Mid-term effects of Cotrel-Dubousset instrumentation on the configuration of the spine and the thoracic cage in thoracic idiopathic scoliosis.
The effect of Cotrel-Dubousset instrumentation (CDI) on the three-dimensional spinal deformity in 24 consecutive patients with idiopathic scoliosis was investigated by posteroanterior and lateral radiographs and by computed tomography preoperatively, postoperatively, and at a mean follow-up of 3.2 years (range 2.0-5.3 years). At follow-up the mean Cobb angle was decreased by 73%, and the translation of the apical vertebra was significantly decreased by 33%. The sagittal contour was significantly improved with thoracic kyphosis T5-12 increased by 46% (6.9 degrees) and lumbar lordosis L1-5 increased by 28% (10.3 degrees) at follow-up. The sagittal diameter was significantly improved by 5 mm at follow-up. Although the vertebral rotation and the size of rib hump was improved postoperatively, this was followed by significant loss of correction, and at follow-up the vertebral rotation and the size of rib hump were not significantly better than preoperatively. The study indicates that while CDI improves the coronal and sagittal plane deformity permanently, the effect on vertetebral rotation and the rib hump deteriorates with time.
Willers
U
U
Department of Orthopaedic Surgery, Huddinge University Hospital, Karolinska Institute, Huddinge, Sweden.
Hedlund
R
R
Aaro
S
S
D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery; D008141:Lordosis / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012399:Rotation; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D035441:Thoracic Wall; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult