Radiological Outcome of Cotrel-Dubousset Instrumentation in Nineteen Patients with Adolescent Idiopathic Scoliosis

Abstract

Objective: Adolescent idiopathic scoliosis is a progressive type of scoliosis that may lead to permanent deformity unless prevented and treated effectively. To present radiological outcome of patients with adolescent idiopathic scoliosis treated with the Cotrel-Dubousset (CD) instrumentation in our clinic. Methods: This was a prospective follow-up study of 19 patients (8 males, 11 females; mean age 18.5 years; age range 12-43 years) who underwent CD instrumentation for late onset idiopathic scoliosis. The CD instrumentation and posterior spinal fusion was performed using the standard technique through either anterior or posterior approach. On average, 13.52 vertebrae (range, 8-16) were included in the spinal fusion. The mean postoperative follow-up duration was 18 months (2-32 months). Results: Cobb angle on frontal plane was corrected 47.74%±21.73% at thoracic region and 34.52%±15.96% at lumbar region. On sagittal plane, the percentage of correction was 28.61%±20.91% on thoracic kyphosis angle and 38.96%±29.73% lumbar lordosis angle. In general, physiological sagittal contour of spine was obtained in 49.2% of patients after CD instrumentation. The most common postoperative complications were hook dislocation (n=8), bending and dislocation of screw (n=7), broken lamina and pedicule (n=5), and infection (n=3), all of which were effectively treated. Conclusio n: CD instrumentation effectively corrects the late onset idiopathic scoliosis if it is performed after a proper preoperative planning.