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
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Published on: July 25, 2025
Shilei Li1, Hongqi Zhang, Chaofeng Guo
1From the Department of Spine Surgery and Orthopedics (Li, Zhang, Guo, Wang, Deng, Liu, Tang), Xiangya Hospital, Central South University, Changsha, China, and the National Clinical Research Center for Geriatric Disorders (Li, Zhang, Guo, Wang, Deng, Liu, Tang), Xiangya Hospital, Central South University, Changsha, China.
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.
