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Surgery for Recurrent Lumbar Disc Herniation During Pregnancy: A Case Report
Jae Meen Lee1, In Ho Han1, Soo Hyeon Moon2
1Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea.
Abstract:
A few cases of lumbar disc herniation (LDH) that have been treated by surgery during pregnancy have been reported in the literature. However, symptomatic recurrent LDH during pregnancy has been rarely reported. A 32-year-old parous woman presented with lumbago and severe right leg pain at 20 weeks' gestation. Eleven years prior to admission, she had undergone an open discectomy for right-sided LDH at the L4-5 level. Magnetic resonance imaging (MRI) showed a recurrent disc herniation that affected the nerve root at the right L4-5 level. The radiating pain did not respond to conservative treat-ment. Revision surgery was performed under general anesthesia and in the left lateral position to avoid fetal stress and aortocaval compression, and the ruptured disc particle was completely removed. Postoperatively, the radiating pain was completely relieved. She delivered a full-term healthy girl (birth weight, 3.39 kg) at 40 weeks' gestation by normal vaginal delivery. We report the rare case of a 32-year-old parous woman with recurrent LDH that was successfully treated by revision surgery. In recurrent LDH patients with incapacitating pain who do not respond to opioid injections, surgical treat-ment could lead to a satisfactory outcome maintaining pregnancy.
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