Cauda Equina in Pregnancy: Early Management and Outcome

Area of Science:

• Neurology
• Neurosurgery
• Obstetrics

Background:

• Cauda equina syndrome (CES) is a rare condition caused by compression of lumbosacral nerve roots.
• CES during pregnancy presents unique diagnostic and management challenges due to its rarity.

Observation:

• A 34-year-old pregnant woman (22 weeks gestation) presented with acute bilateral leg pain, weakness, and urinary retention.
• Neurological examination revealed motor and sensory deficits, with MRI confirming a large L5/S1 disc extrusion.

Findings:

• Urgent surgical decompression (laminotomy) was performed within eight hours of symptom onset.
• The patient experienced immediate relief of radicular pain and gradual recovery of bladder and motor function.
• The pregnancy continued without complication, resulting in a healthy baby delivered via elective Cesarean section.

Implications:

• This case underscores the critical importance of prompt recognition and early surgical intervention for CES in pregnant individuals.
• A multidisciplinary approach is vital for timely diagnosis, surgical management, and ensuring maternal-fetal safety.
• Complete neurological recovery is achievable with prompt treatment, even during pregnancy.