- 2018;21;E63-E70Early Experience of Full-Endoscopic Interlaminar Discectomy for Adolescent Lumbar Disc Herniation with Sciatic Scoliosis
Zhiming Tu, MD, Bing Wang, MD, Lei Li, MD, Yawei Li, MD, PhD, Yuliang Dai, MD, Guohua Lv, MD, PhD, and Tuoqi Li, PhD.
BACKGROUND: Full-endoscopic interlaminar discectomy (FEID) has achieved satisfactory outcome in adolescent lumbar disc herniation (ALDH). Sciatic scoliosis is found to be a common presentation in ALDH. However, few reports are focused on the influences of sciatic scoliosis on ALDH and the prognosis of sciatic scoliosis after FEID.
OBJECTIVE: This study aims to evaluate the clinical and radiological results of FEID in the treatment of ALDH with sciatic scoliosis and to identify the effects of sciatic scoliosis on complication and recurrence.
STUDY DESIGN: A retrospective study.
SETTING: An inpatient surgery center.
METHODS: A series of cases of patients under age 20 with single-level ALDH that underwent FEID between January 2010 and December 2014 were retrospectively analyzed. The patients were divided into 2 groups according to if they had scoliosis or not. Clinical outcomes were evaluated using a visual analog scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI) for the functional assessment, and modified Macnab criteria for the patient satisfaction. Radiological parameters of the scoliosis group such as Cobb angle, CVSL-max, and CVSL-C7 were statistically analyzed.
RESULTS: No significant differences were found between both groups in terms of the mean operative time, the mean length of hospital stay, complications, and recurrences (P > 0.05). VAS and ODI scores were significantly improved in both groups (P < 0.05). However, there were no statistically significant differences between the 2 groups in VAS, ODI, and modified MacNab criteria (P > 0.05). For the scoliosis group, significant improvements were observed in the postoperative sagittal and coronal alignment parameters (P < 0.05).
LIMITATIONS: This was a retrospective study with a relatively small sample size. Additionally, the length of follow-up was short.
CONCLUSIONS: The application of FEID in the treatment of ALDH could achieve satisfactory clinical and radiological outcomes. Sciatic scoliosis was corrected spontaneously without increasing the risk of complication and recurrence.
KEY WORDS: Adolescent lumbar disc herniation, full-endoscopic interlaminar discectomy, sciatic scoliosis, recurrencePDF