title: The Incidence and Risk Factors for Lumbar or Sciatic Scoliosis in Lumbar Disc Herniation and the Outcomes after Percutaneous Endoscopic Discectomy.
abstract: BACKGROUND
  Some patients with lumbar herniated intervertebral disc disease (HIVD) suffer from both pain and lateral shift or trunk list. In addition to pain, patients have concerns regarding whether trunk list is reversible. Surgical treatment is performed when pain is intractable to conservative management, but a reversal of trunk list is an incidental outcome. Percutaneous lumbar endoscopic discectomy (PELD) is one of the surgical treatment options for lumbar HIVD, but no results concerning its effect on trunk list have been reported.
  
  
  OBJECTIVE
  The objectives of the present study were to determine the incidence of, and risk factors for, trunk list scoliosis or lateral shift and to report the outcomes of trunk list after PELD.
  
  
  METHODS
  Retrospective case study. IRB No. H 1111-025-384 SETTING; University medical Center, Seoul, Korea.
  
  
  METHODS
  We selected 164 patients who were less than 60 years old, complained of unilateral leg pain, and underwent PELD. We measured the maximum trunk shift from the central sacral vertical line (CSVL-max) on preoperative whole spine radiographs and classified trunk list as CSVL-max ≥ 10 mm. CSVL-max was measured on serial radiographs taken at one, 3, 6, and 12 months postoperatively in patients with trunk list.
  
  
  RESULTS
  Twenty-nine patients (17.9%) had trunk list (M:F=10:19; mean age, 37.1 ± 11.24 years). Female gender (OR 4.28; 95% CI, 1.49-12.3) and HIVD at L4-5 (OR 5.6; 95% CI, 1.8-16.7) were risk factors for trunk list. Trunk list was normalized (CSVL-max < 10 mm) in 15 (52%) patients after PELD, and the median time for normalization was 3-6 months. Prognostic factors for the recovery of trunk list were not identified.
  
  
  CONCLUSIONS
  Selection bias should be considered in interpreting these results.
  
  
  CONCLUSIONS
  Trunk list, scoliosis or lateral shift, was observed in 18% of the patients at the time of surgery. Female gender and L4-5 disc herniation were risk factors for trunk list. Trunk list was reversible in more than 50% of patients within 6 months of PELD.
authors.affiliation: Department of Medicine, Seoul National University College of Medicine.
authors.forename: Ranhee
authors.initials: R
authors.lastname: Kim
authors.affiliation: Department of Medicine, Seoul National University College of Medicine.
authors.forename: Rae Hyung
authors.initials: RH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine; Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea; Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Chi Heon
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
authors.forename: Yunhee
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine; Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea; Clinical Research Institute, Seoul National University Hospital, Seoul, Korea;Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Sung Bae
authors.initials: SB
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine; Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea;
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine.
authors.forename: Sung-Mi
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine; Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea; Clinical Research Institute, Seoul National University Hospital, Seoul, Korea; Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
authors.forename: Chun Kee
authors.initials: CK
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000453:epidemiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D012307:Risk Factors; D020426:Sciatic Neuropathy / Q000150:complications* / Q000453:epidemiology; D012600:Scoliosis / Q000150:complications* / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult