JAAOS - 2026-06-04 - Journal Article
One-Stage Posterior-Only Multiple-Rod Technique for Severe Scoliosis With Lumbosacral Deformities (<20 Years): A Single-Centre Experience With Minimum 2-Year Follow-up.
Li S, Zhang H, Guo C, Wang Y, Deng A, Liu S, Tang M
Topics
Key Takeaway
In 17 patients under 20 with severe scoliosis and lumbosacral deformity, posterior-only multi-rod constructs corrected the major curve from 62.1° to 19.6° and the lumbosacral Cobb from 33.6° to 7.7°, with corrections maintained at minimum 2-year follow-up.
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Summary
This study evaluated posterior-only multi-rod constructs (3-rod vs. 4-rod) for severe scoliosis with concomitant lumbosacral deformity in patients under 20. Seventeen patients underwent retrospective radiographic and SRS-22 analysis at preop, 1-week postop, and final follow-up. Major curve correction averaged 68% (62.1° to 19.6°) and lumbosacral Cobb correction averaged 77% (33.6° to 7.7°), both maintained at follow-up; SRS-22 self-image scores improved from 2.21 to 3.79, with no significant difference in outcomes between 3-rod and 4-rod configurations.
Key Limitation
The sample size of 17 patients is insufficient to detect meaningful differences between 3-rod and 4-rod constructs or to draw conclusions about rod fracture incidence, which is the primary proposed advantage of bilateral supplementary rod configuration.
Original Abstract
PURPOSE
The purpose of this study was to evaluate the efficacy of multirod constructs in the treatment of young patients (<20 years) with scoliosis accompanied by lumbosacral deformity and to compare the corrective outcomes and postoperative quality of life between 3-rod and 4-rod techniques.
METHODS
Thirty-nine adolescent patients with lumbosacral anomalies underwent surgical treatment at our institution. Following application of the inclusion/exclusion criteria, 17 young patients with severe scoliosis and concomitant lumbosacral deformities were enrolled in this study. Preoperative, 1-week postoperative, and final follow-up standing whole-spine anterior-posterior/lateral radiographs were retrospectively analyzed. The following parameters were assessed: major curve Cobb angle, lumbosacral curve Cobb angle, trunk shift, thoracic kyphosis angle, lumbar lordosis angle, and sagittal vertical axis (SVA), In addition, Scoliosis Research Society-22 (SRS-22) questionnaire scores were collected and analyzed preoperatively and at the final follow-up.
RESULTS
The lumbosacral Cobb angle improved from 33.6° ± 4.5° to 7.7° ± 2.8° postoperatively (P < 0.05), maintained at 8.6° ± 2.6° during follow-up. The major curve decreased from 62.1° ± 8.3° to 19.6° ± 6.5° (P < 0.05), with slight correction loss to 23.3° ± 6.1° at follow-up. Trunk shift reduced from 3.0 ± 1.5 cm to 1.1 ± 0.7 cm (P < 0.05), stabilizing at 1.4 ± 0.6 cm. Sagittal measurements showed TK improved from 29.8° ± 6.0° to 33.3° ± 5.0° postoperatively (P > 0.05), whereas lumbar lordosis increased from 34.2° ± 19.4° to 43.0° ± 7.3° (P > 0.05). SVA changes were notable (P < 0.05). SRS-22 self-image scores improved from 2.21 ± 0.64 to 3.79 ± 0.50 (P < 0.001), with pain scores also enhanced from 4.02 ± 0.58 to 4.71 ± 0.17 (P < 0.001). No statistically significant differences were observed in correction rates or final follow-up SRS-22 scores between 3-rod and 4-rod constructs (P > 0.05).
CONCLUSION
The multiple-rod technique effectively addresses severe scoliosis with lumbosacral deformities in young patients, providing sustained radiographic correction, reduced implant failure risk, and improved clinical outcomes. In long-segment lumbosacral fixation constructs, bilateral supplementary rod configuration may reduce rod fracture risk compared with unilateral reinforcement.