Emergency lumbar disc herniation surgery with spinal anesthesia during pregnancy: Clinical features and long-term outcome

Background: This study aimed to review the safety and prognosis of emergency lumbar microdiscectomy surgery during pregnancy.

Methods: The study included a cohort of ten consecutive pregnant patients who underwent urgent lumbar microdiscectomy surgery between 2016 and 2022-perioperative and perinatal clinical data derived from medical records-a retrospective analysis. The patients were evaluated based on age, gestational age, gravidity, parity, neurological examination findings, and visual analog scale (VAS) pain scores with the early and late postoperative results of mother and newborns with follow-up.

Results: Ten pregnant patients underwent emergency lumbar microdiscectomy surgery during pregnancy. Median maternal age was 29.8 ± 4.02 years (range, 21-34 years), and the mean gestational age was 18.2 ± 5.43 weeks (range, 9-26 weeks). Indications were lumbar disk prolapse (n = 10, including cauda equina, motor deficits with severe pain). All surgeries were performed with the patients in the prone position under spinal anesthesia. No miscarriages, stillbirths, or severe obstetric complications occurred until delivery. All patients improved neurologically after the surgery and, were mobile and could take care of their infants. All 10 infants who were healthy at birth had an unremarkable postnatal development, without any congenital defect.

Conclusions: Urgent lumbar microdiscectomy during pregnancy seems to be safe and maintenance of pregnancy is possible and feasible.