Lumbar microdiscectomy during first trimester of pregnancy: Surgical, anesthetic, and radiation considerations with review of reported cases.

BACKGROUND

Lumbar disc herniation requiring surgical intervention during pregnancy is rare, particularly during the first trimester. Here, we highlight the pros and cons of performing a microdiscectomy (MD) during the first trimester for a pregnant 27-year-old female.

CASE DESCRIPTION: A 27-year-old pregnant female in her first trimester presented with a progressive right foot drop secondary to an L5-S1 disc herniation. After failing 6 weeks of conservative management, she underwent right L5-S1 MD under general anesthesia in the prone position. Maternal hemodynamic stability was maintained throughout the procedure, and fluoroscopy was limited to a single image. Postoperatively, motor strength improved with rehabilitation, and she subsequently delivered a healthy full-term infant without obstetric or neonatal complications.

CONCLUSION

Medically and neurosurgically indicated lumbar MD should be appropriately performed in patients in their first trimester of pregnancy.