Prevalence of Segmental Wire Breakage Using Cotrel-Dubousset Instrumentation in the Management of Idiopathic Scoliosis

STUDY DESIGN: This is a retrospective radiographic and medical record analysis of 77 patients. OBJECTIVES: To determine whether there is an increased prevalence of segmental sublaminar wire breakage associated with the knurled (diamond) pattern machined onto the Cotrel-Dubousset rod as opposed to a smooth rod. SUMMARY OF BACKGROUND DATA: Segmental fixation of vertebral segments with sublaminar wires is a common surgical technique, and the use of sublaminar wires with a knurled Cotrel-Dubousset rod theoretically could cause premature wire breakage. METHODS: Sixty-six patients with idiopathic scoliosis had the Cotrel-Dubousset (knurled rod) system and comprised the study group, and the Texas Scottish Rite Hospital system (smooth rod) was placed in 14 patients, who served as a control group. Serial radiographs after 3, 6, 12, and 24 months were reviewed. All patients had augmentation of their scoliosis constructs with 16-gauge sublaminar wires in the lumbar spine. Minimum follow-up period was 24 months. RESULTS: No wire breakage was noted in any patient. CONCLUSIONS: There is no increased likelihood that the knurled rod pattern will cause wire breakage, provided a solid fusion is obtained.