Harrington instrumentation in combination with Luque method versus Cotrel-Dubousset instrumentation for scoliosis correction

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Abstract

Results of surgical treatment of 60 patients with scoliosis are presented. In 36 patients Harrington instrumentation in combination with Luque method was used for deformity correction, in 24 patients Cotrel-Dubousset instrumentation was applied. In 8 patients with extremely severe rigid scoliosis the deformity correction was preceded by thoracotomy with multilevel diskectomy for spine mobilization. In frontal plane no differences was observed in obtained correction independent on the type of instrumentation. In horizontal and sagittal planes correction obtained i was more marked if Cotrel-Dubousset instrumentation was applied. In Harrington instrumentation follow up period was 1 year, in Cotrel-dubousset instrumentation follow up ranged from 3 months to 1 year. Scoliotic deformity correction by Cotrel-Dubousset instrumentation is showed to be preferable. However taking into account its high cost the use Harrington instrumentation in combination with Luque method may be recommended as alternative method only.

About the authors

S. T. Vetrila

Central Institute of Traumatology and Orthopedics. N.N. Priorov

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

A. A. Kuleshov

Central Institute of Traumatology and Orthopedics. N.N. Priorov

Email: info@eco-vector.com
Russian Federation, Moscow

V. V. Shvets

Central Institute of Traumatology and Orthopedics. N.N. Priorov

Email: info@eco-vector.com
Russian Federation, Moscow

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2. Rice. Fig. 1. Radiographs of patient N. with dysplastic right-sided thoracic scoliosis of the IV degree before surgery and after correction of the deformity with a Harrington distractor with infra-arcular fixation on the concave side and a Luquet rod with a convex side. a — direct projection: before the operation, the total angle of deformity was 100°, after the operation, the correction of the total angle was 54°; b — lateral view: the physiological curves of the spine are smoothed before and after the operation.

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3. Rice. Fig. 2. Radiographs of patient B. with dysplastic right-sided thoracic scoliosis of the III degree before surgery and after correction of the deformity by the CD system according to the standard method. a — direct projection: before the operation, the total angle of deformity was 120°, after the operation, the correction of the total angle was 38°; b — lateral projection: before the operation, the thoracic kyphosis is somewhat smoothed out, after the operation it is within the physiological norm; c — radiographs of the costal hump: after the operation, the costal hump decreased as a result of derotation.

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4. Fig. 2c

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5. Fig. 3. Radiographs of patient T., 13 years old, with dysplastic right-sided thoracic scoliosis of the IV degree before and after surgery - thoracotomy, discectomy T6-7, T7-8, T8-9, T9-10, deformity correction with three rods of the CD system with transpedicular fixation. a — direct projection: correction of the total angle of 60°, the counter-arc angle of 26° was achieved; b — lateral view: before the operation, the thoracic kyphosis was enhanced (90°), after the operation, the correction of the thoracic kyphosis was 30°, the lumbar lordosis was preserved.

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