{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:34:38Z","timestamp":1769726078433,"version":"3.49.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Cervical disc herniation during pregnancy is a rare but clinically significant condition. While conservative management is generally preferred, progressive neurological symptoms may necessitate surgical intervention. When conservative management fails, a multidisciplinary approach is needed when considering surgical intervention to minimize risk to the mother and fetus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present the case of a woman in her mid-30s at 24 weeks of gestation, conceived via in vitro fertilization, who developed progressively worsening left C7 radiculopathy refractory to conservative therapies. After comprehensive multidisciplinary evaluation, she underwent successful anterior cervical discectomy and fusion with placement of a stand-alone interbody cage. Perioperative planning incorporated anesthetic modifications, fetal monitoring strategies, and minimization of radiation exposure. The patient experienced immediate postoperative relief, rapid functional recovery, and an uncomplicated pregnancy course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case illustrates that elective spine surgery during pregnancy can be performed safely when medically indicated, particularly during the 2nd trimester. Meticulous multidisciplinary planning, surgical adaptations to minimize fetal risk, and individualized patient counseling are critical for optimizing maternal and fetal outcomes. This case emphasizes the importance of patient-centered care in managing spinal pathology during pregnancy.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25458\">https:\/\/thejns.org\/doi\/10.3171\/CASE25458<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25458","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T23:49:19Z","timestamp":1756770559000},"source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary management of cervical disc herniation in pregnancy: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Divine C.","family":"Nwafor","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Asuzu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek S.","family":"Bhutada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Carilion Clinic, Virginia Tech School of Medicine, Roanoke, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Pajewski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"},{"name":"Department of Anesthesiology, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Atkins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Sardi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"Obstet Gynecol Surv","first-page":"103","article-title":"Orthopedic issues in pregnancy","volume":"63","author":"Smith","year":"2008","unstructured":"Smith MWMarcus PSWurtz LD.Orthopedic issues in pregnancy. Obstet Gynecol Surv. 2008;63(2):103-111."},{"issue":"7","key":"bib2","series-title":"Glob Spine J","first-page":"908","article-title":"The management of symptomatic lumbar disc herniation in pregnancy: a systematic review","volume":"10","author":"Whiles","year":"2020","unstructured":"Whiles EShafafy RValsamis EMThe management of symptomatic lumbar disc herniation in pregnancy: a systematic review. Glob Spine J. 2020;10(7):908-918."},{"issue":"5","key":"bib3","series-title":"Gynecol Obstet Investig","first-page":"417","article-title":"Low back pain in pregnancy: investigations, management, and role of neuraxial analgesia and anaesthesia: a systematic review","volume":"82","author":"Sehmbi","year":"2017","unstructured":"Sehmbi HD\u2019Souza RBhatia A.Low back pain in pregnancy: investigations, management, and role of neuraxial analgesia and anaesthesia: a systematic review. Gynecol Obstet Investig. 2017;82(5):417-436."},{"issue":"2","key":"bib4","series-title":"J Spine Surg","first-page":"274","article-title":"Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review","volume":"10","author":"Chan","year":"2024","unstructured":"Chan NYLe MReinecker SPrince MMurphy GT.Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review. J Spine Surg. 2024;10(2):274-285."},{"issue":"4","key":"bib5","series-title":"J Orthop Sci","first-page":"911","article-title":"Lumbar disc herniation in a pregnant woman treated with full-endoscopic interlaminar discectomy without X-ray exposure: a case report","volume":"28","author":"Zheng","year":"2023","unstructured":"Zheng QHu XZhang YWang Y.Lumbar disc herniation in a pregnant woman treated with full-endoscopic interlaminar discectomy without X-ray exposure: a case report. J Orthop Sci. 2023;28(4):911-914."},{"issue":"1","key":"bib6","series-title":"Acta Neurochir (Wien)","first-page":"479","article-title":"Lumbar disc herniation and cauda equina syndrome during pregnancy: a systematic review","volume":"166","author":"Hussein","year":"2024","unstructured":"Hussein AQuiceno EPacheco-Barrios NLumbar disc herniation and cauda equina syndrome during pregnancy: a systematic review. Acta Neurochir (Wien). 2024;166(1):479."},{"key":"bib7","series-title":"Spinal Cord Ser Cases","first-page":"93","article-title":"Acute traumatic cervical spinal cord injury in a third-trimester pregnant female with good maternal and fetal outcome: a case report and literature review","volume":"4","author":"Pedaballe","year":"2018","unstructured":"Pedaballe ARChhabra HSTandon VChauhan PVerma R.Acute traumatic cervical spinal cord injury in a third-trimester pregnant female with good maternal and fetal outcome: a case report and literature review. Spinal Cord Ser Cases. 2018;4:93."},{"issue":"6","key":"bib8","series-title":"Antimicrob Agents Chemother","first-page":"3504","article-title":"Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery","volume":"58","author":"Elkomy","year":"2014","unstructured":"Elkomy MHSultan PDrover DREpshtein EGalinkin JLCarvalho B.Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery. Antimicrob Agents Chemother. 2014;58(6):3504-3513."},{"issue":"3","key":"bib9","series-title":"Am J Surg","first-page":"467","article-title":"Pregnancy outcome following non-obstetric surgical intervention","volume":"190","author":"Cohen-Kerem","year":"2005","unstructured":"Cohen-Kerem RRailton COren DLishner MKoren G.Pregnancy outcome following non-obstetric surgical intervention. Am J Surg. 2005;190(3):467-473."},{"issue":"2","key":"bib10","series-title":"Anesth Essays Res","first-page":"160","article-title":"Anaesthetic challenges and management during pregnancy: strategies revisited","volume":"7","author":"Bajwa","year":"2013","unstructured":"Bajwa SJSBajwa SK.Anaesthetic challenges and management during pregnancy: strategies revisited. Anesth Essays Res. 2013;7(2):160-167."},{"key":"bib11","author":"","unstructured":"AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding. PS 8-A. April 2, 2019. American Association of Physicists in Medicine. Accessed August 4, 2025. https:\/\/aapm.org\/org\/policies\/details.asp?id=2552."},{"issue":"4","key":"bib12","series-title":"J Spine Surg","first-page":"696","article-title":"Decreasing radiation dose with FluoroLESS Standalone Anterior Cervical Fusion","volume":"4","author":"Chin","year":"2018","unstructured":"Chin KRPencle FJRQuijada KAMustafa MSMustafa LSSeale JA.Decreasing radiation dose with FluoroLESS Standalone Anterior Cervical Fusion. J Spine Surg. 2018;4(4):696-701."},{"issue":"4","key":"bib13","series-title":"J Spine Surg","first-page":"596","article-title":"A radiographic follow-up study of stand-alone-cage and graft-plate constructs for single-level anterior cervical discectomy and fusion","volume":"3","author":"Baker","year":"2017","unstructured":"Baker JFGomez JShenoy KKim SRazi AKim Y.A radiographic follow-up study of stand-alone-cage and graft-plate constructs for single-level anterior cervical discectomy and fusion. J Spine Surg. 2017;3(4):596-600."},{"issue":"5","key":"bib14","series-title":"Ann Pharmacother","first-page":"824","article-title":"Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis","volume":"40","author":"Koren","year":"2006","unstructured":"Koren GFlorescu ACostei AMBoskovic RMoretti ME.Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40(5):824-829."},{"issue":"2","key":"bib15","series-title":"Obstet Med","first-page":"52","article-title":"Effects of prenatal stress on pregnancy and human development: mechanisms and pathways","volume":"6","author":"Coussons-Read","year":"2013","unstructured":"Coussons-Read ME.Effects of prenatal stress on pregnancy and human development: mechanisms and pathways. Obstet Med. 2013;6(2):52-57."},{"issue":"2","key":"bib16","series-title":"Sleep Med Rev","first-page":"107","article-title":"Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship?","volume":"14","author":"Chang","year":"2010","unstructured":"Chang JJPien GWDuntley SPMacones GA.Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev. 2010;14(2):107-114."},{"issue":"2","key":"bib17","series-title":"Curr Rev Musculoskelet Med","first-page":"137","article-title":"Pregnancy and low back pain","volume":"1","author":"Sabino","year":"2008","unstructured":"Sabino JGrauer JN.Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008;1(2):137-141."},{"issue":"2","key":"bib1","series-title":"Obstet Gynecol Surv","first-page":"103","article-title":"Orthopedic issues in pregnancy","volume":"63","author":"Smith","year":"2008","unstructured":"Smith MWMarcus PSWurtz LD.Orthopedic issues in pregnancy. Obstet Gynecol Surv. 2008;63(2):103-111."},{"issue":"7","key":"bib2","series-title":"Glob Spine J","first-page":"908","article-title":"The management of symptomatic lumbar disc herniation in pregnancy: a systematic review","volume":"10","author":"Whiles","year":"2020","unstructured":"Whiles EShafafy RValsamis EMThe management of symptomatic lumbar disc herniation in pregnancy: a systematic review. Glob Spine J. 2020;10(7):908-918."},{"issue":"5","key":"bib3","series-title":"Gynecol Obstet Investig","first-page":"417","article-title":"Low back pain in pregnancy: investigations, management, and role of neuraxial analgesia and anaesthesia: a systematic review","volume":"82","author":"Sehmbi","year":"2017","unstructured":"Sehmbi HD\u2019Souza RBhatia A.Low back pain in pregnancy: investigations, management, and role of neuraxial analgesia and anaesthesia: a systematic review. Gynecol Obstet Investig. 2017;82(5):417-436."},{"issue":"2","key":"bib4","series-title":"J Spine Surg","first-page":"274","article-title":"Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review","volume":"10","author":"Chan","year":"2024","unstructured":"Chan NYLe MReinecker SPrince MMurphy GT.Lumbar disk herniation in pregnancy: its incidence, presentation and management: a systematic review. J Spine Surg. 2024;10(2):274-285."},{"issue":"4","key":"bib5","series-title":"J Orthop Sci","first-page":"911","article-title":"Lumbar disc herniation in a pregnant woman treated with full-endoscopic interlaminar discectomy without X-ray exposure: a case report","volume":"28","author":"Zheng","year":"2023","unstructured":"Zheng QHu XZhang YWang Y.Lumbar disc herniation in a pregnant woman treated with full-endoscopic interlaminar discectomy without X-ray exposure: a case report. J Orthop Sci. 2023;28(4):911-914."},{"issue":"1","key":"bib6","series-title":"Acta Neurochir (Wien)","first-page":"479","article-title":"Lumbar disc herniation and cauda equina syndrome during pregnancy: a systematic review","volume":"166","author":"Hussein","year":"2024","unstructured":"Hussein AQuiceno EPacheco-Barrios NLumbar disc herniation and cauda equina syndrome during pregnancy: a systematic review. Acta Neurochir (Wien). 2024;166(1):479."},{"key":"bib7","series-title":"Spinal Cord Ser Cases","first-page":"93","article-title":"Acute traumatic cervical spinal cord injury in a third-trimester pregnant female with good maternal and fetal outcome: a case report and literature review","volume":"4","author":"Pedaballe","year":"2018","unstructured":"Pedaballe ARChhabra HSTandon VChauhan PVerma R.Acute traumatic cervical spinal cord injury in a third-trimester pregnant female with good maternal and fetal outcome: a case report and literature review. Spinal Cord Ser Cases. 2018;4:93."},{"issue":"6","key":"bib8","series-title":"Antimicrob Agents Chemother","first-page":"3504","article-title":"Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery","volume":"58","author":"Elkomy","year":"2014","unstructured":"Elkomy MHSultan PDrover DREpshtein EGalinkin JLCarvalho B.Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery. Antimicrob Agents Chemother. 2014;58(6):3504-3513."},{"issue":"3","key":"bib9","series-title":"Am J Surg","first-page":"467","article-title":"Pregnancy outcome following non-obstetric surgical intervention","volume":"190","author":"Cohen-Kerem","year":"2005","unstructured":"Cohen-Kerem RRailton COren DLishner MKoren G.Pregnancy outcome following non-obstetric surgical intervention. Am J Surg. 2005;190(3):467-473."},{"issue":"2","key":"bib10","series-title":"Anesth Essays Res","first-page":"160","article-title":"Anaesthetic challenges and management during pregnancy: strategies revisited","volume":"7","author":"Bajwa","year":"2013","unstructured":"Bajwa SJSBajwa SK.Anaesthetic challenges and management during pregnancy: strategies revisited. Anesth Essays Res. 2013;7(2):160-167."},{"key":"bib11","author":"","unstructured":"AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding. PS 8-A. April 2, 2019. American Association of Physicists in Medicine. Accessed August 4, 2025. https:\/\/aapm.org\/org\/policies\/details.asp?id=2552."},{"issue":"4","key":"bib12","series-title":"J Spine Surg","first-page":"696","article-title":"Decreasing radiation dose with FluoroLESS Standalone Anterior Cervical Fusion","volume":"4","author":"Chin","year":"2018","unstructured":"Chin KRPencle FJRQuijada KAMustafa MSMustafa LSSeale JA.Decreasing radiation dose with FluoroLESS Standalone Anterior Cervical Fusion. J Spine Surg. 2018;4(4):696-701."},{"issue":"4","key":"bib13","series-title":"J Spine Surg","first-page":"596","article-title":"A radiographic follow-up study of stand-alone-cage and graft-plate constructs for single-level anterior cervical discectomy and fusion","volume":"3","author":"Baker","year":"2017","unstructured":"Baker JFGomez JShenoy KKim SRazi AKim Y.A radiographic follow-up study of stand-alone-cage and graft-plate constructs for single-level anterior cervical discectomy and fusion. J Spine Surg. 2017;3(4):596-600."},{"issue":"5","key":"bib14","series-title":"Ann Pharmacother","first-page":"824","article-title":"Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis","volume":"40","author":"Koren","year":"2006","unstructured":"Koren GFlorescu ACostei AMBoskovic RMoretti ME.Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40(5):824-829."},{"issue":"2","key":"bib15","series-title":"Obstet Med","first-page":"52","article-title":"Effects of prenatal stress on pregnancy and human development: mechanisms and pathways","volume":"6","author":"Coussons-Read","year":"2013","unstructured":"Coussons-Read ME.Effects of prenatal stress on pregnancy and human development: mechanisms and pathways. Obstet Med. 2013;6(2):52-57."},{"issue":"2","key":"bib16","series-title":"Sleep Med Rev","first-page":"107","article-title":"Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship?","volume":"14","author":"Chang","year":"2010","unstructured":"Chang JJPien GWDuntley SPMacones GA.Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev. 2010;14(2):107-114."},{"issue":"2","key":"bib17","series-title":"Curr Rev Musculoskelet Med","first-page":"137","article-title":"Pregnancy and low back pain","volume":"1","author":"Sabino","year":"2008","unstructured":"Sabino JGrauer JN.Pregnancy and low back pain. 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