The therapeutic efficacy of MIS-TLIF for patients with sciatic scoliosis caused by lumbar disc herniation: A retrospective study

Abstract

Abstract Background and Objective: Sciatic scoliosis is a clinical syndrome resulting from a minor painful lesion in the muscles, fasciae or ligaments of the lower back, the intervertebral or sacroiliac joints, or a sciatica. This study aimed to explore the efficacy and feasibility of application of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) technique in the treatment of patients with sciatic scoliosis caused by lumbar disc herniation (LDH). Methods From January 2010 to May 2017, a retrospective study was conducted with enrollment of 43 patients with sciatic scoliosis caused by LDH who were treated with MIS-TLIF and completed at least 2-year follow-up. Visual Analog Scale (VAS) and Oswestry Disability Index were evaluated. Radiographic measurements included distance between C7 plumb line and center sacral vertical line, Cobb angle of lumbar curve, lumbar lordosis, sacrum slope, and pelvic tilt. Results The mean VAS score for back pain decreased from 5.13 ± 1.6 preoperatively to 1.42 ± 0.8 at 2-year follow-up (P < 0.05), and the mean VAS score for leg pain reduced from 4.7 ± 1.1 preoperatively to 0.46 ± 0.78 at 2-year follow-up (P < 0.05). The Oswestry Disability Index score improved from 53.3 ± 11.5% preoperatively to 14.3 ± 5% at 2-year follow-up (P < 0.05). The mean Cobb angle decreased from 15.6 ± 4.3° preoperatively to 3.8 ± 2° at 2-year follow-up with a mean correction of 11° (P < 0.05). The mean C7 plumb line and center sacral vertical line was 3.35 ± 1.7 cm preoperatively, and 0.69 ± 0.47cm at 2-year follow-up (P < 0.05). The lumbar lordosis varied from − 23.1 ± 9.4° preoperatively to -36.8 ± 7.5° at 2-year follow-up (P < 0.05). Conclusion MIS-TLIF technique can be used to treat patients with sciatic scoliosis caused by LDH, resulting in favorable clinical outcomes, proper fusion, and satisfactory imbalance correction with less blood loss and complications.