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Surgical Intervention for Cauda Equina Syndrome in the Second and Third Trimesters of Pregnancy

A Report of Three Cases

Look, Nicole, MD1,a; Kleck, Christopher J., MD1; Burger, Evalina L., MD1

doi: 10.2106/JBJS.CC.17.00289
Case Reports
Disclosures

Case: Low back pain affects >50% of pregnant women. However, cauda equina syndrome (CES) during pregnancy is rare. Because a delay in treatment increases the risk of irreversible neurologic damage, acute onset is regarded as a surgical emergency. We describe 3 cases of CES in pregnant women at 24, 27, and 30 weeks’ gestation, respectively.

Conclusion: All 3 of the patients underwent surgical decompression in the prone position under general anesthesia with continuous external monitoring of the fetal heart rate. Intraoperative findings were noteworthy for epidural venous plexus engorgement in 2 of the patients. There were no complications for the patients or the fetuses, and all 3 of the patients had postoperative resolution of the neurologic symptoms.

1Department of Orthopaedics, Anschutz Medical Campus, University of Colorado, Aurora, Colorado

aE-mail address for N. Look: nicole.look@ucdenver.edu

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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