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.

Abstract

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. 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. 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). 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.