• Viktor Zsolt Kovari and Laszlo Horvath.
• Department of Neurosurgery, Hungarian Defense Forces Medical Centre, 44. Robert Karoly krt., Budapest, 1134, Hungary. viktor.zs.kovari@gmail.com.
• Eur Spine J. 2018 Jul 1; 27 (Suppl 3): 483-488.

PurposeThis article presents a surgical solution of a lumbar disc hernia of a pregnant woman focusing on the use of right lateral positioning, spinal anesthesia which has not previously been utilized in third trimester and discusses positioning options, and possible anesthesia methods with the surgical procedure options.MethodsCase report.ResultsA left-sided L5/S1 lumbar disc hernia (verified by magnetic resonance imaging) of a 35-year-old, 32-week-pregnant woman with a deteriorating neurological status leading to cauda syndrome was treated successfully by microdiscectomy in right lateral position applying spinal anesthesia.ConclusionsSo far examples are given for almost every possible patient position in the third trimester except the right lateral one. All the previously presented positionings (prone, left lateral) were equally effective regarding the outcome with none being better than another. For left-sided lumbar pathologies performed in the third trimester the right lateral position might be an alternative option for easier access. Based on the literature an epidural and general anesthesia can be applied successfully in the third trimester. Spinal anesthesia might be another anesthesia consideration.

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