Lumbar microdiscectomy during first trimester of pregnancy: Surgical, anesthetic, and radiation considerations with review of reported cases

Background: Lumbar disc herniation requiring surgical intervention during pregnancy is rare, particularly during the first trimester. Here, we highlight the pros and cons of performing a microdiscectomy (MD) during the first trimester for a pregnant 27-year-old female. Case Description: A 27-year-old pregnant female in her first trimester presented with a progressive right foot drop secondary to an L5–S1 disc herniation. After failing 6 weeks of conservative management, she underwent right L5–S1 MD under general anesthesia in the prone position. Maternal hemodynamic stability was maintained throughout the procedure, and fluoroscopy was limited to a single image. Postoperatively, motor strength improved with rehabilitation, and she subsequently delivered a healthy full-term infant without obstetric or neonatal complications. Conclusion: Medically and neurosurgically indicated lumbar MD should be appropriately performed in patients in their first trimester of pregnancy.