TRATAMENTO CIRÚRGICO DA HÉRNIA DE DISCO LOMBAR EM GESTANTES: RELATO DE DOIS CASOS E REVISÃO SISTEMÁTICA

Krutko, Aleksandr Vladimirovich; Sanginov, Abdugafur Jabborovich; Peleganchuk, Aleksey Vladimirovich; Alshevskaya, Alina Anatolevna; Moskalev, Andrei Vladimirovich; Byvaltsev, Vadim Anatolevich

doi:10.1590/S1808-185120181703193835

Aleksandr Vladimirovich Krutko Correspondence: Neurosurgery Department of NRITO, Frunze str., 17, Novosibirsk, 630091, Russia. ortho-ped@mail.ru

Novosibirsk Research Institute of Traumatology and Orthopaedics, Novosibirsk, Russia

https://orcid.org/0000-0002-2570-3066

Abdugafur Jabborovich Sanginov

Novosibirsk Research Institute of Traumatology and Orthopaedics, Novosibirsk, Russia

https://orcid.org/0000-0002-4744-4077

Aleksey Vladimirovich Peleganchuk

Novosibirsk Research Institute of Traumatology and Orthopaedics, Novosibirsk, Russia

https://orcid.org/0000-0002-4588-428X

Alina Anatolevna Alshevskaya

Biostatistics and Clinical Trials Center, Novosibirsk, Russia

https://orcid.org/0000-0002-7307-4524

Andrei Vladimirovich Moskalev

Biostatistics and Clinical Trials Center, Novosibirsk, Russia

https://orcid.org/0000-0002-6711-3822

Vadim Anatolevich Byvaltsev

Irkutsk State Medical University, Irkutsk, Russia

https://orcid.org/0000-0003-4349-7101

Correspondence: Neurosurgery Department of NRITO, Frunze str., 17, Novosibirsk, 630091, Russia. ortho-ped@mail.ru

All authors declare no potential conflict of interest related to this article.

CONTRIBUTION OF THE AUTHORS: Each author made significant individual contributions to this manuscript. AVK (0000-0002-2570-3066)*, AJS (0000-0002-4744-4077)* and AVP (0000-0002-4588-428X)* were the main contributors in the drafting of the manuscript. AVK, AJS and AVP performed the surgery, followed up the patients and gathered clinical data. AAA (0000-0002-7307-4524)* and AVM (0000-0002-6711-3822)* evaluated the data from the statistical analysis. AJS, AVK and VAB (0000-0003-4349-7101) performed the literature search and review of the manuscript, and contributed to the intellectual concept of the study. *ORCID (Open Researcher and Contributor ID).

	Age	Pregnancy/ delivery	Gestation age when symptoms developed	Surgery time	Cauda equina syndrome	Conservative treatment	Anesthesia type	Surgical position	Level, surgery	If surgery was after delivery (cesarean)?	Residual symptoms within follow-up
1997 Garmel	34	G4 P2	9 weeks	N/A	Yes	bed rest, ice packs, lumbosacral support, physical therapy, and pain medication	N/A	N/A	L5-S1, LE and DE	No	No
1995 LaBan	29	G1 P0	6 weeks	11 weeks	No	5 weeks	N/A	N/A	L5-S1, LE, DE	No	N/A
2008 Han	30	N/A	N/A	11 weeks	No	N/A	Epidural	Prone	L4-L5 and L5-S1, posterior lumbar interbody fusion	No	No
2008 Han	32	N/A	N/A	11 weeks	No	N/A	Epidural	Prone	L4-L5, partial hemiLE, DE	No	No
2007 Curtin	37	G3 P2	<1 week	11 weeks	Yes	Yes	N/A	N/A	L4-L5, lumbar DE and nerve root decompression	No	18 months - persistent paraesthesia down the back of both legs and anesthesia in the saddle area
2014 Speirs	24	G2 P2	15 weeks	15 weeks	Yes	No	General	Prone	L5-S1, DE	No	No
2008 Han	30	N/A	N/A	15 weeks	No	N/A	Epidural	Right lateral decubitus	L5-S1, partial hemiLE, DE	No	No
Author's data	31	G1 P1	4 weeks	16 weeks	No	Yes	Epidural anesthesia	Right lateral	InterLE of L5-S1 on the left, DE	No	10 months - reherniation without need for urgent reoperation
2001 Brown	32	G0 P0	13 weeks	16 weeks	No	Bed rest, analgesics, epidural steroid injection	Epidural	Prone	L5, right LE, partial facetectomy, nerve root decompression; L5-S1, DE	No	10 months - a trace of weakness in the left peroneal muscle group
2004 Vougioukas	36	N/A	N/A	18 weeks	No	N/A	N/A	N/A	L5-S1, nucleotomy	No	No
2006 Abou-Shameh	34	G2 P1	14 weeks	19 weeks	No	4 days - bed rest, routine analgesia	General	Knee/ elbow, with simple side supports	L4-5, right-sided DE	No	No
2003 Reihani-Kermani	26	G0 P0	<16 weeks	20 weeks	Yes	4 weeks - pain medication, exercise plan	N/A	N/A	L4, LE; L3-L4, partial DE	No	3 months - foot drop
2008 Mohapatra	30	G1 P1	<17 weeks	20 weeks	Yes	Yes	General	Prone	L5 and S1, LE; L5- S1, DE	No	7 month - persistent weakness in the feet; incontinent bladder and bowel
2003 Iyilikçi	31	G0 P0	<16 weeks	20 weeks	No	N/A	General (tracheal intubation)	Left lateral	L5-S1, DE	No	No
2001 Brown	31	G0 P0	16 weeks	20 weeks	No	3 weeks - bed rest, two epidural steroid injections, oral steroids, oxycodone, acetaminophen	Epidural	Prone	L5-S1, hemiLE, partial facetectomy, DE	No	15 months - minimal residual hypoesthesia in the right planta
2011 Lee	32	G? P>0	12 weeks	20 weeks	No	2 months	General	Left lateral	L3, right extended medial facetectomy and adhesiolysis; L4-L5, DE	No	No
Author's experience	36	G1 P1	<17 weeks	20 weeks	Yes	Yes	Epidural	Left lateral	InterLE of L5-S1 on the right, DE	No	1 year - moderate discomfort in the right gluteal region
1995 LaBan	36	G3 P1	20 weeks	20 weeks	Yes	No	N/A	N/A	L5-S1, lumbar LE with DE	No	No
2001 Brown	41	G0 P0	14 weeks	20 weeks	Yes	Yes	Epidural	Prone	L5-S1, hemiLE, partial facetectomy, DE	No	4 years - persistent hypoesthesia on the right side of the perineum necessitating urethral dilatation at 3-month intervals; urinary stress incontinence; constipation; 50% improvement in bowel function
1997 Garmel	29	G0 P0	23 weeks	24 weeks	Yes	2 days pain medication, range-of-motion exercises, and a walker	N/A	N/A	L5-S1, DE	No	No
2012 Hakan	34	G2 P?	25 weeks	25 weeks	Yes	No	General	Prone	L5-S1 right partial hemilaminotomy, microDE	No	6-month - bowel and bladder were nearly normal, reduced sensation in the sacral area was continuing
2008 Han	34	N/A	N/A	26 weeks	No	N/A	Epidural	Right lateral decubitus	L4-L5, partial hemiLE, DE	No	No
2015 Martel	27	G1 P0	26 weeks	28 weeks	No	6 days of - dexamethasone	General	Prone	L4-L5, left hemiLE, medial facetectomy, microDE, foraminotomy	No	No
1997 Garmel	28	G5 P1	29 weeks	30 weeks	Yes	4 days of pain medication	N/A	N/A	L5-S1, LE and DE	No	3 months - minimal foot numbness
2007 Kim	30	G0 P0	22 weeks	30 weeks	Yes	Yes	Regional	Prone	L4-L5, DE	No	3 months - persistent hypoesthesia and slightly weakened dorsiflexion on the left side
2008 Han	33	N/A	N/A	30 weeks	No	N/A	Epidural	Left lateral decubitus	L4-L5, partial hemiLE, DE	No	No
2008 Han	30	N/A	N/A	32 weeks	No	N/A	Epidural	Left lateral decubitus	L4-L5, partial hemiLE, DE	No	No
1998 Fahy	32	G3 P?	30 weeks	32 weeks	Yes	No	General	Prone	L4-L5, DE	No	7 months - slight residual weakness in the left anterior tibialis
1998 Fahy	31	N/A	29 weeks	33 weeks	No	4 weeks - analgesics, oral morphine, transcutaneous nerve stimulation	General	Prone	L4-L5, left mini-DE	No	No
2006 Kathirgamanathan	34	G0 P0	33 weeks	33 weeks	Yes	No	General	Left lateral position	L4-L5, DE; L5, nerve root decompression.	No	No
2014 Ochi	33	N/A	32 weeks	Immediately after CS at 34^th week	No	Yes, 2 weeks Patient received physical therapy and acetaminophen for pain relief	Epidural	Prone	(34 weeks) L4-L5, left DE; (after 6 days) L4-L5, right DE	Yes	18 months - numbness and slightly weakened dorsiflexion in the left extremity
2004 Vougioukas	30	G0 P0	35 weeks	35 weeks	No	1 day - analgesics, immobilization	N/A	Left lateral decubitus	L4-L5, partial left DE, hemiLE	No	No
2008 Gupta	37	G2 P1	35 weeks	Immediately after CS at 35^th week	Yes	No	General	Prone	L5-S1, DE	Yes	No
2015 Geftler	33	Gmulti Pmulti	36 weeks	Immediately after CS at 36^th week	Yes	No	General	Prone	L4-L5 partial aminoforaminotomy, DE	Yes	No
1999 Timothy	37	G0 P0	33 weeks	4 weeks after 38 weeks uncomplicated ventouse delivery	Yes	Yes	N\A	N\A	L5-S1, DE	Yes	2 years - gained some anal sphincter control; still uses intermittent catheterization to void urine; absent sensation in the perineal area with associated sexual dysfunction

[1] Correspondence: Neurosurgery Department of NRITO, Frunze str., 17, Novosibirsk, 630091, Russia. ortho-ped@mail.ru

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TRATAMENTO CIRÚRGICO DA HÉRNIA DE DISCO LOMBAR EM GESTANTES: RELATO DE DOIS CASOS E REVISÃO SISTEMÁTICA

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