Idiopathic scoliosis treated with Cotrel-Dubousset instrumentation: evaluation 10 years after surgery

Abstract

Study design: Prospective cohort study with 10-year follow-up.

Objective: To evaluate long-term results after operative treatment with Cotrel-Dubousset (CD) instrumentation for adolescent idiopathic scoliosis (AIS).

Summary of background data: Limited knowledge exists in the evaluation of long-term function with quality of life measures after CD instrumentation in patients with AIS.

Methods: A total of 100 (76 females and 24 males) consecutive AIS patients all with single primary curves were included. Radiologic measures and pain were registered at baseline and at 1- to 5-year follow-up. Quality of life and back specific measures, including EuroQol (EQ) and Oswestry Disability Index (ODI), were obtained by a questionnaire mailed to the patients at 10 years after surgery.

Results: Mean age at operation was 16.8 (SD, 5.3) years, mean Risser sign was Grade 3.2 (SD, 1.5). All patients were observed for 2 years. The average primary curve was reduced from 56 degrees to 19 degrees, and this correction was maintained during follow-up. Fourteen patients had minor complications, and 5 patients had implants removed because of late clinically suspected infections. A total of 86 patients answered the 10-year questionnaire; 97% of the patients considered back function as excellent, good, or fair, and 96% would have done the operation again. Scores for EQ-5D and ODI were slightly worse than in the normal population. Despite this observation, 45% of the patients reported to have consulted a physician or received physiotherapy for back pain during the last year before the 10-year follow-up.

Conclusion: Radiologic results, patient satisfaction, and mean scores for quality of life and back function were excellent after CD instrumentation for AIS, but a considerable number of patients had treatment for back problems.