Emergent spinal pathologies in late-term pregnancy
Pregnancy-induced changes to spinal anatomy and physiology can increase the complexity of neurosurgical intervention in this population. There are numerous reports focused on the neurosurgical management of intracranial pathology for pregnant patients. However, less is known about the neurosurgical...
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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jcvjs.jcvjs_24_24 |
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| _version_ | 1832087211478089728 |
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| author | Souvik Roy Rida Mitha Raj Swaroop Lavadi Rohit Prem Kumar Vinay Jaikumar Matthew Pease Nima Alan Alp Ozpinar Eren Kuris Alan H. Daniels Thomas J. Buell Robert F. Heary Nitin Agarwal D. Kojo Hamilton |
| author_facet | Souvik Roy Rida Mitha Raj Swaroop Lavadi Rohit Prem Kumar Vinay Jaikumar Matthew Pease Nima Alan Alp Ozpinar Eren Kuris Alan H. Daniels Thomas J. Buell Robert F. Heary Nitin Agarwal D. Kojo Hamilton |
| author_sort | Souvik Roy |
| collection | DOAJ |
| description | Pregnancy-induced changes to spinal anatomy and physiology can increase the complexity of neurosurgical intervention in this population. There are numerous reports focused on the neurosurgical management of intracranial pathology for pregnant patients. However, less is known about the neurosurgical management of acute spinal pathology. This study aims to discuss the management of emergent spinal pathology during late-term pregnancy. This is a case series of acute spinal pathologies in pregnancy. Epidural spinal needle fracture, epidural abscess, disc herniation causing an acute neurological deficit, and potential spine trauma. An extensive literature search relevant to the operative cases was performed to highlight the relevant themes to management. (1) The epidural spinal needle fracture was managed by surgical exploration under local anesthesia. (2) The epidural abscess was managed with laminectomy and surgical evacuation of the infective mass under general anesthesia. (3) The acute disc herniation was managed with laminectomy and discectomy under general anesthesia. All three examples were managed with emergent surgeries with improvement of symptoms. (4) The potential spine trauma was managed nonoperatively. Relevant similar cases from the literature review were summarized and strategies for management were outlined. Several factors such as anesthesia type, positioning, and operation sequencing must be considered when managing acute spinal pathology in late-term pregnant patients, necessitating multi-disciplinary input. However, effective management can result in successful surgical intervention and improvement of symptoms. |
| format | Article |
| id | doaj-art-38f945c8e72e4faf86774bc371e5370a |
| institution | Kabale University |
| issn | 0974-8237 0976-9285 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj-art-38f945c8e72e4faf86774bc371e5370a2025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115439139710.4103/jcvjs.jcvjs_24_24Emergent spinal pathologies in late-term pregnancySouvik RoyRida MithaRaj Swaroop LavadiRohit Prem KumarVinay JaikumarMatthew PeaseNima AlanAlp OzpinarEren KurisAlan H. DanielsThomas J. BuellRobert F. HearyNitin AgarwalD. Kojo HamiltonPregnancy-induced changes to spinal anatomy and physiology can increase the complexity of neurosurgical intervention in this population. There are numerous reports focused on the neurosurgical management of intracranial pathology for pregnant patients. However, less is known about the neurosurgical management of acute spinal pathology. This study aims to discuss the management of emergent spinal pathology during late-term pregnancy. This is a case series of acute spinal pathologies in pregnancy. Epidural spinal needle fracture, epidural abscess, disc herniation causing an acute neurological deficit, and potential spine trauma. An extensive literature search relevant to the operative cases was performed to highlight the relevant themes to management. (1) The epidural spinal needle fracture was managed by surgical exploration under local anesthesia. (2) The epidural abscess was managed with laminectomy and surgical evacuation of the infective mass under general anesthesia. (3) The acute disc herniation was managed with laminectomy and discectomy under general anesthesia. All three examples were managed with emergent surgeries with improvement of symptoms. (4) The potential spine trauma was managed nonoperatively. Relevant similar cases from the literature review were summarized and strategies for management were outlined. Several factors such as anesthesia type, positioning, and operation sequencing must be considered when managing acute spinal pathology in late-term pregnant patients, necessitating multi-disciplinary input. However, effective management can result in successful surgical intervention and improvement of symptoms.https://journals.lww.com/10.4103/jcvjs.jcvjs_24_24cauda equinaepidural abscess spineepidural catheterslaborneurosurgical emergenciespregnancy |
| spellingShingle | Souvik Roy Rida Mitha Raj Swaroop Lavadi Rohit Prem Kumar Vinay Jaikumar Matthew Pease Nima Alan Alp Ozpinar Eren Kuris Alan H. Daniels Thomas J. Buell Robert F. Heary Nitin Agarwal D. Kojo Hamilton Emergent spinal pathologies in late-term pregnancy Journal of Craniovertebral Junction and Spine cauda equina epidural abscess spine epidural catheters labor neurosurgical emergencies pregnancy |
| title | Emergent spinal pathologies in late-term pregnancy |
| title_full | Emergent spinal pathologies in late-term pregnancy |
| title_fullStr | Emergent spinal pathologies in late-term pregnancy |
| title_full_unstemmed | Emergent spinal pathologies in late-term pregnancy |
| title_short | Emergent spinal pathologies in late-term pregnancy |
| title_sort | emergent spinal pathologies in late term pregnancy |
| topic | cauda equina epidural abscess spine epidural catheters labor neurosurgical emergencies pregnancy |
| url | https://journals.lww.com/10.4103/jcvjs.jcvjs_24_24 |
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