Andre, Emilie; Courtivron, Benoit De; Bergerault, François; Abelin-Genevois, Kariman; Odent, Thierry
In: Eur Spine J, vol. 32, no. 7, pp. 2574–2579, 2023, ISSN: 1432-0932.
@article{pmid37173531,
title = {Influence of the thoracolumbar junction flexibility on the risk of adding-on after posterior vertebral arthrodesis for thoracic idiopathic adolescent scoliosis},
author = {Emilie Andre and Benoit De Courtivron and François Bergerault and Kariman Abelin-Genevois and Thierry Odent},
doi = {10.1007/s00586-023-07763-9},
issn = {1432-0932},
year = {2023},
date = {2023-07-01},
journal = {Eur Spine J},
volume = {32},
number = {7},
pages = {2574--2579},
abstract = {PURPOSE: The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra.nnMETHODS: We included 105 thoracic AIS patients who had a posterior spinal fusion with a 2 years minimum follow-up. Thoracolumbar junction flexibility was assessed on dynamic sagittal X-rays and compared to the standing position. Adding-on was defined according to radiographic Wang criteria. The junction was considered flexible if the variability from the static position to flexion and/or extension was greater than 10°.nnRESULTS: Mean age of the patients was 14 ± 2 years. The preoperative mean Cobb angle was 61 ± 12.7° and 27.5 ± 7.7° after surgery. Mean follow-up was 3.1 years. Twenty-nine patients (28%) developed an adding-on. Thoracolumbar junction range of motion was higher (p = 0.017) with higher flexibility in flexion (p < 0.001) in the no adding-on group. In no adding-on group, 53 patients (70%) had a flexible thoracolumbar junction, and 23 patients (30%) had a stiff thoracolumbar junction in flexion and flexible in extension. In adding-on group, 27 patients (93%) had a stiff thoracolumbar junction, and 2 patients (7%) had a flexible junction in flexion and stiff in extension.nnCONCLUSION: The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra.nnMETHODS: We included 105 thoracic AIS patients who had a posterior spinal fusion with a 2 years minimum follow-up. Thoracolumbar junction flexibility was assessed on dynamic sagittal X-rays and compared to the standing position. Adding-on was defined according to radiographic Wang criteria. The junction was considered flexible if the variability from the static position to flexion and/or extension was greater than 10°.nnRESULTS: Mean age of the patients was 14 ± 2 years. The preoperative mean Cobb angle was 61 ± 12.7° and 27.5 ± 7.7° after surgery. Mean follow-up was 3.1 years. Twenty-nine patients (28%) developed an adding-on. Thoracolumbar junction range of motion was higher (p = 0.017) with higher flexibility in flexion (p < 0.001) in the no adding-on group. In no adding-on group, 53 patients (70%) had a flexible thoracolumbar junction, and 23 patients (30%) had a stiff thoracolumbar junction in flexion and flexible in extension. In adding-on group, 27 patients (93%) had a stiff thoracolumbar junction, and 2 patients (7%) had a flexible junction in flexion and stiff in extension.nnCONCLUSION: The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.
Brochard, Charlène; Jezequel, Magali; Blanchard-Dauphin, Anne; Kerdraon, Jacques; Perrouin-Verbe, Brigitte; Leroi, Anne-Marie; Reymann, Jean Michel; Peyronnet, Benoît; Morçet, Jeff; Siproudhis, Laurent
In: Colorectal Dis, vol. 25, no. 6, pp. 1267–1276, 2023, ISSN: 1463-1318.
@article{pmid36799340,
title = {Transanal irrigation is a better choice for bowel dysfunction in adults with Spina bifida: A randomised controlled trial},
author = {Charlène Brochard and Magali Jezequel and Anne Blanchard-Dauphin and Jacques Kerdraon and Brigitte Perrouin-Verbe and Anne-Marie Leroi and Jean Michel Reymann and Benoît Peyronnet and Jeff Morçet and Laurent Siproudhis},
doi = {10.1111/codi.16518},
issn = {1463-1318},
year = {2023},
date = {2023-06-01},
journal = {Colorectal Dis},
volume = {25},
number = {6},
pages = {1267--1276},
abstract = {AIM: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.nnMETHODS: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.nnRESULTS: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.nnCONCLUSIONS: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIM: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.nnMETHODS: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.nnRESULTS: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.nnCONCLUSIONS: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.
Risk factors for upper urinary tract deterioration in adult patients with spina bifida
Haudebert, Camille; Hascoet, Juliette; Samson, Emmanuelle; Jezequel, Magali; Voiry, Caroline; Brochard, Charlène; Richard, Claire; Kerdraon, Jacques; Siproudhis, Laurent; Manunta, Andréa; Peyronnet, Benoit
In: World J Urol, vol. 41, no. 4, pp. 1187–1192, 2023, ISSN: 1433-8726.
@article{pmid36808530,
title = {Risk factors for upper urinary tract deterioration in adult patients with spina bifida},
author = {Camille Haudebert and Juliette Hascoet and Emmanuelle Samson and Magali Jezequel and Caroline Voiry and Charlène Brochard and Claire Richard and Jacques Kerdraon and Laurent Siproudhis and Andréa Manunta and Benoit Peyronnet},
doi = {10.1007/s00345-023-04314-1},
issn = {1433-8726},
year = {2023},
date = {2023-04-01},
journal = {World J Urol},
volume = {41},
number = {4},
pages = {1187--1192},
abstract = {PURPOSE: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages.nnMETHODS: A large single-center restrospective study was conducted in our national referral center for spina bifida patients using our patients' files. All urodynamics curves were assessed by the same examinator. Functional and/or morphological evaluation of the upper urinary tract were done at the same moment as the urodynamic exam (between 1 week before and 1 month after). Kidney function was assessed using creatinine serum levels or 24 h urinary creatinine levels (creatinine clearance) for walking patients, or with the 24 h urinary creatinine level for wheelchair-users.nnRESULTS: We included 262 spina bifida patients in this study. Fifty-five patients had a poor bladder compliance (21.4%) and 88 of them had detrusor overactivity (33.6%). Twenty patients had a stage 2 kidney failure (eGFR < 60 ml/min) and 81 patients out of 254 (30.9%) had an abnormal morphological examination. There were three urodynamic findings significantly associated with UUTD: bladder compliance (OR = 0.18; p = 0.007), Pdetmax (OR = 14.7; p = 0.003) and detrusor overactivity (OR = 1.84; p = 0.03).nnCONCLUSION: In this large series of spina bifida patients, maximum detrusor pressure and bladder compliance are the main urodynamic findings determinants of UUTD risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages.nnMETHODS: A large single-center restrospective study was conducted in our national referral center for spina bifida patients using our patients’ files. All urodynamics curves were assessed by the same examinator. Functional and/or morphological evaluation of the upper urinary tract were done at the same moment as the urodynamic exam (between 1 week before and 1 month after). Kidney function was assessed using creatinine serum levels or 24 h urinary creatinine levels (creatinine clearance) for walking patients, or with the 24 h urinary creatinine level for wheelchair-users.nnRESULTS: We included 262 spina bifida patients in this study. Fifty-five patients had a poor bladder compliance (21.4%) and 88 of them had detrusor overactivity (33.6%). Twenty patients had a stage 2 kidney failure (eGFR < 60 ml/min) and 81 patients out of 254 (30.9%) had an abnormal morphological examination. There were three urodynamic findings significantly associated with UUTD: bladder compliance (OR = 0.18; p = 0.007), Pdetmax (OR = 14.7; p = 0.003) and detrusor overactivity (OR = 1.84; p = 0.03).nnCONCLUSION: In this large series of spina bifida patients, maximum detrusor pressure and bladder compliance are the main urodynamic findings determinants of UUTD risk.
Goudelocke, Colin; Xavier, Keith; Pecha, Barry; Burgess, Kimberly; Perrouin-Verbe, Marie-A; Krlin, Ryan; Michaels, Jodi; Shah, Sagar; Peyronnet, Benoît; Zaslau, Stanley; Champs, Mylène; Papi, Bianca; Bittner, Katie; Elterman, Dean; Nitti, Victor
In: Neurourol Urodyn, vol. 42, no. 4, pp. 761–769, 2023, ISSN: 1520-6777.
@article{pmid36917003,
title = {Evaluation of clinical performance and safety for the rechargeable InterStim Micro device in overactive bladder subjects: 6-month results from the global postmarket ELITE study},
author = {Colin Goudelocke and Keith Xavier and Barry Pecha and Kimberly Burgess and Marie-A Perrouin-Verbe and Ryan Krlin and Jodi Michaels and Sagar Shah and Benoît Peyronnet and Stanley Zaslau and Mylène Champs and Bianca Papi and Katie Bittner and Dean Elterman and Victor Nitti},
doi = {10.1002/nau.25171},
issn = {1520-6777},
year = {2023},
date = {2023-04-01},
journal = {Neurourol Urodyn},
volume = {42},
number = {4},
pages = {761--769},
abstract = {AIMS: Sacral neuromodulation (SNM) is an advanced therapy option for the treatment of overactive bladder (OAB), nonobstructive urinary retention, and fecal incontinence. The aim of this ongoing prospective, multicenter, global, postmarket study is to confirm safety and clinical performance of the InterStim Micro system for SNM in all indications. Reported here are the results for the OAB cohort through 6-month follow-up.nnMETHODS: Eligible OAB subjects that had a successful therapy evaluation were enrolled after implant of an InterStim Micro implantable pulse generator (IPG). Subjects completed voiding diaries and the Overactive Bladder Quality of Life questionnaire (OAB-q) at baseline and follow-up visits occurring at 3 months and 6 months postimplant. Safety was evaluated as device-, procedure-, or therapy-related adverse events. The primary objective for the OAB cohort was to demonstrate an improvement in OAB-q Health Related Quality of Life (HRQL) total score at 3 months postimplant compared to baseline.nnRESULTS: Sixty-eight OAB subjects were enrolled and implanted with an InterStim Micro IPG. Of those, 67 and 66 subjects completed the 3- and 6-month follow-up visits, respectively. The OAB-q HRQL demonstrated a statistically significant improvement from baseline to 3-month follow-up with an average increase of 33 ± 24 points (n = 67, p < 0.001). The change was also observed at 6-months with an average increase of 31 ± 23 points (n = 65) compared to baseline. Eighty-two percent of subjects achieved the minimally important difference in HRQL score at 3- and 6-month, respectively, with a change of 10 points or greater. The majority of subjects reported that their bladder condition was better at 3-month (92.5%, 62/67) and 6-month (89%, 59/66) compared to before they were treated with SNM therapy delivered by the InterStim Micro system. For subjects with urgency urinary incontinence (UUI), the average change from baseline to follow-up in UUI episodes/day was -3.6 (95% CI: -4.7, -2.6; n = 62) at 3-month and -3.7 (95% CI: -4.7, -2.7; n = 61) at 6-month. Among subjects with urgency-frequency (UF), the average change from baseline to follow up in voids/day was -4.5 (95% CI: -6.3, -2.7; n = 52) at 3-months and -4.4 (95% CI: -6.0, -2.7; n = 52) at 6-month. The cumulative incidence of device-, procedure-, or therapy- related adverse events was 7.4% (5/68). Out of these five related adverse events, there was one serious adverse event (1.5%, implant site pain) at the time of database snapshot.nnCONCLUSIONS: These data confirm the safety and clinical performance of the InterStim Micro device for subjects with OAB by demonstrating a significant improvement in OAB-q HRQL score at 3-month. Similar improvements were observed at 6 months in addition to an incidence of adverse events that is comparable to previously reported rates for SNM.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIMS: Sacral neuromodulation (SNM) is an advanced therapy option for the treatment of overactive bladder (OAB), nonobstructive urinary retention, and fecal incontinence. The aim of this ongoing prospective, multicenter, global, postmarket study is to confirm safety and clinical performance of the InterStim Micro system for SNM in all indications. Reported here are the results for the OAB cohort through 6-month follow-up.nnMETHODS: Eligible OAB subjects that had a successful therapy evaluation were enrolled after implant of an InterStim Micro implantable pulse generator (IPG). Subjects completed voiding diaries and the Overactive Bladder Quality of Life questionnaire (OAB-q) at baseline and follow-up visits occurring at 3 months and 6 months postimplant. Safety was evaluated as device-, procedure-, or therapy-related adverse events. The primary objective for the OAB cohort was to demonstrate an improvement in OAB-q Health Related Quality of Life (HRQL) total score at 3 months postimplant compared to baseline.nnRESULTS: Sixty-eight OAB subjects were enrolled and implanted with an InterStim Micro IPG. Of those, 67 and 66 subjects completed the 3- and 6-month follow-up visits, respectively. The OAB-q HRQL demonstrated a statistically significant improvement from baseline to 3-month follow-up with an average increase of 33 ± 24 points (n = 67, p < 0.001). The change was also observed at 6-months with an average increase of 31 ± 23 points (n = 65) compared to baseline. Eighty-two percent of subjects achieved the minimally important difference in HRQL score at 3- and 6-month, respectively, with a change of 10 points or greater. The majority of subjects reported that their bladder condition was better at 3-month (92.5%, 62/67) and 6-month (89%, 59/66) compared to before they were treated with SNM therapy delivered by the InterStim Micro system. For subjects with urgency urinary incontinence (UUI), the average change from baseline to follow-up in UUI episodes/day was -3.6 (95% CI: -4.7, -2.6; n = 62) at 3-month and -3.7 (95% CI: -4.7, -2.7; n = 61) at 6-month. Among subjects with urgency-frequency (UF), the average change from baseline to follow up in voids/day was -4.5 (95% CI: -6.3, -2.7; n = 52) at 3-months and -4.4 (95% CI: -6.0, -2.7; n = 52) at 6-month. The cumulative incidence of device-, procedure-, or therapy- related adverse events was 7.4% (5/68). Out of these five related adverse events, there was one serious adverse event (1.5%, implant site pain) at the time of database snapshot.nnCONCLUSIONS: These data confirm the safety and clinical performance of the InterStim Micro device for subjects with OAB by demonstrating a significant improvement in OAB-q HRQL score at 3-month. Similar improvements were observed at 6 months in addition to an incidence of adverse events that is comparable to previously reported rates for SNM.
[The French National Committee on Obstetrical and Fetal Ultrasound guidelines 2022 (CNEOF)]
2023, ISSN: 2468-7189.
@misc{pmid36649816,
title = {[The French National Committee on Obstetrical and Fetal Ultrasound guidelines 2022 (CNEOF)]},
author = { },
doi = {10.1016/j.gofs.2023.01.006},
issn = {2468-7189},
year = {2023},
date = {2023-04-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {51},
number = {4},
pages = {221--226},
abstract = {The 2022 CNEOF guidelines (Conférence nationale d'échographie obstétricale et fœtale) report has been recently issued. It presents the necessary evolutions for the years to come, in a philosophy of optimal security for patients and caregivers, through a homogenization of ultrasound screening practices. As a source of changes in practices, this new version raises concerns, and even reticence, which must be heard and addressed, by reminding that this report is not fixed and can be adapted to the realities of practice over time and their feedback. This short text presents the CNEOF, the novelties of the 2022 report and details some important parts of the report that have been a source of questioning in the month following its publication. The aim of this text is to present a summary (in addition to the full report) to reassure, through education, all the parties involved in this medical practice which is so exciting and of major importance for perinatal health. Thus, the types of ultrasound examinations (screening, diagnostic, expertise…), the conditions of their realization, dating, biometries and the items part of the ultrasound reports are presented with elements of precision useful for their implementation.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
The 2022 CNEOF guidelines (Conférence nationale d’échographie obstétricale et fœtale) report has been recently issued. It presents the necessary evolutions for the years to come, in a philosophy of optimal security for patients and caregivers, through a homogenization of ultrasound screening practices. As a source of changes in practices, this new version raises concerns, and even reticence, which must be heard and addressed, by reminding that this report is not fixed and can be adapted to the realities of practice over time and their feedback. This short text presents the CNEOF, the novelties of the 2022 report and details some important parts of the report that have been a source of questioning in the month following its publication. The aim of this text is to present a summary (in addition to the full report) to reassure, through education, all the parties involved in this medical practice which is so exciting and of major importance for perinatal health. Thus, the types of ultrasound examinations (screening, diagnostic, expertise…), the conditions of their realization, dating, biometries and the items part of the ultrasound reports are presented with elements of precision useful for their implementation.
Cacioppo, Marine; Menard, Hélène; Philiponnet, Camille Olivari; Pabic, Estelle Le; Brochard, Charlène; Peyronnet, Benoit; Violas, Philippe; Riffaud, Laurent; Bonan, Isabelle
In: Ann Phys Rehabil Med, vol. 66, no. 2, pp. 101685, 2023, ISSN: 1877-0665.
@article{pmid35717001,
title = {Prevalence and risk factors for scoliosis in adults with closed and open spina bifida: A large, cross-sectional study},
author = {Marine Cacioppo and Hélène Menard and Camille Olivari Philiponnet and Estelle Le Pabic and Charlène Brochard and Benoit Peyronnet and Philippe Violas and Laurent Riffaud and Isabelle Bonan},
doi = {10.1016/j.rehab.2022.101685},
issn = {1877-0665},
year = {2023},
date = {2023-03-01},
journal = {Ann Phys Rehabil Med},
volume = {66},
number = {2},
pages = {101685},
abstract = {BACKGROUND: Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB).nnOBJECTIVES: The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB.nnMETHODS: This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors.nnRESULTS: In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively).nnCONCLUSION: About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB).nnOBJECTIVES: The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB.nnMETHODS: This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors.nnRESULTS: In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively).nnCONCLUSION: About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.
Protocol for Electrical Conductivity Signal Collection and Processing in Scoliosis Surgery
Saghbiny, Elie; Silva, Jimmy Da; Chaimi, Celia; Chandanson, Thibault; Vialle, Raphael
In: Adv Orthop, vol. 2023, pp. 9955520, 2023, ISSN: 2090-3464.
@article{pmid38024482b,
title = {Protocol for Electrical Conductivity Signal Collection and Processing in Scoliosis Surgery},
author = {Elie Saghbiny and Jimmy Da Silva and Celia Chaimi and Thibault Chandanson and Raphael Vialle},
doi = {10.1155/2023/9955520},
issn = {2090-3464},
year = {2023},
date = {2023-01-01},
journal = {Adv Orthop},
volume = {2023},
pages = {9955520},
abstract = {INTRODUCTION: Pedicle screw placement is a common procedure in spinal surgery. The misplacement rate with lateral and medial cortical perforation is 5-11%. Several techniques are used to decrease this rate. Many studies proved that electrical conductivity increases accuracy during pedicle screw placement but no study has interpreted conductivity values.nnMETHODS: The data are collected from patients operated for scoliosis in a single university hospital. After the posterior surgical approach is made, each pedicle is prepared classically. Instead of the classic curved pedicle probe, the surgeon uses a probe with the same shape that measures the conductivity at its tip. Conductivity values are recorded through a Bluetooth application. Each pedicle trajectory is then qualified after manual palpation with a feeler. A trajectory is qualified as optimal when palpation shows a bone tunnel without any breach, breached when there was a breach, and a modification of the probe direction was needed. A trajectory that does not meet the abovementioned definitions is excluded from the statistical analysis.nnRESULTS: 21 patients with 457 pedicles are recorded. The average age of the population is 14.71 ± 1.86 years. 17 patients (81%) have idiopathic adolescent scoliosis. One patient has Rett syndrome, one has hypotonia, one has cerebral palsy, and one has congenital malformation. The depth of the instrument is measured semiautomatically. This technique is validated when compared with the manual technique using the Bland-Altman agreement method (mean differences = -0.279 mm, upper limit = 2.2 mm, and lower limit = -2.7 mm) and Deming regression (slope = 1.06 ± 0.004).nnCONCLUSION: This study establishes a protocol to collect electrical conductivity signals in spine surgery with synchronization to the depth of the instrument. Real-time conductivity signal feedback alerts the surgeon of a probable breach in the spinal canal, so he can change the direction of the pedicle aim.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Pedicle screw placement is a common procedure in spinal surgery. The misplacement rate with lateral and medial cortical perforation is 5-11%. Several techniques are used to decrease this rate. Many studies proved that electrical conductivity increases accuracy during pedicle screw placement but no study has interpreted conductivity values.nnMETHODS: The data are collected from patients operated for scoliosis in a single university hospital. After the posterior surgical approach is made, each pedicle is prepared classically. Instead of the classic curved pedicle probe, the surgeon uses a probe with the same shape that measures the conductivity at its tip. Conductivity values are recorded through a Bluetooth application. Each pedicle trajectory is then qualified after manual palpation with a feeler. A trajectory is qualified as optimal when palpation shows a bone tunnel without any breach, breached when there was a breach, and a modification of the probe direction was needed. A trajectory that does not meet the abovementioned definitions is excluded from the statistical analysis.nnRESULTS: 21 patients with 457 pedicles are recorded. The average age of the population is 14.71 ± 1.86 years. 17 patients (81%) have idiopathic adolescent scoliosis. One patient has Rett syndrome, one has hypotonia, one has cerebral palsy, and one has congenital malformation. The depth of the instrument is measured semiautomatically. This technique is validated when compared with the manual technique using the Bland-Altman agreement method (mean differences = -0.279 mm, upper limit = 2.2 mm, and lower limit = -2.7 mm) and Deming regression (slope = 1.06 ± 0.004).nnCONCLUSION: This study establishes a protocol to collect electrical conductivity signals in spine surgery with synchronization to the depth of the instrument. Real-time conductivity signal feedback alerts the surgeon of a probable breach in the spinal canal, so he can change the direction of the pedicle aim.
Rougereau, Grégoire; Langlais, Tristan; Vigan, Marie; Hardy, Alexandre; Vialle, Raphaël; Marty-Diloy, Thibault; Cambon-Binder, Adeline
In: Foot Ankle Surg, vol. 28, no. 8, pp. 1279–1285, 2022, ISSN: 1460-9584.
@article{pmid35717494,
title = {Ankle syndesmosis biomechanical evaluation by shear-waves elastography in healthy young adults: Assessment of the reliability and accuracy of the measurements and definition of a corridor of normality},
author = {Grégoire Rougereau and Tristan Langlais and Marie Vigan and Alexandre Hardy and Raphaël Vialle and Thibault Marty-Diloy and Adeline Cambon-Binder},
doi = {10.1016/j.fas.2022.05.003},
issn = {1460-9584},
year = {2022},
date = {2022-12-01},
journal = {Foot Ankle Surg},
volume = {28},
number = {8},
pages = {1279--1285},
abstract = {BACKGROUND: Aims of this study were: 1/ to evaluate the shear wave speed (SWS) properties of the anteroinferior tibiofibular ligament (AITFL) and the distal interosseous membrane (DIOM) in neutral, dorsal flexion and plantar flexion positions in a cohort of healthy adult volunteers; 2/ to assess the reliability and reproducibility of these measurements.nnMETHODS: Both ankles were analyzed by shear wave elastography (SWE) in 20 healthy patients (10 females/10 males) standing on a hinge support with their ankles in neutral, 20° dorsal flexion and 30° plantar flexion positions. Stiffness of AITFL and DIOM was evaluated by SWS measurement.nnRESULTS: The SWS of AITFL and DIOM were minimal in the plantar flexion position (4.28 m/s [2.65-5.11] and 3.35 m/s [1.69-4.55], respectively). It increased significantly for both ligaments in neutral position (4.69 m/s [3.53-5.71] and 3.81 m/s [1.91-4.74], respectively; p < 0.0001), and reached their maximum values in dorsal flexion (6.58 m/s [5.23-8.34] and 4.79 m/s [3.07-6.19], respectively; p < 0.0001). There was no correlation between each ligament regardless the positions. SWS of AITFL was independent of demographic characteristics analyzed. SWS of DIOM was negatively correlated with height in dorsal flexion (ρ = -0.35; p = 0.03) and in plantar flexion (ρ = -0.37; p = 0.02). Female gender was associated with increased DIOM SWS in neutral (p = 0.005), dorsal flexion (p = 0.003), and plantar flexion (p = 0.001) positions. Moreover, foot morphology (foot arch, hind foot frontal deviation) did not impact AITFL nor DIOM SWS. Inter- and intra-observer measurements were all good or excellent.nnCONCLUSION: The AITFL and DIOM, stabilizers of the distal tibiofibular syndesmosis, increase in stiffness while dorsal flexion increases. This study describes a reliable and reproducible protocol to assess their stiffness by SWE, and defines a corridor of normality.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Aims of this study were: 1/ to evaluate the shear wave speed (SWS) properties of the anteroinferior tibiofibular ligament (AITFL) and the distal interosseous membrane (DIOM) in neutral, dorsal flexion and plantar flexion positions in a cohort of healthy adult volunteers; 2/ to assess the reliability and reproducibility of these measurements.nnMETHODS: Both ankles were analyzed by shear wave elastography (SWE) in 20 healthy patients (10 females/10 males) standing on a hinge support with their ankles in neutral, 20° dorsal flexion and 30° plantar flexion positions. Stiffness of AITFL and DIOM was evaluated by SWS measurement.nnRESULTS: The SWS of AITFL and DIOM were minimal in the plantar flexion position (4.28 m/s [2.65-5.11] and 3.35 m/s [1.69-4.55], respectively). It increased significantly for both ligaments in neutral position (4.69 m/s [3.53-5.71] and 3.81 m/s [1.91-4.74], respectively; p < 0.0001), and reached their maximum values in dorsal flexion (6.58 m/s [5.23-8.34] and 4.79 m/s [3.07-6.19], respectively; p < 0.0001). There was no correlation between each ligament regardless the positions. SWS of AITFL was independent of demographic characteristics analyzed. SWS of DIOM was negatively correlated with height in dorsal flexion (ρ = -0.35; p = 0.03) and in plantar flexion (ρ = -0.37; p = 0.02). Female gender was associated with increased DIOM SWS in neutral (p = 0.005), dorsal flexion (p = 0.003), and plantar flexion (p = 0.001) positions. Moreover, foot morphology (foot arch, hind foot frontal deviation) did not impact AITFL nor DIOM SWS. Inter- and intra-observer measurements were all good or excellent.nnCONCLUSION: The AITFL and DIOM, stabilizers of the distal tibiofibular syndesmosis, increase in stiffness while dorsal flexion increases. This study describes a reliable and reproducible protocol to assess their stiffness by SWE, and defines a corridor of normality.
Rougereau, Grégoire; Marty-Diloy, Thibault; Vigan, Marie; Vialle, Raphaël; Soubeyrand, Marc; Langlais, Tristan
In: J Hand Surg Eur Vol, vol. 47, no. 11, pp. 1134–1141, 2022, ISSN: 2043-6289.
@article{pmid35953882,
title = {Biomechanical assessment of the central band of the interosseous membrane using shear wave elastography: reliability and reproducibility},
author = {Grégoire Rougereau and Thibault Marty-Diloy and Marie Vigan and Raphaël Vialle and Marc Soubeyrand and Tristan Langlais},
doi = {10.1177/17531934221114301},
issn = {2043-6289},
year = {2022},
date = {2022-12-01},
journal = {J Hand Surg Eur Vol},
volume = {47},
number = {11},
pages = {1134--1141},
abstract = {The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults. IV.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults. IV.
Impact of sleep-disordered breathing on the management of children with Chiari malformation type I
Vagianou, Foteini; Khirani, Sonia; Denis, Timothée De Saint; Beccaria, Kevin; Amaddeo, Alessandro; Breton, Sylvain; James, Syril; Paternoster, Giovanna; Arnaud, Eric; Zerah, Michel; Fauroux, Brigitte
In: Pediatr Pulmonol, vol. 57, no. 12, pp. 2954–2962, 2022, ISSN: 1099-0496.
@article{pmid35962649,
title = {Impact of sleep-disordered breathing on the management of children with Chiari malformation type I},
author = {Foteini Vagianou and Sonia Khirani and Timothée De Saint Denis and Kevin Beccaria and Alessandro Amaddeo and Sylvain Breton and Syril James and Giovanna Paternoster and Eric Arnaud and Michel Zerah and Brigitte Fauroux},
doi = {10.1002/ppul.26113},
issn = {1099-0496},
year = {2022},
date = {2022-12-01},
journal = {Pediatr Pulmonol},
volume = {57},
number = {12},
pages = {2954--2962},
abstract = {OBJECTIVES: Children with Chiari malformation type I (CM-I) have an increased risk of sleep apnea. The aim of the study was to describe the management of CM-I patients in relation to symptoms, magnetic resonance imaging (MRI) findings and sleep apnea syndrome (SAS).nnMETHODS: We performed a retrospective analysis of clinical charts of all 57 CM-I patients seen between September 2013 and April 2017.nnRESULTS: A total of 45 patients had isolated CM-I or associated co-morbidity (CM-Iia), 5 had craniosynostosis (CM-Ics), and 7 a polymalformative syndrome (CM-Ipm). The prevalence of SAS, defined as an apnea-hypopnea index >1 event/h, was high in CM-I ranging from 50% to 80% according to the CM-I group. The prevalence of central sleep apnea (CSA) was low, with 5 (9%) patients having CSA and only 3 patients with CM-Iia having isolated CSA. A total of 17 patients (30%) had foramen magnum decompression (FMD). Neither positive symptoms of CM-I nor MRI findings alone, nor both combined were good indicators for FMD. No correlation was observed between the cerebellar tonsil descent and SAS in CM-I. But all 5 patients with CSA had a FMD. The combination of MRI findings and/or symptoms of CM-I together with moderate-to-severe SAS best discriminated patients who needed a FMD.nnCONCLUSION: Our findings highlight the importance of a combined evaluation of symptoms, MRI and polygraphy results in the management of CM-I patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Children with Chiari malformation type I (CM-I) have an increased risk of sleep apnea. The aim of the study was to describe the management of CM-I patients in relation to symptoms, magnetic resonance imaging (MRI) findings and sleep apnea syndrome (SAS).nnMETHODS: We performed a retrospective analysis of clinical charts of all 57 CM-I patients seen between September 2013 and April 2017.nnRESULTS: A total of 45 patients had isolated CM-I or associated co-morbidity (CM-Iia), 5 had craniosynostosis (CM-Ics), and 7 a polymalformative syndrome (CM-Ipm). The prevalence of SAS, defined as an apnea-hypopnea index >1 event/h, was high in CM-I ranging from 50% to 80% according to the CM-I group. The prevalence of central sleep apnea (CSA) was low, with 5 (9%) patients having CSA and only 3 patients with CM-Iia having isolated CSA. A total of 17 patients (30%) had foramen magnum decompression (FMD). Neither positive symptoms of CM-I nor MRI findings alone, nor both combined were good indicators for FMD. No correlation was observed between the cerebellar tonsil descent and SAS in CM-I. But all 5 patients with CSA had a FMD. The combination of MRI findings and/or symptoms of CM-I together with moderate-to-severe SAS best discriminated patients who needed a FMD.nnCONCLUSION: Our findings highlight the importance of a combined evaluation of symptoms, MRI and polygraphy results in the management of CM-I patients.