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Neurulation is the embryological process which forms the precursors of the central nervous system and occurs after gastrulation has established the three primary cell layers of the embryo: ectoderm, mesoderm, and endoderm. In humans, the majority of this system is formed via primary neurulation, in which the central portion of the ectoderm—originally appearing as a flat sheet of cells—folds upwards and inwards, sealing off to form a hollow neural tube. As development proceeds, the...
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Related Experiment Video

Updated: May 23, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

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Emergent spinal pathologies in late-term pregnancy.

Souvik Roy1,2,3, Rida Mitha4, Raj Swaroop Lavadi4

  • 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Journal of Craniovertebral Junction & Spine
|March 10, 2025
PubMed
Summary

Managing acute spinal pathology in late-term pregnancy requires careful consideration of anesthesia and positioning. This case series highlights successful emergent surgical interventions for conditions like epidural abscess and disc herniation, improving patient outcomes.

Keywords:
Cauda equinaepidural abscess spineepidural catheterslaborneurosurgical emergenciespregnancy

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Area of Science:

  • Neurosurgery
  • Obstetrics
  • Spinal Surgery

Background:

  • Pregnancy alters spinal anatomy and physiology, complicating neurosurgical interventions.
  • Intracranial pathology in pregnant patients is well-documented, but acute spinal pathology management is less understood.

Purpose of the Study:

  • To discuss the management strategies for emergent spinal pathology in late-term pregnancy.
  • To review case series of acute spinal pathologies during pregnancy.

Main Methods:

  • Case series of four pregnant patients with acute spinal pathologies.
  • Literature review to identify relevant themes and management strategies.
  • Analysis of surgical interventions, anesthesia types, and patient positioning.

Main Results:

  • Successful surgical management of epidural spinal needle fracture, epidural abscess, and acute disc herniation with symptom improvement.
  • Nonoperative management for potential spine trauma.
  • Identification of key factors: anesthesia, positioning, and operation sequencing.

Conclusions:

  • Emergent surgical intervention for specific acute spinal pathologies in late-term pregnancy can be effective.
  • Multidisciplinary input is crucial for optimizing management.
  • Careful consideration of patient-specific factors ensures successful surgical outcomes.