CD surgery

The CD system was developed by French physician Cotrel and engineer Dubousset in 1987. The system consists of two metal rods with rough surfaces of gems, which are fixed to the two sides of the lamina by a plurality of hooks and are laterally pulled by two transverse traction devices. Pull a powerful fixture that makes up a rectangle. The operation uses the side curved concave side to open, the convex side pressure, the lateral pulling and derotating force acts on the top of the side curvature, and the joint correction force is corrected to correct the deformity. Since only the key vertebral body needs to be fixed, the peeling is small and the damage is small. And correcting deformities is powerful and reliable. Treating diseases: scoliosis Indication In addition to use for idiopathic scoliosis, CD surgery can also be used for spinal fractures, spinal vertebral spondylolisthesis and other operations. Preoperative preparation According to the X-ray film of the patient's hanging position, the distance between the upper and lower ends of the intervertebral space should be measured to select a suitable length of metal rod, and the metal rod can be pre-bent according to the angle of the surgery under the traction correction angle, and the thoracic kyphosis should be considered. The angle of the lumbar lordosis should be adjusted during the operation. Surgical procedure Incision and exposure According to the fusion segment determined before surgery, a midline incision is made between the upper and lower fusion vertebrae. If the scoliosis is severe, a curved incision to the convex side can be made a little, and the arcuate incision should not be made along the spinous process or the arcuate incision to avoid orthopedics. After the impact of beauty. Cut the skin and subcutaneous superficial fascia along the incision line, and make a proper blunt dissection on the convex side to reveal the spinous process tip. Cut along the superior ligament of the spine, revealing to the spinous process, and separating the concave side of the spine. Using the Cobb stripper with the spinous process as the fulcrum, the paraspinal tissue was pushed out to the outside of the spinous process and the lamina bone until the articular process, and the hemorrhage was filled with gauze while peeling, and the adjacent lamina was separated and revealed. The thoracic vertebrae were exposed to both sides of the transverse process, and the convex and concave sides were extensively loosened. The transverse intersegmental ligaments and muscles were removed, and the thoracolumbar spine was subjected to arthrotomy. 2. Placement of metal hooks 1 pedicle hook placement: the articular cartilage surface is scraped off at the lower edge of the articular process at the upper end of the concave side. After the depth of the pedicle probe is tested, the closed pedicle hook is placed, and the open vertebral body on the middle vertebral body is placed in the same way. Bow root and convex side upper end closure and a convex side top vertebral pedicle opening hook; 2 placement of thoracic vertebral lamina hook: concave side lower intermediate hook placed on the upper edge of the vertebral body with an open hook; 3 placed lumbar plate hook: The concave side hook is placed on the upper edge of the lower end of the vertebral body, the ligamentum flavum is not removed, and the ligamentum flavum is peeled off only by the laminectomy. 3. Bone graft Same as memory alloy rod spinal orthopedics. 4. Place the metal rod First put the concave side metal rod, put two opposite hooks on the metal rod, first put the rod into the upper end vertebral pedicle hook hole, then down to the lower end vertebral lamina hook hole, and finally put the opening hook Inside, and fixed with a hook. 5. Correcting lateral deformity After confirming that the hook and the rod are properly placed, use Harrington to open the forceps to pressurize the upper and lower vertebrae while correcting the rotational deformity to restore the thoracic kyphosis and lumbar lordosis. 6. convex side metal rod placement The placement method is the same as the concave side, and when the concave side is stretched orthopedic, the convex side is simultaneously pressurized. 7. Lateral traction device fixation Place 2 or 3 transverse traction devices under and above the upper and lower vertebra hooks, grasp the metal rod, and tighten the nut to fix the two metal rods together.