Cotrel-Dubousset instrumentation technique for revision of failed lumbosacral fusion.

Failed lumbosacral fusion represents a major problem for the orthopaedic surgeon. The authors report on a clinical study in which 18 patients, all previously operated on and still symptomatic, were revised using Cotrel Dubousset instrumentation to achieve rigid fixation and to correct deformities at the lumbosacral junction. In short-term follow-up, there have been no failures of hardware and the patients' clinical symptoms have improved. The surgical procedure is described, the biomechanical rationale of lumbosacral instability is analyzed, and a method of restoring physiologically normal frontal and saggital curvatures is offered.