Four-rod technique for neuromuscular scoliosis and pelvic obliquity correction: technical note and case series

Surgical correction of neuromuscular scoliosis is a challenging problem facing spine surgeons. Many patients require long constructs and pelvic fixation to obtain adequate curve correction and pelvic obliquity correction. The aim of this technical note is to describe a technique for sequential pelvic obliquity and scoliotic curve correction in patients with neuromuscular scoliosis using four rods in upper thoracic to pelvis posterior spinal fusion, without the need for intraoperative traction. We present 5 cases of neuromuscular scoliosis that underwent upper thoracic to pelvis posterior spinal fusion using the four-rod technique and demonstrate improvement in major Cobb angle and pelvic obliquity immediately postoperatively and maintained at final follow-up (range: 2-16 years). Preliminary findings from this small case series support the use of four-rod correction technique for correction of neuromuscular scoliosis and pelvic obliquity.