Summary
Between 1968 and 1977, 72 patients with idiopathic scoliosis underwent Harrington Instrumentation (HI). Between 1985 and 1988, 21 patients with idiopathic scoliosis had posterior spinal fusion with Cotrel-Dubousset instrumentation (CDI). All patients were operated by the same orthopedic surgeon. None of the CDI patients had postoperative brace or cast protection, the HI group had on average 6 months' postoperative brace treatment. The two groups of patients were comparable in age, sex, and type of curves. The HI group and CDI group were reexamined with clinical and radiological assessment after mean periods of 148 months and 60 months respectively. The average preoperative Cobb angle in the CDI group was 59.9° (HI group 67.8°), which improved to 20.8° (HI group 33°) postoperatively — a correction of 66.3% (HI group 51.3%). The loss of correction on reassessment amounted to 5% in the CDI group and 20.7% in the HI group. In both groups, the mean rib hump height was reduced to 2.2 cm. In 40% of the Harrington patients, a flat back was found, but this was not related to clinical back pain. The rate of complications and reintervention was 9.5% in the CDI group and 8.3% in the HI group. There were no neurological complications. Subjectively, 86% of the Harrington patients and 95.2% of the CDI patients rated the results of their operation as “good” or “very good”. The CDI group showed better results in correction of the Cobb angle and loss of correction, while saving one mobile lumbar segment. The correction of the rib hump showed the same results for both techniques. Blood loss and operation time was much lower in the HI group. However, the rate of complications was similar in both groups.
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References
Aaro S, Dahlborn M (1982) The effect of Harrington Instrumentation on the longitudinal axis rotation of the apical vertebra and on the spinal rib cage deformity in idiopathic scoliosis studied by computer tomography. Spine 7:456–462
Akbarnia BA, Scheid KE, Merenda JT, Graviss E (1988) The three dimensional correction of CD instrumentation in idiopathic scoliosis. In: Proceedings of the fifth International Congress on Cotrel Dubousset Instrumentation. Sauramps, Montpellier, pp 39–43
Bauer R, Mostegl A, Hingshammer R (1988) Cotrel-Dubousset Instrumentation for the correction of spinal curvature. Arch Orthop Trauma Surg 107:364–368
Cotrel Y, Dubousser J (1984) Nouvelle technique d'osthéosynthèse rachidienne ségmentaire par voie postérieure. Rev Chir Orthop 70:489–495
Cundy PJ, Paterson DC, Hillier TM, Sutherland AD, Stephen JP, Foster BK (1990) Cotrel-Dubousset Instrumentation and vertebral rotation in adolescent idiopathic scolios. J Bone Joint Surg [Br] 72:670–674
Ecker ML, Betz RR, Trent PS, Mahboubi S, Mesgarzadeh M, Bonakdapour A, Drummond DS, Clancy M (1988) Computer tomography evaluation of Cotrel Dubousset Instrumentation in idiopathic scoliosis. Spine 13:1141–1144
Gray JM, Smith BW, Ashley RK, LaGrone MO, Mall J (1991) Derotational analysis of Cotrel Dubousset Instrumentation in idiopathic scoliosis. Spine 16:391–393
Harrington PR (1962) Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg [Am] 44:591–610
Hopf C, Matthias HH, Heine J, Syndicus G (1988) Experiences with the CDI after the operation of more than 120 cases. In: Proceedings of the Fifth International Congress on Cotrel Dubousset Instrumentation. Sauramps, Montpellier, pp 195–200
King HA, Moe JH, Bradford DS, Winter RB (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg [Am] 65:1305–1313
Krismer M, Bauer R, Sterzinger W (1992) Scoliosis correction by Cotrel Dubousset Instrumentation. The effect of derotation and three dimensional correction. Spine 17:263–269
Krismer M, Behensky H, Bauer R (1994) A comparison of Harrington and CD instrumentation in King III curves. European Spine Deformities Society Fifth Biannual Conference, Birmingham
Lenke LD, Bridwell KH, Baldus C, Blanke K, Schoenecker PL (1993) Ability of Cotrel Dubousset instrumentation to preserve distal lumbar motion segments in adolescent idiopathic scoliosis. J Spinal Disord 6:339–350
Luque E, Cardoso A (1977) Segmental correction of scoliosis with rigid internal fixation. Orthop Trans 1:136–137
Malcom-Smith NA, McMaster MJ (1991) The use of induced hypotension to control bleeding during posterior fusion for scoliosis. J Bone Joint Surg [Br] 65:255–258
Paterson DC, Cundy PJ, Hillier TM, Sutherland AD, Stephen JP, Foster BK, van Dulken TB, Dickison DM (1988) Vertebral rotation with Cotrel Dubousset spinal instrumentation. Proceedings of the fifth International Congress on Cotrel Dubousset Instrumentation. Sauramps, Montpellier, pp 33–38
Revill SI, Robinson JO, Rosen M, Hogg MIJ (1976) The reliability of a linear analogue scale for evaluating pain. Anaesthesia 31:1191
Scheier H (1972) Klinische Untersuchung bei Kreuzschmerzen. Orthopaede 1:130–137
Schlenzka D, Poussa M, Muschik M (1993) Operative treatment of adolescent idiopathic thoracic scoliosis. Harrington DTT versus Cotrel Dubousset instrumentation. Clin Orthop 297:155–160
Shufflebarger HL, Ellis RD, Clark CE (1989) Cotrel Dubousset instrumentation in adolescent idiopathic scoliosis: minimum 2-year follow up. Orthop Trans 13:79–80
Stagnara P, Fauchet R (1973) Morbus Scheuermann. Orthopaede 2:162–172
Thulbourne T, Gillespie R (1976) The rib hump in idiopathic scoliosis. Measurement, analysis and response to treatment. J Bone Joint Surg [Br] 58(1): 64–71
Transfeldt EE, Thompson JP, Bradford DS (1989) The threedimensional deformity in adolescent idiopathic scoliosis with special reference to rotation and coupling. Proceedings of the Sixth International Congress on Cotrel Dubousset Instrumentation. Sauramps, Montpellier, pp 81–88
Wood KB, Transfeldt EE, Ogilvie JW, Schendel MJ, Bradford DS (1991) Rotational changes of the vertebral pelvic axis following Cotrel Dubousset instrumentation. Spine 16:404–408
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Humke, T., Grob, D., Scheier, H. et al. Cotrel-Dubousset and Harrington Instrumentation in idiopathic scoliosis: a comparison of long-term results. Eur Spine J 4, 280–283 (1995). https://doi.org/10.1007/BF00301034
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DOI: https://doi.org/10.1007/BF00301034