Cotrel-Dubousset instrumentation for the treatment of severe scoliosis

In a multicentric study, 36 cases (40 curves) of severe scoliosis were anal ysed; 19 were idiopathic and 17 neurological, Cobb angles ranged from 70 de grees to 145 degrees, all had undergone three-rod Cotrel-Dubousset (CD) ins trumentation. The correction on the frontal plane achieved more than 50% of die preoperative angle (53.9% for idiopathic curves and 55.6% for neurolog ical ones). On the sagittal plane the pathological shape of the spine was r educed and distinctly ameliorated. In ten patients, the authors successfull y applied a technique, alternative to the original one, which was based on the use of two or three screws in the lumbar area, one supplementary pedicl e transverse claw on the cranial area and two rods connected by a domino, i nstead of a single rod (the longer one applied on the concave side). The ma in complications were: one case of infection, three of vascular compression of the duodenum, one of crank-shaft phenomenon and one laminar hook displa cement. The excellent result achieved in both, idiopathic and neurological severe and stiff scoliosis shows the efficacy, reliability and versatility of CD three-rod instrumentation.