Minimally invasive transforaminal lumbar interbody fusion in the treatment of sciatic scoliosis caused by lumbar disc herniation: a 2-year follow-up of coronal and sagittal balance

doi:10.3969/j.issn.2095-4344.2964

Abstract

Abstract: BACKGROUND: The sciatic scoliosis is considered as a compensatory attempt of the body to relieve nerve irritation. If dealt with inappropriate and delayed, it may be developed in structural scoliosis. There was controversial about the treatment of such cases.
OBJECTIVE: To compare the safety and effectiveness of single-level open versus minimally invasive transforaminal lumbar interbody fusion in the treatment of sciatic scoliosis caused by lumbar disc herniation.
METHODS: Data of 47 patients with sciatic scoliosis caused by lumbar disc herniation who were treated in Peking University People’s Hospital from January 2010 to January 2014 were retrospectively analyzed. The main symptom was severe back and lower limb pain, complicated with trunk tilt. Twenty-five patients underwent single-level open transforaminal lumbar interbody fusion therapy (open group). Twenty-two patients underwent minimally invasive transforaminal lumbar interbody fusion therapy (minimal invasion group). The single-level surgery was conducted in both groups. The patients were followed up for at least 2 years. The clinical effects and photographic parameters were compared between the two groups.
RESULTS AND CONCLUSION: (1) There was no significant difference in age, gender, spinal levels operated and all the coronal and sagittal parameters preoperatively between the two groups (P > 0.05). (2) There was no significant difference in operation time between the two groups (P > 0.05). The amount of bleeding, postoperative time to the ground, and average length of hospital stay were better in the minimal invasion group than in the open group (P < 0.05). (3) Clinical efficacy score: Compared with preoperatively, visual analogue scale score and Oswestry disability index were significantly improved in both groups at 6 months and 2 years after operation (P < 0.05). No significant difference was found at the same time point in both groups (P > 0.05). (4) Balance of coronal plane and sagittal plane: The deformity at 2 years after operation was significantly improved compared with that before operation (P < 0.05). There was no significant difference between the two groups at the same time point (P > 0.05). (5) Solid fusion was achieved in both groups. (6) It is concluded that minimally invasive transforaminal lumbar interbody fusion in the treatment of single-level sciatic scoliosis caused by lumbar disc herniation obtained similar effect as open fusion. Moreover, it has the advantages of less bleeding, faster recovery and shorter hospital stay.

Key words: bone, lumbar spine, minimally invasive, foramen, interbody fusion, intervertebral disc, scoliosis, Cobb angle

CLC Number:

Liang Yan, Zhao Yongfei, Zhu Zhenqi, Liu Haiying, Mao Keya. Minimally invasive transforaminal lumbar interbody fusion in the treatment of sciatic scoliosis caused by lumbar disc herniation: a 2-year follow-up of coronal and sagittal balance[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 409-413.

Figures/Tables 6

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