Cotrel-Dubousset instrumentation in idiopathic scoliosis. A preliminary report

This is a preliminary report on Cotrel-Dubousset (CD) instrumentation for the surgical management of idiopathic thoracic scoliosis. From September 1985 through April 1986, 37 patients were treated at the authors' hospital, by posterior spinal fusion with CD instrumentation. Twelve patients had surgical treatment of spinal deformity associated with other disorders or had revision surgery. The remaining 25 patients, with no prior surgery, were diagnosed as having juvenile or adolescent idiopathic scoliosis. After operation, this group of patients was routinely noted to have significant improvement in rib deformity. This is associated with the rotational correction achieved with CD instrumentation and contrasts with the minimal rib deformity correction with Harrington instrumentation documented by some workers. In this series, no rib resections have been necessary in conjunction with CD instrumentation. No postoperative external immobilization was used. Ambulation began on the second postoperative day, and patients were discharged five to seven days after operation. Gradual resumption of normal activities was allowed at six weeks, and full activities, other than contact sports, after three months.