Modification of Cotrel-Dubousset's original hook constructs for idiopathic scoliosis

Brian S. Grossman, John F Sarwark*, Richard D. Lim, Michael F Schafer, Stuart Montgomery, Vincenzo DeRosa, Kellen Choi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

We performed a retrospective review of 41 patients (ages 9-18 years) who underwent posterior spinal fusion with either Isola or Cotrel-Dubousset (CD) instrumentation to determine whether the presence of an apical hook on the thoracic convexity affected initial and long-term sagittal and coronal correction in adolescent idiopathic scoliosis surgery. A study group of 38 female and three male patients was evaluated (2-5 years of follow-up). Twenty-three patients (Group A) were treated with an up-going hook at the convex apex of the thoracic curve, and 18 patients (Group B) with, similar curves were instrumented without an apical hook. Results showed that Group A's average preoperative coronal curve of 48°decreased to 17°, whereas Group B's preoperative average of 52°decreased to 25°. At follow-up, no statistical significance was noted in either coronal curve correction (p 0.203) or sagittal kyphosis (p = 0.38) between Groups A and B. We conclude that omission of the up-going hook at the apex of the thoracic convexity can reduce postoperative discomfort in patients undergoing posterior spinal fusion, without sacrificing curve correction or balance.

Original languageEnglish (US)
Pages (from-to)500-503
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume19
Issue number4
DOIs
StatePublished - Jan 1 1999

Keywords

  • Apical convex hook placement
  • Idiopathic scoliosis
  • Posterior instrumentation
  • Posterior spinal fusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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