A three-dimensional radiographic comparison of Cotrel-Dubousset and Colorado instrumentations for the correction of idiopathic scoliosis

Study Design. A prospective clinical study comparing two instrumentation sy stems for the correction of idiopathic scoliosis. Objectives.To measure the short-term three-dimensional changes in the shape of the spine after corrective surgery and compare the Cotrel-Dubousset ins trumental to the more;re recent Colorado instrumentation to determine wheth er one system provides better three-dimensional correction. Summary of Background Data. Adequate three-dimensional correction of scolio tic deformities has been reported with the Cotrel-Dubousset instrumentation system running the past decade, a new generation of more versatile and use r-friendly spinal implants has appeared, but there are no reports available to indicate whether similar or better correction can be obtained with thes e newer systems. Methods. The dimensional geometry of the thoracic and lumber spine was docu mented in the standing, position using a three-dimensional reconstruction t echnique based on multiplanar radiography in 67 adolescents with idiopathic scoliosis undergoing correction by a posterior approach. Changes in spinal shape were measured 3 days before and 1 month after the surgery in 31 pati ents with Cotrel-Dubousset instrumentation and 36 patients with Colorado in strumentation. Results. In both groups, adequate three-dimensional correction of the scoli otic deformities was documented for thoracic and lumbar curves, with signif icant changes in the frontal plane in the plane of maximum curvature, and i n its orientation. When comparing both groups, bet better correction was ob tained in the frontal plane with the instrumentation (65% vs. 48% with Cotr el-Dubousset), a finding that may be explained by the significantly greater ter proportion of pedicle screws used in this group. Conclusion. Both instrumentation techniques achieve affective and comparabl e three-dimensional correction of the scoliotic deformities.