Our 32-year-old daughter is pregnant on bedrest because of a bulging disc. There is some concern that if she doesn’t have surgery to remove the disc, she could end up paralyzed. Is it really safe to do this type of operation on a pregnant woman?

A bulging disc in the lumbar spine can respond to conservative care. Proper positioning, specific exercises, and avoiding certain movements can help reduce pressure from the disc on the spinal nerve roots.

A more serious problem occurs when the disc protrudes and presses on the cauda equina. Cauda equina means horse tail. It was given that name because nerve roots that form the tail branch off from the spinal cord from L1-5 and S1-5. Located at the bottom of the spinal cord, these nerve roots are bunched together and look like a horse’s tail.

Cauda equina syndrome is a serious neurologic condition. There is a sudden loss of function of the nerve roots. The patient experiences numbness, tingling, weakness, and even paralysis. There may be significant bowel and bladder dysfunction. If left unchanged or untreated, permanent damage can occur.

MRIs can be done during pregnancy. The radiologist reviews the case and evaluates the risk-benefit ratio. Immediate surgery is usually recommended for this problem. The risk of permanent paralysis with this kind of problem is often too great to treat progressive cauda equina in any other way.

Surgery to remove the bulging disc (discectomy is usually done. There are published cases of pregnancy women having lumbar MRIs and discectomy for this problem. No harm was done to the baby with the MRI or the surgery and a normal birth has been reported.