Impending Cauda Equina Syndrome Requiring Decompression in Pregnancy - Obtaining Consent and a Novel Surgical Technique
Fabian Wong1*, James Geddes1, Anna Kuligowska1 and Bahram Fakouri1
1Trauma & Orthopaedic Surgery, Guy’s & St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom.
*Corresponding Author: Fabian Wong, Trauma & Orthopaedic Surgery, Guy’s & St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom.
Received: August 25, 2022 Published: September 06, 2022
Abstract
A 33-year-old female in her 5th week of pregnancy presented with an acute exacerbation of chronic low back pain and new onset bilateral sciatica, but normal motor and sensory function. She underwent an urgent MRI scan of her lumbar spine which demonstrated a massive disc extrusion at L4/5 causing severe canal stenosis and compression of the cauda equina. The treatment options and risks were discussed with input from specialities including spinal surgery, obstetric and anaesthetic teams. After 36 hours she developed a left sided foot drop and underwent urgent decompression with informed consent. We used a novel surgical technique to avoid the use of intra-operative ionising radiation, thus minimising any risk to the foetus. This case highlights the importance of a careful, patient-centered, multidisciplinary approach to the consent process.
Keywords: Cauda Equina Syndrome; Pregnancy; First Trimester; Consent; Spinal Surgery; Discectomy; Foot Drop.
Citation: Wong F, Geddes J, Kuligowska A, Fakouri B. “Impending Cauda Equina Syndrome Requiring Decompression in Pregnancy – Obtaining Consent and a Novel Surgical Technique”. SVOA Orthopaedics 2022, 2:5, 97-100.