Cotrel-Dubousset instrumentation for the treatment of thoracolumbar fractures.

Abstract

Cotrel-Dubousset instrumentation (CDI) was introduced in 1984 primarily for the treatment of scoliosis. The applications of this unique and versatile system have expanded to other diseases of the spine. Thoracolumbar fractures are a common management problem for which the device seems to be well suited. We review our results of 15 patients with unstable thoracolumbar fractures treated with CDI at an average of 24 months' follow-up. The results are promising and compare favorably with other forms of surgical and medical management. Postoperatively, there was a loss of 2 degrees in the angle of deformity and 0.9 mm of vertebral body displacement. Incomplete neurological injuries improved one or more Frankel grades in 75% of our patients. There were three complications (20%). CDI offers theoretical advantages over Harrington instrumentation and conservative (nonoperative) management. The use of CDI in the treatment of unstable thoracolumbar fractures is endorsed by these results.