Société Française de Chirurgie du Rachis – Congrès 2019

Hommage du Dr Jean-Paul Steib, lu à l’occasion du Congrès 2019 à Strasbourg

Monsieur Cotrel (27/04/25 – 29/01/19) est mort en janvier, discrètement. Dans sa 94° année.
Ce chirurgien a révolutionné la chirurgie de la scoliose et de là, celle du rachis.
Breton, il quitte Dinan en 1943, pour faire sa médecine à Paris. Il se destine à l’obstétrique.
En 1948 on lui demande d’effectuer un remplacement d’un mois à l’institut Calot menacé de fermeture (déjà) s’il n’y a pas un médecin résident. Il y arrive le 6 octobre. Il y restera 30 ans. Il y rencontra son épouse Marie Lou qui lui donna 8 enfants.

Il apprit vite l’orthopédie sous la houlette de Jean Cauchoix, délégué par Paris à Berck, un jour et demi par semaine. La première greffe pour scoliose fut réalisée en 1953. Le patient était opéré dans son plâtre réducteur qu’il gardait 15 mois, couché.
En 1958 Yves Cotrel bénéficia de la bourse Eisendrath qui lui permit de rendre visite aux grands noms de la chirurgie rachidienne américaine.

En 6 mois, il visita John Cobb, Joseph Risser, Paul Harrington, Ignacio Ponseti, John Moe et Walter Blount.
Il deviendra membre de la SRS dès sa création en 1966.

De retour à Berck il met en pratique les idées qui avaient germé lors de son voyage et met au point le plâtre EDF (Elongation, Dérotation, Flexion) qu’il réalise sur le cadre qui portera son nom.
En 1964 il opère le premier patient hors du plâtre en traction sur sa table avec un greffon encastré qui tient la réduction.
Il met au point la traction vertébrale dynamique actionnée par la force des jambes du patient puis le distracteur dynamométrique.
Il a vite utilisé la technique de Harrington introduite en France par Claude-Régis Michel. Il la perfectionne en inventant le DTT et le crochet pédiculaire.
En 1968 en rentrant de la SRS, il fonde avec Christian Salanova le GES : Groupe d’étude de la Scoliose. La première réunion eut lieu à Berk en 1969 avec pour président Pierre Stagnara.
Le GES aurait eu 50 ans cette année !

L’institut Calot devient un grand centre de chirurgie de la scoliose avec plus de 200 scoliotiques hospitalisés. De nombreux chirurgiens du monde entier viennent le visiter.
Les idées d’Yves Cotrel sont mises en forme par l’atelier de monsieur Belembert qui réparait les gouttières, rue Rothschild.
Il sortira de cet atelier le cadre de correction des scolioses, la table spéciale pour chirurgie du rachis, les divers dispositifs de traction vertébrale, les crochets dont le crochet pédiculaire, le DTT et les divers instruments de chirurgie (rugines, gouges…).
En 1973 l’atelier devient Sofamor (SOciété de FAbrication de Matériel ORthopédique avec Raoul Lanoy son ouvrier serrurier de génie. Les employés de l’usine disaient en parlant de lui : « le docteur ».

Cette société deviendra en 1993 Sofamor-Danek pour entrer à la fin du siècle dans le portefeuille de Medtronic.

En 1974 il ouvre une consultation à Paris au centre Saint Vincent.
En octobre 1975, fatigué, il profite de sa consultation à Paris pour subir un ECG d’effort à Tenon. Alors qu’il pédale fort, il fait une série de trois arrêts cardiaques réanimés difficilement.
Il racontera par la suite son expérience de mort imminente (near death experience).
On lui met en place un pacemaker atomique (plutonium).

Cet épisode met fin, à 50 ans, à sa carrière de chirurgien.

Il est remplacé à Calot par Daniel Chopin. Il se retire en Bretagne dans sa maison de Kerrozen. Il s’ennuie et « regarde pousser les salades ». Il découvre les dossiers de ses opérés et s’interroge sur la correction des scolioses et sur l’immobilisation postopératoire, longue, de ces opérés.

Il s’inspire des travaux de Harrington et de Luque et dessine des prototypes que lui réalise Sofamor.
Il va ainsi mettre au point une tige sans point faible et des crochets ouverts permettant une prise multi-segmentaire du rachis.

Le 15 décembre 1982, il présente son instrumenttion à Jean Dubousset et, le 21 janvier 1983, ils opèrent ensemble une scoliose sur maladie de Friedreich. Ils obtiennent une réduction incroyable et le patient se lève rapidement, sans aucune contention externe.
En septembre 1983 Michel Guillaumat opère le premier adulte.
Le CD était né, avec en prime, la rotation de la tige.

En janvier 1985 j’ai eu l’honneur d’opérer à Strasbourg, mes premiers CD assisté par le maître. En septembre 85 Raymond Roy-Camille effectuait avec Christian Mazel le premier CD avec vis pédiculaires. En 1987 Claude Argenson était le premier à utiliser le CD dans les fractures. La vis bouchon est née en 1989 ce qui lui a valu de nombreux procès aux Etats Unis où la vis pédiculaire a été interdite jusqu’au 27 juillet 1998.
Le Groupe Internationnal Cotrel Dubousset (GICD) est créé en mai 86 pour permettre l’enseignement et la diffusion internationnale de la technique.

Les chirurgiens français (CD surgeons) partaient à la conquête du monde en enseignant la technique. Les plus grands noms de la chirurgie rachidienne sont venus en France ou aux cours organisés dans leur pays pour apprendre. C’est ce que nous avons appelé l’aventure du CD.

Yves Cotrel, vers 1984

Malgré de nouveaux problèmes de santé il crée, à l’Institut de France, la Fondation Yves Cotrel pour la recherche en pathologie rachidienne qui a initié et financé de nombreux travaux sur l’origine de la scoliose.
Nous avions fêté avec lui les 20 ans du CD au GES de Strasbourg en 2003 et les 25 ans du CD à Paris en 2008 dans une grande réunion où nous discutions des cas avec la technique du début et la technique de l’époque. Marie-Lou est partie fin 2011. Il a doucement décliné sans elle qui l’avait toujours soutenu, pour s’éteindre le 29 janvier de cette année.
Son enterrement à Dinan rassemblait un grand nombre de ses anciens opérés qui n’étaient plus des enfants. Les bancs étaient remplis de dizaines et de dizaines de tiges de Harrington bien alignées.

Monsieur Cotrel était un grand homme :
A l’international où ses idées ont été acceptées. Le monde entier opère les rachis selon ses principes.
Au niveau national, il a été le chef d’école et d’industrie qui a fait rayonner la France
A mon humble niveau, il a été un père chirurgical à l’origine de toute ma carrière.
Des millions d’hommes et de femmes vont bien grâce à lui.
Merci Monsieur. Reposez en paix, le chemin est tracé.

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  1. Je suis une enfant de la guerre et de plus en pension chez des religieuses nous étions très mal nourries … aprés une fracture du col du fémur et déviation de la colonne vertébrale j’ai été hospitalisée à l’institut CALOT de BERCK pendant plus de 3 ans et j’ai connu les plâtres A’Boot etc ….. Mariée , 4 enfants , en 1988 j’ai dû à nouveau retourner à l’institut CALOT pour une arthrodèse complète de la colonne vertébrale , opérée par le formidable et merveilleux docteur et chirurgien DANIEL CHOPIN . Grace à ces deux chirurgiens j’ai pu continuer une vie normale et être encore chez moi , sans eux , celà n’aurait pas été possible …
    Merci à vous , je fais partie de ces millions d’hommes et de femmes qui vont bien grâce à vous .
    ps: j’étais à l,institut CALOT au temps du mariage du DOCTEUR COTREL et je me souviens encore de ce jour ….

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