An unusual case of spinal arteriovenous malformation presenting with severe paraplegia at term pregnancy

Positioning issues of spinal surgery during pregnancy

“…1 Ligamentum laxity, relative osteoporosis, and, most obviously, both body mass index and habitus-related postural changes certainly play a significant role in this regard.2, 3, 4 Luckily, the event of a serious spinal pathology requiring a surgical intervention is very rare because conservative management is usually the gold standard.5, 6, 7 Nevertheless, a nonnegligible percentage of patients may have the necessity to undergo a surgical spinal procedure for different pathologies including tumoral, vascular, traumatic, or degenerative diseases. 8,9,10,11 Although it is a physiological phenomenon, pregnancy is related to a series of anesthesiological, surgical and even ethical issues that may imply relevant variations from standard spinal surgical procedures. The surgical strategy may indeed vary according to several factors, such as the nature and location of the underlying pathology, the stage of the pregnancy, and the clinical conditions of mother and fetus.…”