Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2024

Open Access 01-12-2024 | Scoliosis | Research

Percutaneous endoscopic lumbar discectomy for single and double segment lumbar disc herniation with sciatic scoliosis in adults: a retrospective study

Authors: Jitao Yang, Haopeng Luan, Jiawei Ren, Jiyuan Tao, Weibin Sheng, Hailong Guo, Qiang Deng

Published in: BMC Surgery | Issue 1/2024

Login to get access

Abstract

Objective

Sciatic scoliosis can be seen in patients with lumbar disc herniation. Percutaneous endoscopic lumbar discectomy (PELD) is a common surgical method for the treatment of lumbar disc herniation. The difference between single-segment lumbar disc herniation and double-segment lumbar disc herniation with Sciatic Scoliosis in adults after PELD needs further study. The aim of this study was to compare the imaging features of single-segment and double-segment lumbar disc herniation with Sciatic Scoliosis in adults and to further explore the clinical outcomes of functional improvement and scoliosis imaging parameters of the two groups after PELD.

Methods

Adult patients with lumbar disc herniation with sciatic scoliosis who received PELD from January 2019 to June 2022 were analyzed retrospectively. According to the number of operative segments, the patients were divided into a single-segment group and a double-segment group. Perioperative parameters were observed and compared between the two groups. The Visual Analogue Scale (VAS) score, Oswestry dysfunction index (ODI), Japanese Orthopaedic Association scores (JOA) and imaging parameters of the two groups were recorded and compared before the operation and during the follow-up.

Results

A total of 53 patients with single segments and 21 patients with double segments were included in this study. During the follow-up, the VAS score, ODI index and JOA score of the two groups were significantly improved as compared with those before the operation(P < 0. 05). Ninety-two point five percent of single-segment patients and 90.5% of double segment patients returned to normal scoliosis within 12 months after the operation. The operation time, number of intraoperative fluoroscopy times and the amount of intraoperative blood loss in single-segment patients were better than those in double-segment group(P < 0. 05). At the last follow-up, the AVT, CBD and SVA in the double-segment group were 5.2 ± 2.3, 5.1 ± 1.0 and 12.2 ± 3.0 mm, respectively, which were higher than those in the single-segment group (1.9 ± 0.4, 1.1 ± 1.6 and 3.9 ± 2.1 mm) (P < 0. 05).

Conclusion

PELD is an effective treatment for single-segment and double-segment lumbar disc herniation with Sciatic scoliosis. Double-segment patients can enjoy similar clinical efficacy to single-segment patients, avoiding complications caused by decompression, fusion, and internal fixation. Scoliosis was corrected spontaneously within 12 months after operation, and the sagittal curve was significantly improved in both groups. The improvement of coronal and sagittal balance in double -segment patients may take longer.
Literature
1.
Wu W, Chen Y, Yu L, Li F, Guo W. Coronal and sagittal spinal alignment in lumbar disc herniation with scoliosis and trunk shift. J Orthop Surg Res. 2019;14:264.CrossRefPubMedPubMedCentral
2.
3.
Liang C, Sun J, Cui X, Jiang Z, Zhang W, Li T. Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy. Bmc Musculoskelet Disord. 2016;17:305.CrossRefPubMedPubMedCentral
4.
Diebo BG, Shah NV, Boachie-Adjei O, Zhu F, Rothenfluh DA, Paulino CB, Schwab FJ, Lafage V. Adult spinal deformity. Lancet. 2019;394:160–72.CrossRefPubMed
5.
Kim R, Kim RH, Kim CH, Choi Y, Hong HS, Park SB, Yang SH, Kim S, Chung CK. The incidence and risk factors for lumbar or sciatic scoliosis in lumbar disc herniation and the outcomes after percutaneous endoscopic discectomy. Pain Physician. 2015;18:555–64.CrossRefPubMed
6.
Wang L, Li C, Wang L, Qi L, Liu X. Sciatica-related spinal imbalance in lumbar disc herniation patients: radiological characteristics and recovery following endoscopic discectomy. J Pain Res. 2022;15:13–22.CrossRefPubMedPubMedCentral
7.
Chang H, Chang H, Wu J, Tu T, Fay L, Chang P, Wu C, Huang W, Cheng H. Scoliosis may increase the risk of recurrence of lumbar disc herniation after microdiscectomy. J Neurosurgery: Spine. 2016;24:586–91.PubMed
8.
Suk K, Lee H, Moon S, Kim NL. Lumbosacral scoliotic list by lumbar disc herniation. Spine (Philadelphia Pa 1976). 2001;26:667–71.CrossRef
9.
Gadjradj PS, Harhangi BS, Amelink J, van Susante J, Kamper S, van Tulder M, Peul WC, Vleggeert-Lankamp C, Rubinstein SM. Percutaneous transforaminal endoscopic discectomy versus open microdiscectomy for lumbar disc herniation. Spine. 2021;46:538–49.CrossRefPubMed
10.
Kapetanakis S, Gkantsinikoudis N, Charitoudis G. Implementation of percutaneous transforaminal endoscopic discectomy in competitive elite athletes with lumbar disc herniation: original study and review of the literature. Am J Sports Med. 2021;49:3234–41.CrossRefPubMed
11.
Choi KC, Kim J, Park C. Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation. Pain Physician. 2016;19:E291–E300.CrossRefPubMed
12.
Chen P, Hu Y, Li Z. Percutaneous endoscopic transforaminal discectomy precedes interlaminar discectomy in the efficacy and safety for lumbar disc herniation. Biosci Rep 2019, 39.
13.
Tu Z, Wang B, Li L, Li Y, Dai Y, Lv G, Li T. Early experience of full-endoscopic interlaminar discectomy for adolescent lumbar disc herniation with sciatic scoliosis. Pain Physician. 2018;21:E63–E70.PubMed
14.
Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH. Reliability analysis for radiographic measures of lumbar lordosis in adult scoliosis: a case–control study comparing 6 methods. Eur Spine J. 2010;19:1551–7.CrossRefPubMedPubMedCentral
15.
Zhang Y, Li W, Xu L, Jiang E, Qiu Y, Zhu Z. Sciatic scoliosis evolution after lumbar discectomy: a comparison between adolescents and young adults. Pain Physician. 2019;22:E457–65.PubMed
16.
Li Y, Fredrickson V, Resnick DK. How should we grade lumbar disc herniation and nerve root compression? A systematic review. Clin Orthop Relat Res. 2015;473:1896–902.CrossRefPubMed
17.
Sun X, Kong C, Zhang T, Lu S, Wang W, Sun S, Guo M, Ding J. Correlation between multifidus muscle atrophy, spinopelvic parameters, and severity of deformity in patients with adult degenerative scoliosis: the parallelogram effect of lma on the diagonal through the apical vertebra. J Orthop Surg Res. 2019;14(1):276.CrossRefPubMedPubMedCentral
18.
Xie D, Zhang J, Ding W, Yang S, Yang D, Ma L, Zhang J. Abnormal change of paravertebral muscle in adult degenerative scoliosis and its association with bony structural parameters. Eur Spine J. 2019;28:1626–37.CrossRefPubMed
19.
Chon J, Kim H, Lee JH, Yoo SD, Yun DH, Kim DH, Lee SA, Han YJ, Lee HS, Han YR, et al. Asymmetric atrophy of paraspinal muscles in patients with chronic unilateral lumbar radiculopathy. Annals of Rehabilitation Medicine. 2017;41:801.CrossRefPubMedPubMedCentral
20.
Ozgen S, Konya D, Toktas OZ, Dagcinar A, Ozek MM. Lumbar disc herniation in adolescence. Pediatr Neurosurg. 2007;43:77–81.CrossRefPubMed
21.
Benzakour T, Igoumenou V, Mavrogenis AF, Benzakour A. Current concepts for lumbar disc herniation. Int Orthop. 2019;43:841–51.CrossRefPubMed
22.
Yamada K, Nakamae T, Nakanishi K, Kamei N, Hiramatsu T, Okuda T, Hashimoto T, Ujigo S, Morisako T, Tsuchikawa Y, et al. Long-term outcome of targeted therapy for low back pain in elderly degenerative lumbar scoliosis. Eur Spine J. 2021;30:2020–32.CrossRefPubMed
23.
Heo JH, Kim CH, Chung CK, Choi Y, Seo YG, Kim DH, Park SB, Moon JH, Heo W, Jung JM. Quantity of disc removal and radiological outcomes of percutaneous endoscopic lumbar discectomy. Pain Physician. 2017;20:E737–46.PubMed
24.
Yang S, Zhang F, Ding W. Analysis of clinical and neurological outcomes in patients with cauda equina syndrome caused by acute lumbar disc herniation: a retrospective-prospective study. Oncotarget. 2017;8:84204–9.CrossRefPubMedPubMedCentral
25.
Cong L, Zhu Y, Tu G. A meta-analysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation. Eur Spine J. 2016;25:134–43.CrossRefPubMed
26.
Li X, Han Y, Di Z, Cui J, Pan J, Yang M, Sun G, Tan J, Li L. Percutaneous endoscopic lumbar discectomy for lumbar disc herniation. J Clin Neurosci. 2016;33:19–27.CrossRefPubMed
27.
Liu C, Zhou Y. Percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion for massive lumbar disc herniation. Clin Neurol Neurosurg. 2019;176:19–24.CrossRefPubMed
28.
Choi K, Shim H, Hwang J, Shin SH, Lee DC, Jung HH, Park HA, Park C. Comparison of surgical invasiveness between microdiscectomy and 3 different endoscopic discectomy techniques for lumbar disc herniation. World Neurosurg. 2018;116:e750–8.CrossRefPubMed
29.
Shen Z, Zhong Z, Wu Q, Zheng S, Shen X, Chen J. Predictors for poor outcomes after percutaneous endoscopic lumbar discectomy: a retrospective study of 241 patients. World Neurosurg. 2019;126:e422–31.CrossRefPubMed
30.
Fan KY, Lui TH. Bilateral traumatic hip dislocation with sciatic nerve palsy. Case Reports 2015, 2015, bcr2014204031.
31.
Maeno T, Okuda S, Haku T, Yamashita T, Matsumoto T, Sugiura T, Oda T, Iwasaki M. Anterior migration of an interbody graft in posterior lumbar interbody fusion: report of three cases without removal of the migrated graft. J Orthop Science: Official J Japanese Orthop Association. 2019;24:742–5.CrossRef
32.
Zhao Y, Qi L, Ding C, Quan S, Xu B, Yu Z, Li C. Characteristics of sciatic scoliotic list in lumbar disc herniation. Glob Spine J 2022, 1258249539.
33.
34.
Jentzsch T, Geiger J, Bouaicha S, Slankamenac K, Nguyen-Kim TD, Werner CM. Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine. Bmc Med Imaging. 2013;13:34.CrossRefPubMedPubMedCentral
35.
Bae JS, Jang J, Lee S, Kim JU. Radiological analysis of lumbar degenerative kyphosis in relation to pelvic incidence. Spine J. 2012;12:1045–51.CrossRefPubMed
36.
Min WK, Lee CH. Comparison and correlation of pelvic parameters between low-grade and high-grade spondylolisthesis. J Spinal Disord Tech. 2014;27:162–5.CrossRefPubMed
37.
Takegami K, An HS, Kumano F, Chiba K, Thonar EJ, Singh K, Masuda K. Osteogenic protein-1 is most effective in stimulating nucleus pulposus and annulus fibrosus cells to repair their matrix after chondroitinase abc–induced in vitro chemonucleolysis. Spine J. 2005;5:231–8.CrossRefPubMed
38.
Karamouzian S, Eskandary H, Faramarzee M, Saba M, Safizade H, Ghadipasha M, Malekpoor AR, Ohadi A. Frequency of lumbar intervertebral disc calcification and angiogenesis, and their correlation with clinical, surgical, and magnetic resonance imaging findings. Spine. 2010;35:881–6.CrossRefPubMed
39.
Miyagi M, Millecamps M, Danco AT, Ohtori S, Takahashi K, Stone LS. Issls Prize winner. Spine. 2014;39:1345–54.CrossRefPubMed
Metadata
Title
Percutaneous endoscopic lumbar discectomy for single and double segment lumbar disc herniation with sciatic scoliosis in adults: a retrospective study
Authors
Jitao Yang
Haopeng Luan
Jiawei Ren
Jiyuan Tao
Weibin Sheng
Hailong Guo
Qiang Deng
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2024
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-024-02314-5

Other articles of this Issue 1/2024

BMC Surgery 1/2024 Go to the issue

Research

Contralateral translaminar endoscopic approach for highly down-migrated lumbar disc herniation using percutaneous biportal endoscopic surgery

Research

Retrospective analysis of the incidence of appendiceal neoplasm and malignancy in patients treated for suspected acute appendicitis

Research

Clinical observation of male bulbar urethral strictures resulting from straddle injuries associated with falling from heights and riding activities

Research

Post-cholecystectomy bile duct injuries: a retrospective cohort study

Research

Essential surgery delivery in the Northern Kivu Province of the Democratic Republic of the Congo

Research

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage