The Management of Symptomatic Lumbar Disc Herniation in Pregnancy: A Systematic Review
| Autor: | S. Elsayed, Epaminondas Markos Valsamis, Roozbeh Shafafy, Giuseppe Lambros Morassi, Oliver Stokes, Chris Horton, Emily Whiles |
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| Rok vydání: | 2020 |
| Předmět: |
Pregnancy
medicine.medical_specialty business.industry medicine.disease Optimal management Surgery herniation 03 medical and health sciences 0302 clinical medicine Lumbar medicine Orthopedics and Sports Medicine 030212 general & internal medicine Neurology (clinical) Lumbar disc herniation Limited evidence pregnancy business Review Articles 030217 neurology & neurosurgery lumbar disc |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5682 |
| Popis: | Study Design: Systematic review. Objectives: Lumbar disc herniation (LDH) has been reported to affect 1 in 10 000 pregnant women. There is limited evidence available regarding the optimal management of LDH in pregnant patients. We aimed to review the current evidence for the management of symptomatic LDH in pregnancy through critical appraisal and analysis of the available literature. Methods: Searches were conducted in Medline, Embase, PubMed, Science Direct, and The Cochrane Library from inception using predetermined search terms. All peer-reviewed studies of pregnant women with symptomatic LDH were included. The quality of eligible articles was assessed and extracted data and characteristics were pooled for analysis. References cited by studies were screened to identify other relevant publications. Results: Thirty studies involving 52 patients were identified. Compared to surgically managed patients, conservatively managed patients had a higher full recovery rate (61.54% vs 56.41%) and reported a lower rate of persistent symptoms (30.77% vs 38.54%). Compared to patients who were treated surgically for cauda equina syndrome, patients treated surgically for sciatica had a higher full recovery rate (80.95% vs 27.78%) and reported a lower rate of persistent symptoms (14.29% vs 66.67%). Conclusion: There is limited evidence to guide the management of pregnant patients with LDH. Despite a suggestion toward improved outcomes with conservative management, the presence of selection bias and the overall poor quality of current research precludes reliable conclusions from being drawn. Decision making for this patient group should be undertaken within a multidisciplinary setting. |
| Databáze: | OpenAIRE |
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