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The CAB hook

CAB hook is a new auxiliary implant for use in posterior approach scoliosis surgery.

The CAB implants are simple in structure. They are made in two main forms, symmetrical and asymmetrical, in various sizes. They are “horseshoe” shaped, and both of their hooked ends are designed in such a way that they circle around the basis of the transverse processes and are fixed in the costo-transverse space. The two rods are connected onto the CAB hook by means of two screw fastened latches.

The patients are operated through the usual posterior approach in prone position on a spine surgical table (3). The use of an image intensifier is not necessary for the proper placement of the hooks. There are only a few implant specific instruments required for proper placement and adjustment of the hooks (Figure 2.)

Since 2007 we operated 42 patients with the CAB hook with an average preoperative Cobb angle of 59.3° (28° - 92°). In 3 cases the posterior approach was preceded by ventral release and Halo traction. In 4 cases besides the CAB hooks, SCS hooks and pedicular screws, in 3 cases both CAB and SCS hooks, in 9 cases CAB hooks with SCS pedicular screws, and in 23 cases only CAB were used. The average follow-up time was 21.6 month (2-51).

The three side versions of CAB hook The three side versions of CAB hook

The size and side options for the CAB hook The size and side options for the CAB hook

Results: All of the patients are satisfied with the results. No reoperation was needed due to loss of correction, pain, implant failure, or infection. The average postoperative Cobb angle decreased to 24.7° (4°- 60°). Based on this we calculated the Cincinnati Correction Index (CCI) which was 1.53 (0.70-4.8) which means that our correction exceeded the flexibility of the spine based on the lateral bending X-ray by 53%.

A 14 year-old girl’ s pre- and postoperative X-rays A 14 year-old girl’ s pre- and postoperative X-rays

Conclusion: As with all new surgical techniques and implants after the short learning curve we were able to improve the degree of correction and decrease the time of surgery. One of the advantages of the CAB hook is that besides a few implant specific instruments, no special instrumentation is required for insertion and image intensifier does not need to be used.

Csernátony Z, Kiss L, Manó S, Hunya Zs. Our experience and early results with a complementary implant for the correction of major thoracic curves. European Spine Journal. DOI: 10.1007/s00586-013-2698-4.

General information

Parent department:
Department of Orthopaedic Surgery, University of Debrecen

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