A GREAT MIMICKER OF ADOLESCENT IDIOPATHIC SCOLIOSIS: SCIATIC SCOLIOSIS. A RETROSPECTIVE REVIEW OF 18 ADOLESCENT PATIENTS WITH AT LEAST 2 YEARS OF FOLLOW-UP

Objective: Sciatic scoliosis (SS) induced by lumbar disc herniation (LDH) is a great mimicked of adolescent idiopathic scoliosis (AIS).This study aimed to evaluate the clinical-radiographic presentation of SS in adolescents caused by LDH, while reporting on the average 3 years results of lumbar microdiscectomy in terms of radiographic and functional outcomes.Materials and Methods: Eighteen adolescent patients who presenting for evaluating SS with radiculopathy were enrolled.They had an average age/follow-up duration of 17.1 years/36.8months.Lumbar microdiscectomy was applied to them.Radiographic measurements, including the analysis of curve pattern, major curve magnitude and coronal balance were undertaken.Results: A short lumbosacral curve combined with an opposite sided long thoracic and/or thoracolumbar curve was detected.16/18 patients were detected to have LDH at the convex side of the lumbosacral curve.14/18 were detected to have a trunk shift directed to the opposite side of the LDH.Average major curve magnitudes pre-op and at the last follow-up (FU) visit were 25.1°/4.2°respectively (p=0.001).Patients had an average pre-operative coronal imbalance of 4.1 cm reduced to 1.3 cm at the last FU (p=0.003).Average visual analogue scale leg-back and Oswestry Disability Index scores improved from 7.1-4.2and 36.1% pre-operatively to 1.3-0.7 and 6.2% at the last FU (p<0.001).SF-36 scores were detected to be improved with high statistical significance at the last FU.Conclusion: SS was associated with short lumbosacral curves accompanied by long thoracic and/or thoracolumbar curves, while the LDH was often located at the convex side.In adolescent cases, microdiscectomy could yield an immediate recovery of the radicular pain in addition to excellent functional outcomes, while successfully restoring the coronal balance in the long term follow-up.