Highlights Complex injury and unique anatomic relationships at the sacropelvic region. Use of modified approach to access the fracture site of the sacrum where dural tear is common. No complications after surgery. Alternative treatments for managing complex pelvic and sacral fractures Denis type 2.

Introduction Primary adult degenerative scoliosis is one of the adult scoliosis group that presents in adult patient without history of scoliosis during childhood or adolescence. This condition may be asymptomatic, mild low back pain, radiculopathy symptoms, or may be causing severe low back pain and major neurological symptoms including weakness and numbness of the lower extremities which can affect the patient quality of life. Case presentation In this study, we presented seven cases of primary degenerative adult scoliosis that was treated either with decompression alone, decompression with short segment fusion and deformity correction, and decompression with long segment fusion and deformity correction. The parameters measured in this study were lumbar regional angle, Cobb angle, and pelvic parameters. The functional status of the patient was measured using Oswestry Disability Index (ODI). Discussion The main purpose for surgical treatment in primary degenerative adult scoliosis depends on the clinical presentation and also the patient's expectations .From the study, we found that all patient underwent surgery had improvement of functional status that measured with ODI score. The mean of pre operative ODI score was 49.70 (± 13.61 SD) (severe disability) and for post operative was 21.8 (± 13.40 SD) (moderate disability). Surgery decompressed the neural element and stabilize the spine. Conclusion Surgery treatment in patients with degenerative adult scoliosis was shown to have better functional outcomes regardless of the technique used. Further study with bigger sample with corresponding statistical analytic is mandatory.

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Highlights Various pathologies might occur at the adjacent segments after lumbar spinal fusion. Some patients are afraid to undergo second or next open surgery and prefer minimally invasive surgery. The procedure was successful with no complications. The radiculopathy decreased after the surgery.

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