The History of Cotrel-Dubousset (CD) Instrumentation

The came out because of the meeting of 2 « open minds » Yves Cotrel who had a great experience of scoliosis was looking for an instrumentation able to avoid any post-operative immobilization and Jean Dubousset, with much less experience in scoliosis surgery had remark that the scoliosis deformity was 3 dimensional and that the existing device to correct it, the Harrington instrumentation (from post) or Dwyer instrumentation (from ant) were not working to produce a 3D correction, so was looking to try to obtain a device able to correct 3D.It was why on 23 January 1983 the first case was operate on by Jean Dubousset thank to the prototype produce by the company developed by Yves Cotrel, according the principle to have instrumentation on both side of the curve with bone fixation (segmental) realized thank to hooks (pedicular and laminar) attached to 2 parallel rods, linked themselves by 2 transverse DTT system (already used and designed by Yves Cotrel to improve Harrington instrumentation stability). The surgery was done with the clever acceptation not only of the family but also from the director of the hospital St Vincent de Paul, Christain Paire.The result was ok, the patient get up 2 days after surgery without cast and brace. Every week a new case was done with improvement of new instruments, realized promptly thanks to the efficacy of the company (SOFAMOR). Around the 10th case the stiffness of the curve required bending of the rods to enter the hooks doing so, Jean Dubousset who was doing the surgery remark that moving the rods inside the hooks, the spine was moving and in one second the rotation of a present rod as a reduction maneuver was discovered.After a good experience, 8 month later the instrumentation was experimented and used with and by Michel Guillaunat for adult patients always without postoperative cast or brace.This instrumentation was a real revolution and was the begining of a wide expansion for the adult patients as well as for short instrumentation or large curves and used for any kind of pathologies, idiopathic, congenital, paralytic, traumatic, etc…In addition thanks to the genious of Yves Cotrel a large teaching program with interactive exchange between the surgeons was developed all over the world under the name of GICD (Group International CD) with yearly meetings everywhere in the world.Finally the French company created by Yves Cotrel became associate with then completely absorbed by an american one, Medtronic.With a large part of the money coming from this decision Yves Cotrel create (under the control of Institut de France) the Yves Cotrel Foundation, completely devolved to the research about the etiology of idiopathic scoliosis with 30 laboratories all around the world sponsored by the foundation with yearly meeting in Paris to control and present all the discoveries leading to better understanding and improved treatment of idiopathic scoliosis and other spinal deformities