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

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 to 19, 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.