Radiological characteristics in coronal and sagittal planes and short-term postoperative outcomes in patients with lumbar disc herniation accompanied by sciatic scoliosis.

To investigate the coronal and sagittal radiological characteristics of patients with lumbar disc herniation (LDH) with sciatic scoliosis, to establish a new typing system, and to assess the difference in efficacy between percutaneous endoscopic lumbar discectomy (PELD) and transforaminal lumbar interbody fusion (TLIF). Patients with LDH with sciatic scoliosis who underwent surgical treatment in our hospital from January 2023 to December 2024 were retrospectively analyzed, and the clinical data of the patients were collected. According to the different surgical methods, they were divided into PELD group and TLIF group. Radiological parameters were measured on the basis of full spine frontal and lateral radiographs. Coronal radiological characteristics were evaluated by using Chunde Li typing, sagittal radiological characteristics were evaluated by using LL and SVA, and scoliosis resolution rate was used to evaluate the resolution of scoliosis in patients. A total of 137 patients were included, including 25 patients with coronal type 1 A, 86 patients with type 1B, and 26 patients with type 2. Four sagittal types were identified by sagittal LL and SVA. Among them, 39 patients (28.5%) showed reduced lumbar lordosis but maintained balance in the sagittal position, 40 patients (29.2%) showed lumbar lordosis maintained and a combination of sagittal imbalance, and 27 patients (19.7%) showed lumbar kyphosis with sagittal imbalance. The TLIF group had higher operation time, bleeding, and postoperative hospitalization days than the PELD group. At one week after surgery, both groups achieved satisfactory clinical outcomes, and in patients with sagittal type III and type IV, the scoliosis resolution rate of scoliosis was higher in the TLIF group than in the PELD group. Patients with sciatic scoliosis often have a combination of reduced sagittal lumbar lordosis, sagittal imbalance, and lumbar kyphosis. PELD and TLIF can achieve good surgical efficacy and coronal and sagittal orthopedic results in sciatic scoliosis. The TLIF group had a longer operation time, more bleeding, and more postoperative hospitalization days. For patients with combined sagittal imbalance, the short-term coronal orthopedic results of TLIF were better than those of PELD.