Adolescent scoliosis secondary to lumbar disc herniation: The effect of posterior lumbar discectomy on scoliotic curve improvement
Zezhang Zhu, Yong Qiu, Qinghua Zhao, Bin Wang, Yang Yu
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Paper #89 Adolescent scoliosis secondary to … -
Zezhang Zhu, No Relationships
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Yong Qiu, No Relationships
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Qinghua Zhao, No Relationships
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Bin Wang, No Relationships
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Yang Yu, No Relationships
2010 Euro Spine Meeting Authors Disclosure Information Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Objectives
~ To identify the curve pattern of scoliosis ~ To investigate the effect of posterior discectomy on the curve improvement
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Demography Cases No. Age
Gender Radiographic measurements
26 17.7 yrs (range, 14.3-20.0 yrs).
M: 18; F: 8
curve pattern, specific curve features, trunk shift, sagittal profile
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Methods
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Results ~ All patients had a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side ~ 80.7% patients had an irregular proximal curve characterized by difficulty in identifying the exact apex ~ 88.5% patients showed a trunk shift >2.0 cm Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Association between the side of lumbosacral curve and the side of disc herniation
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Association between the direction of trunk shift and the side of disc herniation
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Results
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
A
B
C
D
E
18.4-years-old-boy with L5-S1 disc herniation and scoliosis A, B, MRI revealed L5-S1 disc protrusion with impingement of the right S1 nerve root . C, Preoperative AP radiograph showed 32°left thoracic curve and 27° right lumbosacral curve, the trunk shift was 7.7 cm. D, Immediately after surgery, 11°thoracic curve and 7°lumbosacral curve with the trunk shift as 0.9 cm. E, 2.5 years after surgery, 5°thoracic curve and 3°lumbosacral curve, the trunk shift was 0.5 cm. Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
Conclusion ~ A short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side has been noted in all the patients ~ The direction of lumbosacral curve and trunk shift is related to the side of disc herniation ~ A majority of patients have a small curve size while a significant coronal imbalance. ~ Earlier decompression can provide a greater opportunity for spontaneous correction of scoliosis Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
References 1. 2. 3. 4.
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Suk KS, et al. Lumbosacral scoliotic list by lumbar disc herniation. Spine, 2001. 26(6): 667-71. Matsui H, et al. Significance of sciatic scoliotic list in operated patients with lumbar disc herniation. Spine, 1998. 23(3):338-42. Krishnan KM, et al. Lumbar scoliosis associated with a disc herniation in an adult. Rheumatology (Oxford), 2001. 40(12): 1427-8. Ishihara H, et al. Lumbar intervertebral disc herniation in children less than 16 years of age. Long-term follow-up study of surgically managed cases. Spine, 1997. 22(17):20449. Kumar R, et al. Adolescent lumbar disc disease: findings and outcome. Childs Nerv Syst, 2007. 23(11):1295-9. Martinez-Lage JF, et al. Lumbar disc herniation in early childhood: case report and literature review. Childs Nerv Syst, 2003. 19(4):258-60. Smorgick Y, et al. Mid- to long-term outcome of disc excision in adolescent disc herniation. Spine J, 2006. 6(4): 380-4. Zheng GX, et al. Reliability of the Modified Oswestry Disability Index for evaluating patients with low back pain. Chinese Journal of Spine and Spinal Cord, 2002. 12(1): 3. Ozgen S, et al. Lumbar disc herniation in adolescence. Pediatr Neurosurg, 2007. 43(2): 77-81. Lee DY, et al. Percutaneous endoscopic lumbar discectomy for adolescent lumbar disc herniation: surgical outcomes in 46 consecutive patients. Mt Sinai J Med, 2006. 73(6): 864-70.
Spine Surgery, Drum Tower Hospital, Nanjing University, CHINA
