Characteristics of Sciatic Scoliosis in Lumbar Disc Herniation and Comparative Radiographic Outcomes After Treatment With Full-Endoscopic Interlaminar Discectomy

Abstract

Study Design

Retrospective cohort study.

Background

Sciatic scoliosis is attributed to non-structural scoliosis resulting from the irritation of spinal nerve roots. Although limited research has addressed the specific characteristics of sciatic scoliotic curve patterns, there is a lack of reported data on the pre- and post-radiographic outcomes of patients with sciatic scoliosis caused by lumbar disc herniation who have undergone full-endoscopic interlaminar discectomy (FEID).

Objectives

To analyze the distinctive pattern and compare the radiographic results in patients with sciatic scoliosis caused by lumbar disc herniation who have undergone FEID.

Methods

The medical records of patients with sciatic scoliosis caused by lumbar disc herniation who underwent FEID from 2016 to 2022 were gathered and analyzed. The study focused on the prevalence of sciatic scoliosis, the specific location of the lumbar disc herniation, the level of the curve in sciatic scoliosis, and the comparison of pre- and post-operative changes in radiographic outcomes.

Results

A total of 178 patients were analyzed, revealing a prevalence of sciatic scoliosis at 33.7% (60 out of 178). The predominant anatomical location of lumbar disc herniation in cases of sciatic scoliosis was found to be the L4-L5 level, accounting for 56.67% (34 out of 60). The observed lumbosacral curve exhibited a typical pattern with a mean Cobb angle of 14° (range: 2.5–35, standard deviation = 7.46). The mean C7PL-CSVL distance was also measured at 36.2 mm (range: 1–170, standard deviation = 32.5). The mean lumbar lordosis was 21° (range: −1.8–50, standard deviation = 12.96), while the mean Sagittal vertical axis was recorded at 40.9 mm (range: −85–160, standard deviation = 47.8). Notably, no statistically significant difference was observed in the anatomical location of lumbar disc herniation and the apical curve level of sciatic scoliosis. Furthermore, 68% of cases of sciatic scoliosis demonstrated improvement within 12 months, with the average time to improvement being 4 months following FEID.

Conclusion

The FEID procedure has the potential to lead to the natural resolution of sciatic scoliosis within a year. These findings suggest that sciatic scoliosis may not be a reliable indicator for determining the specific anatomical location of disc herniation.