Introduction

Sciatica scoliosis could be observed in lumbar disc herniation patients. Posterior endoscopic transforaminal discectomy is recommended to treat such situation. However, there are only a few reports about the evolution of the curve after lumbar surgery. The purpose of this study was to analyze the radiological characteristics of sciatica scoliosis and to further characterize the curve evolution after posterior endoscopic transforaminal discectomy.

Methods

LDH patients with sciatic scoliosis who underwent posterior endoscopic transforaminal discectomy from 2020 to 2021 and were followed up for at least 2yrs were retrospectively reviewed. Radiographic parameters were measured on standing whole spine radiographs including the apical vertebral translation (AVT), distance from the C7 plumb line to the central sacral line (CSVL-C7PL). Patients with the preoperative AVT ≥20mm were enrolled in present study. The AVT was measured on serial radiographs taken at 1, 6 months, and last follow-up to evaluate the curve evolution. The resolution of scoliosis was defined as AVT≤10 mm during follow-up. Coronal balance was defined as CSVL-C7PL≤10 mm.

Results

A total of 42 LDH patients were included in this study. The incidence of scoliosis secondary to LDH was 23.8%. All patients had a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side. At the postoperative 2 yrs follow-up, all patients recovered to normal sagittal and coronal balance. 83.3% of the LDH patients achieved resolution of scoliosis within 6 months after surgery. 92.8% of the LDH patients achieved resolution of scoliosis within 1 yrs after surgery.

Discussion

The incidence of sciatica scoliosis secondary to LDH is 23.8%. Spontaneous correction of sciatica scoliosis could be achieved when sciatica was relived after posterior endoscopic transforaminal discectomy and well-maintained during follow-up.