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 systems 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 instrumental to the more;re recent Colorado instrumentation to determine whether one system provides better three-dimensional correction. Summary of Background Data. Adequate three-dimensional correction of scoliotic deformities has been reported with the Cotrel-Dubousset instrumentation system running the past decade, a new generation of more versatile and user-friendly spinal implants has appeared, but there are no reports available to indicate whether similar or better correction can be obtained with these newer systems. Methods. The dimensional geometry of the thoracic and lumber spine was documented in the standing, position using a three-dimensional reconstruction technique 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 patients with Cotrel-Dubousset instrumentation and 36 patients with Colorado instrumentation. Results. In both groups, adequate three-dimensional correction of the scoliotic deformities was documented for thoracic and lumbar curves, with significant changes in the frontal plane in the plane of maximum curvature, and in its orientation. When comparing both groups, bet better correction was obtained in the frontal plane with the instrumentation (65% vs. 48% with Cotrel-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 comparable three-dimensional correction of the scoliotic deformities.