Case report: The operation for the lumbar disk herniation just after cesarean delivery in the third trimester of pregnancy

• We suggest treatment strategy for a pregnant woman with lumber disk herniation.
• The discectomy was performed just after cesarean delivery in the third trimester.
• There were not any complications with mother and baby after operation.
• It is necessary to cooperate with a pediatrician, an obstetrician, and an anesthesiologist.
• It is important to discuss in advance to be able to respond quickly for changeable situation.

INTRODUCTIONLow back pain is common during pregnancy. However, the incidence of symptomatic lumbar disc herniation during pregnancy is very rare. We report a case of lumbar disc herniation underwent discectomy just after cesarean delivery in the third trimester of pregnancy.PRESENTATION OF CASEA 33-year-old woman presented at 32 weeks gestation. She had a low back pain and the left-sided leg pain below the knee. At 34 weeks gestation, she had severe weakness of the left extension halluces longus, left ankle dorsiflexion. MRI showed a large disc herniation at L4/5 expanded to the spinal canal more. The cesarean delivery was performed in the supine position. The patient was then turned to a prone position, and a left L4/5 discectomy was performed. But the day after surgery, she had a severe low back pain and the right leg pain below the knee. MRI showed a disc herniation at L4/5 on the right side of the spinal canal. At 6 days after the first surgery, a right L4/5 discectomy was performed. In the immediate postoperative period, the patient experienced complete relief of the right leg pain.DISCUSSIONIt is necessary to cooperate with a pediatrician, an obstetrician, and an anethesiologists. For obtaining the best outcome on mother and child, it is important to discuss in advance to be able to respond quickly for changeable situation.CONCLUSIONIt is necessary to conduct the operation under pregnancy in consideration of the great influence on mother and child.