Sciatic Scoliosis Evolution after Lumbar Discectomy: A Comparison Between Adolescents and Young Adults

Abstract

Background: Scoliosis secondary to lumbar disc herniation (LDH) may occur in both adolescents and adults. As the spine is more flexible in adolescents than in adults, the curve features and curve evolution could be different between these 2 cohorts, which were unclear. Objectives: To compare the radiologic features of scoliosis secondary to LDH between adolescents and adults, and to further characterize the curve evolution after lumbar discectomy in 2 cohorts. Study Design: A retrospective study. Setting: An inpatient surgery center. Methods: Patients with scoliosis secondary to LDH who underwent surgical intervention between 2010 and 2016 were reviewed. Radiographic parameters were measured on standing whole spine radiographs. The apical vertebral translation was measured on serial radiographs taken before surgery, one month and 6 months after surgery, and at last follow-up to evaluate the curve evolution. Meanwhile, the patients’ reported outcomes were evaluated. According to age, patients were divided into adolescent and adult group. Comparisons between the 2 groups were made with regards to the preoperative and postoperative radiographic parameters and clinical outcomes. Results: A total of 42 adolescent and 41 adult patients were included in this study. The incidence of scoliosis secondary to LDH in the adolescents was significantly higher than that in the adults. Adolescent patients present remarkably higher incidence of coronal balance as compared with the adult patients preoperatively. No significant difference was observed between the 2 groups in terms of preoperative radiographic parameters. A total of 85.7% of the adolescent patients and 92.7% of the adult patients achieved resolution of scoliosis within 6 months after surgery. Limitations: This was a retrospective study with a small series of cases and relatively short-term follow-up. Conclusions: The incidence of scoliosis secondary to LDH in adolescents is significantly higher than in adults. Moreover, adolescent patients are more likely to present coronal balance before surgery. The 2 cohorts could have comparable curve evolution, and resolution of scoliosis generally occurred within 6 months after surgery. Key words: Sciatic scoliosis, lumbar disc herniation, adolescent, adult, resolution, lumbar discectomy