%0 Journal Article
%T Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rate
%A Franz Mueller
%A Herbert Gluch
%J Scoliosis
%D 2012
%I BioMed Central
%R 10.1186/1748-7161-7-13
%X A total of 40 patients with AIS underwent CD instrumentation in our department within 3£¿years and between 1990 and 1992. For the retrospective analysis, first all the patient documents were reviewed, and pre-/postoperative X-ray images as well as those at the latest follow-up were analysed. Furthermore, it was attempted to conduct a clinical survey using the SRS-24 questionnaire, which was sent to the patients after a preceding announcement on the phone.Radiologically, the frontal main curvature was improved from a preoperative angle of 69.2¡ã to a postoperative angle of 35.4¡ã, and the secondary curvature was improved from a preoperative angle of 42.6¡ã to a postoperative angle of 20.5¡ã. The latest radiological follow-up at average 57.4£¿months post surgery showed an average loss of correction of 9.6¡ã (main curvature) and 4.6¡ã (secondary curvature), respectively.Within the first 30£¿days post surgery, 3 out of 40 patients (7.5%) received early operative revision for the dislocation of hooks or rods.At an average of 45.7£¿months (range 11 to 142£¿months), 19 out of 40 patients (47.5%; including 2 patients with early revision) received late operative revisions: The reasons were late infection (10 out of 40 patients; 25%) with the development of fistulae (7 cases) or putrid secretion (3 cases), which was resolved with the complete removal of instrumentation after all. The average time until revision was 35.5£¿months (range 14 to 56£¿months) after CD instrumentation. Furthermore, complete implant removal was necessary in 8 out of 40 patients (20%) for late operate site pain (LOSP). The average time until removal of instrumentation was 62.7 months (range 18 to 146£¿months) post surgery; and one patient received partial device removal for prominent instrumentation 11£¿months post surgery. Altogether, only 22 out of 40 CD instrumentations (55%) were still in situ.After an average period of 14.3 years post surgery, it was possible to follow-up 14 out of 40 patients (35%) using the SR
%K Adolescent idiopathic scoliosis
%K Surgery
%K Outcome
%U http://www.scoliosisjournal.com/content/7/1/13/abstract