and electromyography complemented conservative treatment during the final stage of pregnancy. Each patient was delivered by cesarean section. Large lumbar disc herniations in each case were subsequently identified by myelography. In all five cases, lumbar laminectomy was successful in facilitating the eventual resolution of the signs and symptoms of the radiculopathy. Although the mechanical and postural stresses of pregnancy have been cited as predisposing causes of a herniated lumbar disc, this study suggests otherwise. Lumbosacral vertebral disc ruptures of pregnancy, while relatively rare, should nevertheless be recognized early, distinguished from other causes of lumbosacral gestational plexopathy, and promptly treated.