title: Case report: The operation for the lumbar disk herniation just after cesarean delivery in the third trimester of pregnancy.
abstract: BACKGROUND
  Low 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.
  
  
  METHODS
  A 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.
  
  
  CONCLUSIONS
  It 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.
  
  
  CONCLUSIONS
  It is necessary to conduct the operation under pregnancy in consideration of the great influence on mother and child.
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan. Electronic address: hironoriochi1105@yahoo.co.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ochi
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Ohno
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Kubota
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Hanyu
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Department of Orthopaedic Surgery, Koshigaya Municipal Hospital, Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Mukasa
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University School of Medicine, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko
keywords: Cesarean delivery; Discectomy; Lumbar disk herniation; Prone position; Supine position; Trimester of pregnancy