Cotrel-Dubousset instrumentation in adults. A preliminary report

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Biomedical Engineering

Background:

• The Cotrel-Dubousset (CD) system, initially for adolescent scoliosis, was evaluated for adult spinal conditions.
• Assessing the CD system's efficacy and safety in a diverse adult patient cohort is crucial.

Purpose of the Study:

• To evaluate the Cotrel-Dubousset (CD) system's effectiveness in treating various adult spinal disorders.
• To compare the CD system's outcomes with conventional surgical techniques in adults.

Main Methods:

• Retrospective review of the first 50 adult cases treated with the CD system at Johns Hopkins.
• Analysis of curve correction, fusion success, operative time, blood loss, hospitalization, and neurological complications.
• Comparison of motion segments spared versus traditional instrumentation systems (Harrington, Luque).

Main Results:

• CD system yielded results comparable to standard techniques for adult scoliosis.
• Transpedicle screws (88 in 18 patients) were safely used in tumor, spondylolisthesis, and trauma cases without neurological complications.
• CD instrumentation reduced vertebral levels required for fixation, preserving an average of 1.6 lumbar motion segments per case.

Conclusions:

• The CD system is a versatile and safe option for various adult spinal conditions beyond adolescent idiopathic scoliosis.
• CD instrumentation, particularly with transpedicle fixation, offers advantages over conventional methods for spinal pathology due to neoplasm, spondylolisthesis, and trauma.
• The CD system allows for significant preservation of lumbar motion segments, improving patient outcomes.