In 30 adolescent patients with 36 structural curves undergoing posterior spinal arthrodesis using Cotrel-Dubousset (CD) Instrumentation, computer tomography (CT) was performed to evaluate the change in rotation and in the sagittal plane. The average preoperative Cobb angle was 51.7deg;, and improved to 18.7deg; postoperatively, or 64.9percnt;. The angle of rotation of the apical vertebra relative to the anterior midline of the body (RAML) improved from 27.9deg; preoperatively to 21.5deg; postoperatively (23.9percnt;). The angle of rotation relative to the sagittal plane (RAsag) improved from 15.2deg; preoperatively to 13.4deg; postoperatively (14.3percnt;). The kyphotic angle increased an average of 10.6deg; In the 14 patients whose preoperative angle was less than 25deg;. As measured by CT, CD instrumentation improves both the rotational and sagittal plane deformities better than that reported for other systems.
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