Sciatic scoliosis: An easily misdiagnosed disease in adolescents and young adults

Objective This study aimed to analyze the clinical presentation and surgical outcome of scoliotic listing due to herniated intervertebral disc in adolescents or young adults, and making a differential diagnosis between sciatic scoliosis and idiopathic scoliosis. Materials and Methods This retrospective review focused on a group of five adolescents or young adults with herniation of the intervertebral disc who initially presented scoliotic posture between January 2005 and September 2011. The history, physical examination, imaging studies, and operative findings were recorded and analyzed. Results Three males and two females, with a mean age of 17.3 years (range, 14–24 years), were enrolled in our study. All of them had been misdiagnosed as having idiopathic scoliosis and had been treated for this for several months. All had a positive straight leg raising test (SLRT) result between 30° and 60° prior to surgery, which improved to 80° after surgery. In all five cases, the convexity of scoliosis was at the same side of the disc herniation. The Cobb angle in all patients improved after surgery (mean, 26.9° preop to 11° postop). Conclusion It is important to obtain a detailed history, and to perform a physical examination (positive SLRT) and imaging studies (lack of vertebral rotation in the standing anterior–posterior radiographs) in adolescents or young adults with painful scoliosis, which may help us make a differential diagnosis from idiopathic scoliosis.