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Clinical approach and surgical strategy for spinal diseases in pregnant women: a report of ten cases

 In-Ho Han  ;  Sung-Uk Kuh  ;  Jae-Hoon Kim  ;  Dong-Kyu Chin  ;  Keun-Su Kim  ;  Young-Sul Yoon  ;  Byung-Ho Jin  ;  Yong-Eun Cho 
 SPINE, Vol.33(17) : 614-619, 2008 
Journal Title
Issue Date
Adult ; Female ; Humans ; Neurosurgical Procedures/methods* ; Orthopedic Procedures/methods* ; Pregnancy ; Pregnancy Complications/pathology ; Pregnancy Complications/surgery* ; Retrospective Studies ; Spinal Diseases/pathology ; Spinal Diseases/surgery*
pregnancy ; herniated lumbar disc ; spinal tuberculosis ; spinal tumor ; therapeutic abortion
STUDY DESIGN: Case series retrospective review.

OBJECTIVE: To present the treatment guideline for spinal diseases in pregnant women.

SUMMARY OF BACKGROUND DATA: Treatment for spinal diseases in pregnant women is a special clinical challenge because of complex medical and surgical clinical problems.

METHODS: We retrospectively reviewed 10 patients who underwent surgery for spinal diseases, who were diagnosed during pregnancy at our hospital from February 1992 to October 2005. Six patients had herniated lumbar discs, 3 patients had spinal tumors, and 1 patient had spinal tuberculosis.

RESULTS: Five patients with HLDs underwent partial hemilaminectomy and discectomy during pregnancy and maintained the pregnancy. One patient underwent posterior lumbar interbody fusion and had a therapeutic abortion 6 days after lumbar surgery. In 1 patient with hemangioblastoma at the level of T8-T9 level, prepartum surgery was performed maintaining pregnancy in gestational age, 29 weeks. In another patient with hemangioblastoma at the T10 level, a preoperative cesarean section and tumor removal surgery were performed under the same anesthesia in gestational age 34 weeks. One patient had recurrent intramedullary ependymoma at the C3-T2 level. She had the preterm baby by vaginal delivery before spinal operation in gestational age 33 weeks and underwent tumor removal surgery. One patient with tuberculous spondylitis at the level of T3-T5 level, therapeutic abortion performed in gestational age, 16 weeks because of inevitable radiation exposure during fusion surgery.

CONCLUSION: In most spinal diseases, including HLD and tumors, prepartum surgical treatment can be safely performed maintaining pregnancy. For patients with progressive neurologic deficit at 34 to 36 weeks gestation or later, spine surgery should be performed following the induction of delivery or a cesarean section, or at the same time.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Kim, Jae Hoon(김재훈) ORCID logo https://orcid.org/0000-0001-6599-7065
Yoon, Young Sul(윤영설)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
Jin, Byung Ho(진병호)
Han, In Ho(한인호)
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