Comparison of Harrington Rod and Cotrel-Dubousset Devices in Surgical Correction of Adolescent Idiopathic Scoliosis

Background: Since the time of Paul Harrington numerous implants have been introduced for correction of scoliosis, but none are ideal. Newer devices are very expensive, and in our country some patients cannot afford them. Objectives: The aim of this study was to compare the results of the Harrington rod (HR) device and the newer Cotrel-Dubousset (CD) device in treatment of adolescent idiopathic scoliosis (AIS). Materials and Methods: A retrospective review assessed patients with AIS admitted for spinal curve correction treated with HR (n = ۱۲۰) and CD devices (n = ۱۳۸) between October ۱۹۸۸ to April ۲۰۰۱ at the Shafa Yahyaeian Hospital, Tehran, Iran. We extracted information from the patient’s file and radiographs before, after and two years post-operation. Results: The mean age of patients was ۱۶.۷ ± ۲.۵ years. There was no statistically significant difference between the two groups regarding gender, age, curve before surgery, and percentage of flexibility. The mean curvature was ۷۰ ± ۲۰.۷ in the HR and ۶۴.۸۱ ± ۱۹.۴ in the CD group before surgery (P = ۰.۰۹); and the mean curvature was ۴۰ ± ۱۶.۳ and ۲۶.۵۸ ± ۱۵.۳۷ in HR and CD groups respectively after surgery (P = ۰.۱۵۶). The mean curvature was ۴۷.۲ ± ۱۵.۹ in HR and ۳۱.۲ ± ۱۵.۴ in CD groups at two years follow-up (P = ۰.۱۵۶). Conclusions: Results of many studies have shown no significant impairment in long-term quality of life and function in patients treated with Harrington rods. According to previously performed studies and the current study, surgical correction with Harrington rods seem to be comparable with the newer more expensive CD device. Although there is no doubt that the preference is to use newer devices in view of some disadvantages of HR, but this does not preclude using it for patients that cannot afford the newer devices.