Abstract
Sciatic scoliosis caused by lumbar disc herniation can be improved by discectomy. However, there have been few studies investigating the course of severe sciatic scoliosis after discectomy. Herein, the authors analyze the characteristics of sciatic scoliosis due to lumbar disc herniation and any change in the scoliosis after discectomy and consider the appropriate surgical approach for sciatic scoliosis.
A retrospective study of 134 patients who underwent discectomy was performed. The preoperative and postoperative L1-5 Cobb angle was measured. The direction of scoliosis, the location of disc herniation, clinical parameters and the postoperative course of the scoliosis were investigated.
Of the 76 patients, 54 (71%) had a lumbar disc herniation at the convex side of the scoliosis. There was no statistical significance between the location of disc herniation and the direction of scoliosis. In the 36 patients who had a follow-up X-ray in more than 1 year, there was a statistical significance in preoperative Cobb angle between 3-10°group (33 patients) and 10°<group (3 patients) (5.3°, 20.8°. p=0.005). But after the discectomy, the scoliosis improved in two groups and there was no statistical significance in postoperative Cobb angle. Two patients with severe scoliosis of more than 20°also had improvement of their scoliosis from the early period after discectomy.
These results indicate that the direction of sciatic scoliosis wasn't associated with the location of disc herniation, but was related to the side of disc herniation.
The authors suggest that discectomy is an appropriate surgical approach for sciatic scoliosis, even if the scoliosis is severe, without spinal fixation.
