Open AccessThe Incidence and Risk Factors for Lumbar or Sciatic Scoliosis in Lumbar Disc Herniation and the Outcomes after Percutaneous Endoscopic Discectomy
Author(s) -
Ranhee Kim,
Rae Hyung Kim,
Chi Heon Kim,
Yunhee Choi,
Hyun Sook Hong,
Sung Bae Park,
Seung Heon Yang,
Sung-Mi Kim,
Chun Kee Chung
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2015/18/555
Subject(s) - medicine , trunk , lumbar , scoliosis , surgery , low back pain , discectomy , percutaneous , sciatica , back pain , diskectomy , lumbar disc disease , lumbar vertebrae , ecology , alternative medicine , pathology , biology
Background: Some patients with lumbar herniated intervertebral disc disease (HIVD) sufferfrom both pain and lateral shift or trunk list. In addition to pain, patients have concernsregarding whether trunk list is reversible. Surgical treatment is performed when pain isintractable to conservative management, but a reversal of trunk list is an incidental outcome.Percutaneous lumbar endoscopic discectomy (PELD) is one of the surgical treatment optionsfor lumbar HIVD, but no results concerning its effect on trunk list have been reported.Objectives: The objectives of the present study were to determine the incidence of, andrisk factors for, trunk list scoliosis or lateral shift and to report the outcomes of trunk list afterPELD.Study Design: Retrospective case study. IRB No. H 1111-025-384Setting; University medical Center, Seoul, Korea.Methods: We selected 164 patients who were less than 60 years old, complained ofunilateral leg pain, and underwent PELD. We measured the maximum trunk shift from thecentral sacral vertical line (CSVL-max) on preoperative whole spine radiographs and classifiedtrunk list as CSVL-max ≥ 10 mm. CSVL-max was measured on serial radiographs taken at one,3, 6, and 12 months postoperatively in patients with trunk list.Results: Twenty-nine patients (17.9%) had trunk list (M:F=10:19; mean age, 37.1 ± 11.24years). Female gender (OR 4.28; 95% CI, 1.49 – 12.3) and HIVD at L4-5 (OR 5.6; 95% CI,1.8 - 16.7) were risk factors for trunk list. Trunk list was normalized (CSVL-max < 10 mm)in 15 (52%) patients after PELD, and the median time for normalization was 3 – 6 months.Prognostic factors for the recovery of trunk list were not identified.Limitations: Selection bias should be considered in interpreting these results.Conclusion: Trunk list, scoliosis or lateral shift, was observed in 18% of the patients at thetime of surgery. Female gender and L4-5 disc herniation were risk factors for trunk list. Trunklist was reversible in more than 50% of patients within 6 months of PELD.Key words: Lumbar, scoliosis, lumbar/sciatic, trunk list, endoscope, disc, discectomy, sciatica,spine, percutaneous endoscopic discectomy