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

Yıl 2017, Cilt: 3 Sayı: 2, 1 - 8, 28.08.2017

Murat Çalbıyık

https://doi.org/10.19127/mbsjohs.315163

Öz

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.

Conclusion: CD
instrumentation effectively corrects the late onset idiopathic scoliosis if it
is performed after a proper preoperative planning.

Anahtar Kelimeler

Curl-up exercise, abdominal muscles, sternocleidomastoid, electromyography

Kaynakça

• Ameri E, Ghandhari H, Hesarikia H, Rasouli HR, Vahidtari H, Nabizadeh N. Comparison of harrington rod and cotrel-dubousset devices in surgical correction of adolescent idiopathic scoliosis. Trauma Mon 2013;18(3):134-8.
• Cobb JR. Outline for the study of scoliosis. Am Acad Orthop Surg Instr Course Lect 1948;5:261-5.
• Cotrel Y, Dubousset J. Nouvelle technique d’ostheosynthèse rachidienne sègmentaire par voie postèrieure. Rev Chir Orthop 1984;70:489-95.
• Cunin V. Early-onset scoliosis: current treatment. Orthop Traumatol Surg Res 2015;101(1 Suppl):S109-18.
• Dubousset J, Cotrel Y. Application technique of Cotrel-Dubousset instrumentation for scoliosis deformities. Clin Orthop Relat Res 1991;264:103-10.
• Gunnoe BA. Adolescent idiopathic scoliosis. Orthop Rev. 1990 Jan;19(1):35-43.
• Helenius I, Remes V, Yrjönen T, Ylikoski M, Schlenzka D, Helenius M, Poussa M. Harrington and Cotrel-Dubousset instrumentation in adolescent idiopathic scoliosis. Long-term functional and radiographic outcomes. J Bone Joint Surg Am 2003;85-A(12):2303-9.
• King HA, Moe JH, Bradford DS, Winter RB. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am 1983;65(9):1302-13.
• Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Chil Orthop 2013;7(1):3-9.
• Lykissas MG, Jain VV, Nathan ST, Pawar V, Eismann EA, Sturm PF, Crawford AH. Mid- to long-term outcomes in adolescent idiopathic scoliosis after instrumented posterior spinal fusion: a meta-analysis. Spine (Phila Pa 1976) 2013;38(2):E113-9.
• Puno RM, Grossfeld SL, Johnson JR, Holt RT. Cotrel-Dubousset instrumentation in idiopathic scoliosis. Spine (Phila Pa 1976) 1992;17(8 Suppl):S258-62.
• Remes V, Helenius I, Schlenzka D, Yrjönen T, Ylikoski M, Poussa M. Cotrel-Dubousset (CD) or Universal Spine System (USS) instrumentation in adolescent idiopathic scoliosis (AIS): comparison of midterm clinical, functional, and radiologic outcomes. Spine (Phila Pa 1976) 2004 Sep 15;29(18):2024-30.
• Risser JC. The iliac apophysis; an invaluable sign in the management of scoliosis. Clinical Orthopaedics 1958;11:111-9.
• Shindle MK, Khanna AJ, Bhatnagar R, Sponseller PD. Adolescent idiopathic scoliosis: modern management guidelines. J Surg Orthop Adv 2006;15(1):43-52.
• Wajanavisit W, Woratanarat P, Thiabratana P, Woratanarat T, Laohacharoensombat W. A comparison between the Cotrel-Dubousset and the pedicle screw-plate instrumentations in the adolescent idiopathic scoliosis. J Med Assoc Thai 2009;92 Suppl5:S95-101.
• Weiss HR, Goodall D. The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. Eur J Phys Rehabil Med 2008;44:177-93.
• Weiss HR, Karavidas N, Moramarco M, Moramarco K. Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature. Asian Spine J 2016;10(6):1163-9.