Percutaneous Endoscopic Lumbar Discectomy for Single-Level Lumbar Disc Herniation With Sciatic Scoliosis in Adults: A Retrospective Study of 76 Patients.

Abstract

Retrospective study. To evaluate the clinical and radiologic results of PELD in the treatment of different segments of lumbar disc herniation with sciatic scoliosis in adults. PELD is an effective surgical method for the treatment of adult lumbar disc herniation, but the curative effect of different surgical segments is not clear for patients with sciatic scoliosis. Adult patients with single-level lumbar disc herniation with sciatic scoliosis who underwent PELD were divided into 3 groups according to the surgical segments: group A(L2-3, L3-4), group B(L4-5), and group C(L5-S1). Lumbar and leg pain was assessed using the Visual Analogue Scale(VAS), functional recovery was assessed using the Oswestry Disability Index(ODI) and the Japanese Orthopaedic Association(JOA), modified Macnab criteria were used to assess clinical outcomes and coronal and sagittal imaging parameters of patients were also measured. A total of 76 patients were included in this study. One month after the operation, the ODI index in group C was higher than that in groups A and B, and the JOA score was lower than that in groups A and B. During the final follow-up, the excellent and good rate of modified Macnab criteria was 94.7% in all patients. The SVA of patients in group C was higher than that of patients in groups A and B. TK and LL were lower than those of patients in groups A and B. Coronal Cobb angle and apical vertebral translation (AVT) changes were directly proportional to postoperative TK and LL improvements in each group. PELD is a safe and effective treatment for single-level lumbar disc herniation with sciatic scoliosis in adults, and the amount of correction of coronal scoliosis and trunk deviation in patients after surgery is significantly correlated with the amount of improvement of compensatory sagittal thoracic lordosis and lumbar kyphosis. The patients with L5-S1 may require a longer recovery time.