Two-Port Fetoscopic Repair of Myelomeningocele in Fetal Lambs
Guilbaud, Lucie; Roux, Nathalie; Friszer, Stéphanie; Dhombres, Ferdinand; Vialle, Raphaël; Shah, Zoobia; Garabedian, Charles; Bessières, Bettina; Rocco, Federico Di; Zerah, Michel; Jouannic, Jean-Marie
In: Fetal Diagn Ther, vol. 45, no. 1, pp. 36–41, 2019, ISSN: 1421-9964.
@article{pmid29466789,
title = {Two-Port Fetoscopic Repair of Myelomeningocele in Fetal Lambs},
author = {Lucie Guilbaud and Nathalie Roux and Stéphanie Friszer and Ferdinand Dhombres and Raphaël Vialle and Zoobia Shah and Charles Garabedian and Bettina Bessières and Federico Di Rocco and Michel Zerah and Jean-Marie Jouannic},
doi = {10.1159/000485655},
issn = {1421-9964},
year = {2019},
date = {2019-01-01},
journal = {Fetal Diagn Ther},
volume = {45},
number = {1},
pages = {36--41},
abstract = {OBJECTIVE: The aim of this study was to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) repair with a running single suture using a 2-port access in the sheep model.nnMETHODS: Eighteen fetuses underwent surgical creation of a MMC defect at day 75. Fetuses were then randomized into 3 groups. Four fetuses remained untreated (control group). In the other 14 fetuses, a prenatal repair was performed at day 90: 7 fetuses had an open repair (oMMC), and 7 fetuses had a fetoscopic repair (fMMC) using a single-layer running suture through a 2-port access. Lambs were sacrificed at term, and histological examinations were performed.nnRESULTS: Hindbrain herniation was observed in all live lambs in the control group. A complete closure of the defect was achieved in all the lambs of the fMMC group. A complete healing of the defect and no hindbrain herniation were observed in all live lambs of the oMMC and fMMC groups. The durations of surgeries were not statistically different between the oMMC and the fMMC groups (60 vs. 53 min, p = 0.40), as was the risk of fetal loss (fMMC: 1/7, oMMC: 3/7, p = 0.56).nnDISCUSSION: Fetoscopic repair of MMC can be performed using a single-layer running suture through a 2-port access and may be promising to reduce the risk of premature rupture of membranes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Jouannic, Jean-Marie; Zerah, Michel; Rigouzzo, Agnès; Guilbaud, Lucie
2019, ISSN: 1471-0528.
@misc{pmid30320496,
title = {Re: Perinatal outcomes after open fetal surgery for myelomeningocele repair: a retrospective cohort study},
author = {Jean-Marie Jouannic and Michel Zerah and Agnès Rigouzzo and Lucie Guilbaud},
doi = {10.1111/1471-0528.15462},
issn = {1471-0528},
year = {2019},
date = {2019-01-01},
journal = {BJOG},
volume = {126},
number = {1},
pages = {130--131},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
Hernandez, Thibault; Thenard, Thomas; Vergari, Claudio; Robichon, Leopold; Skalli, Wafa; Vialle, Raphaël
In: Orthop Traumatol Surg Res, vol. 104, no. 5, pp. 617–622, 2018, ISSN: 1877-0568.
@article{pmid29908357,
title = {Coronal trunk imbalance in idiopathic scoliosis: Does gravity line localisation confirm the physical findings?},
author = {Thibault Hernandez and Thomas Thenard and Claudio Vergari and Leopold Robichon and Wafa Skalli and Raphaël Vialle},
doi = {10.1016/j.otsr.2018.04.018},
issn = {1877-0568},
year = {2018},
date = {2018-09-01},
journal = {Orthop Traumatol Surg Res},
volume = {104},
number = {5},
pages = {617--622},
abstract = {BACKGROUND: Adolescent idiopathic scoliosis (AIS) can require surgical procedures that have major consequences. Coronal imbalance as assessed clinically using a plumb line is a key criterion for selecting patients to surgery. Nevertheless, the reference standard for assessing postural balance of the trunk is gravity line localisation within a validated frame of reference. Recent studies have established that the gravity line can be localised after body contour reconstruction from biplanar radiographs. The objective of this study was to validate a gravity line localisation method based on biplanar radiographs in a population with AIS then to validate gravity line position versus plumb line position.nnHYPOTHESIS: Plumb line and gravity line assessments of coronal balance correlate with each other.nnMATERIAL AND METHODS: A gravity line localisation method based on biplanar radiography was validated in 14 patients with AIS versus force platform as the method of reference. Normal plumb line and gravity line positions were determined in 27 asymptomatic adolescents using biplanar radiography. The results of the two methods were then compared in 53 patients with AIS.nnRESULTS: The reliability of gravity line localisation in the coronal plane based on biplanar radiography was 2.4mm (95% confidence interval). The distance between the gravity line and the middle of the line connecting the centres of the two femoral heads (HA) showed a strongly significant association with plumb line position computed as the distance from the vertical line through the middle of T1 and the centre of the S1 endplate (T1V/S): r=0.71, p<0.0001. Of the 20 patients with plumb line results indicating coronal imbalance, 11 (55%) had a normal gravity line-to-HA distance. Of the 33 patients with normal plumb line results, 7 (21%) had an abnormal gravity line-to-HA distance.nnCONCLUSION: The results of this study validate gravity line determination from biplanar radiographs in a population with AIS. Plumb line position correlated significantly with gravity line position but was less accurate for guiding surgical decisions.nnLEVEL OF EVIDENCE: IV, retrospective study.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis
Langlais, Tristan; Vergari, Claudio; Pietton, Raphael; Dubousset, Jean; Skalli, Wafa; Vialle, Raphael
In: Eur Radiol, vol. 28, no. 7, pp. 2830–2837, 2018, ISSN: 1432-1084.
@article{pmid29404767,
title = {Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis},
author = {Tristan Langlais and Claudio Vergari and Raphael Pietton and Jean Dubousset and Wafa Skalli and Raphael Vialle},
doi = {10.1007/s00330-018-5309-2},
issn = {1432-1084},
year = {2018},
date = {2018-07-01},
journal = {Eur Radiol},
volume = {28},
number = {7},
pages = {2830--2837},
abstract = {OBJECTIVES: In vitro studies showed that annulus fibrosus lose its integrity in idiopathic scoliosis. Shear-wave ultrasound elastography can be used for non-invasive measurement of shear-wave speed (SWS) in vivo in the annulus fibrosus, a parameter related to its mechanical properties. The main aim was to assess SWS in lumbar annulus fibrosus of scoliotic adolescents and compare it to healthy subjects.nnMETHODS: SWS was measured in 180 lumbar IVDs (L3L4, L4L5, L5S1) of 30 healthy adolescents (13 ± 1.9 years old) and 30 adolescent idiopathic scoliosis patients (13 ± 2 years old, Cobb angle: 28.8° ± 10.4°). SWS was compared between the scoliosis and healthy control groups.nnRESULTS: In healthy subjects, average SWS (all disc levels pooled) was 3.0 ± 0.3 m/s, whereas in scoliotic patients it was significantly higher at 3.5 ± 0.3 m/s (p = 0.0004; Mann-Whitney test). Differences were also significant at all disc levels. No difference was observed between males and females. No correlation was found with age, weight and height.nnCONCLUSION: Non-invasive shear-wave ultrasound is a novel method of assessment to quantitative alteration of annulus fibrosus. These preliminary results are promising for considering shear-wave elastography as a biomechanical marker for assessment of idiopathic scoliosis.nnKEY POINTS: • Adolescent idiopathic scoliosis may have an altered lumbar annulus fibrosus. • Shear-wave elastography can quantify lumbar annulus fibrosus mechanical properties. • Shear-wave speed was higher in scoliotic annulus than in healthy subjects. • Elastography showed potential as a biomechanical marker for characterizing disc alteration.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
[Micturition disorders in children]
Charlanes, Audrey; Lallemant-Dudek, Pauline; Forin, Véronique
In: Rev Prat, vol. 68, no. 6, pp. e249–e254, 2018, ISSN: 0035-2640.
@article{pmid30869274,
title = {[Micturition disorders in children]},
author = {Audrey Charlanes and Pauline Lallemant-Dudek and Véronique Forin},
issn = {0035-2640},
year = {2018},
date = {2018-06-01},
journal = {Rev Prat},
volume = {68},
number = {6},
pages = {e249--e254},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Morel, Baptiste; Moueddeb, Sonia; Blondiaux, Eleonore; Richard, Stephen; Bachy, Manon; Vialle, Raphael; Pointe, Hubert Ducou Le
In: Eur Spine J, vol. 27, no. 5, pp. 1082–1088, 2018, ISSN: 1432-0932.
@article{pmid29340779,
title = {Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients},
author = {Baptiste Morel and Sonia Moueddeb and Eleonore Blondiaux and Stephen Richard and Manon Bachy and Raphael Vialle and Hubert Ducou Le Pointe},
doi = {10.1007/s00586-018-5464-9},
issn = {1432-0932},
year = {2018},
date = {2018-05-01},
journal = {Eur Spine J},
volume = {27},
number = {5},
pages = {1082--1088},
abstract = {PURPOSE: The aim of this study was to compare the radiation dose, image quality and 3D spine parameter measurements of EOS low-dose and micro-dose protocols for in-brace adolescent idiopathic scoliosis (AIS) patients.nnMETHODS: We prospectively included 25 consecutive patients (20 females, 5 males) followed for AIS and undergoing brace treatment. The mean age was 12 years (SD 2 years, range 8-15 years). For each patient, in-brace biplanar EOS radiographs were acquired in a standing position using both the conventional low-dose and micro-dose protocols. Dose area product (DAP) was systematically recorded. Diagnostic image quality was qualitatively assessed by two radiologists for visibility of anatomical structures. The reliability of 3D spine modeling between two operators was quantitatively evaluated for the most clinically relevant 3D radiological parameters using intraclass correlation coefficient (ICC).nnRESULTS: The mean DAP for the posteroanterior and lateral acquisitions was 300 ± 134 and 433 ± 181 mGy cm for the low-dose radiographs, and 41 ± 19 and 81 ± 39 mGy cm for micro-dose radiographs. Image quality was lower with the micro-dose protocol. The agreement was "good" to "very good" for all measured clinical parameters when comparing the low-dose and micro-dose protocols (ICC > 0.73).nnCONCLUSION: The micro-dose protocol substantially reduced the delivered dose (by a factor of 5-7 compared to the low-dose protocol) in braced children with AIS. Although image quality was reduced, the micro-dose protocol proved to be adapted to radiological follow-up, with adequate image quality and reliable clinical measurements. These slides can be retrieved under Electronic Supplementary Material.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pedersen, Peter Heide; Xavier, Fred; Vergari, Claudio; Skalli, Wafa; Eiskjær, Søren Peter; Vialle, Raphael
In: Spine Deform, vol. 5, no. 6, pp. 444, 2017, ISSN: 2212-1358.
@article{pmid31997201,
title = {Paper #9: Nano-Dose Protocol for 3D Reconstruction of the Spine in Early Onset Scoliosis: Preliminary Results of a Phantom Based and Clinically Validated Study using Stereo-Radiography},
author = {Peter Heide Pedersen and Fred Xavier and Claudio Vergari and Wafa Skalli and Søren Peter Eiskjær and Raphael Vialle},
doi = {10.1016/j.jspd.2017.09.012},
issn = {2212-1358},
year = {2017},
date = {2017-11-01},
journal = {Spine Deform},
volume = {5},
number = {6},
pages = {444},
abstract = {This is a prospective study validating the reproducibility of 3D reconstruction of the spine using a new reduced micro-dose protocol. A pilot group of children with scoliosis underwent micro-dose- and additional reduced micro-dose (nano-dose) full-spine imaging. 3D reconstructions of both protocols were evaluated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lamerain, Mayalen; Bachy, Manon; Dubory, Arnaud; Kabbaj, Reda; Scemama, Caroline; Vialle, Raphaël
In: Clin Spine Surg, vol. 30, no. 7, pp. E857–E863, 2017, ISSN: 2380-0194.
@article{pmid27404854,
title = {All-Pedicle Screw Fixation With 6-mm-Diameter Cobalt-Chromium Rods Provides Optimized Sagittal Correction of Adolescent Idiopathic Scoliosis},
author = {Mayalen Lamerain and Manon Bachy and Arnaud Dubory and Reda Kabbaj and Caroline Scemama and Raphaël Vialle},
doi = {10.1097/BSD.0000000000000413},
issn = {2380-0194},
year = {2017},
date = {2017-08-01},
journal = {Clin Spine Surg},
volume = {30},
number = {7},
pages = {E857--E863},
abstract = {PURPOSE: Recently introduced cobalt-chromium (CoCr) rods that rely solely on pedicle screws produce very good results in correcting scoliotic curves. All-pedicle screws constructs are also suspected of decreasing thoracic kyphosis. The current study was designed to evaluate sagittal correction in adolescent idiopathic scoliosis patients, using 6-mm CoCr rods and all-screw constructs.nnMATERIALS AND METHODS: A total of 61 patients treated by posterior spinal fusion and instrumentation, using all-pedicle screw constructs were included. The mean age at surgery was 15.4 years (range, 12-18 y). Forty-five patients (group A) were diagnosed with decreased thoracic kyphosis, and 16 patients (group B) had normal (35-50 degrees) thoracic kyphosis.nnRESULTS: The preoperative main Cobb angle was 62.93±19.38 degrees in group A and 73.45±22.13 degrees in group B. In group A, the postoperative main Cobb angle was 23.33±12.71 degrees. In group B, the postoperative main Cobb angle was 27.20±10.04 degrees. The T4-T12 thoracic kyphosis improved postoperatively from 18.15±10.29 to 28.18±8.35 degrees in group A. In group B, the postoperative T4-T12 thoracic kyphosis was 40.34±3.13 degrees. Statistical analysis showed a significant improvement between preoperative and postoperative values of T4-T12 thoracic kyphosis in group A. In group B, the differences in T4-T12 thoracic kyphosis values were not statistically significant.nnCONCLUSIONS: Our result demonstrates a significant improvement of T4-T12 thoracic kyphosis in the hypokyphotic group of patients and confirms that CoCr rods can produce sagittal corrections in hypokyphotic adolescent idiopathic scoliosis patients. Our results confirm the benefit of combining all-pedicle screw constructs with a posterolateral translational in situ bending procedure to correct hypokyphosis directly.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fetoscopic patch coverage of experimental myelomenigocele using a two-port access in fetal sheep
Guilbaud, Lucie; Roux, Nathalie; Friszer, Stéphanie; Garabedian, Charles; Dhombres, Ferdinand; Bessières, Bettina; Fallet-Bianco, Catherine; Rocco, Federico Di; Zerah, Michel; Jouannic, Jean-Marie
In: Childs Nerv Syst, vol. 33, no. 7, pp. 1177–1184, 2017, ISSN: 1433-0350.
@article{pmid28550526,
title = {Fetoscopic patch coverage of experimental myelomenigocele using a two-port access in fetal sheep},
author = {Lucie Guilbaud and Nathalie Roux and Stéphanie Friszer and Charles Garabedian and Ferdinand Dhombres and Bettina Bessières and Catherine Fallet-Bianco and Federico Di Rocco and Michel Zerah and Jean-Marie Jouannic},
doi = {10.1007/s00381-017-3461-7},
issn = {1433-0350},
year = {2017},
date = {2017-07-01},
journal = {Childs Nerv Syst},
volume = {33},
number = {7},
pages = {1177--1184},
abstract = {PURPOSE: This study aims to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) coverage using a sealed inert patch through a two-port access, in the sheep model.nnMETHODS: Forty-four fetuses underwent surgical creation of a MMC defect at day 75 and were divided into four groups according to the MMC repair technique, performed at day 90. Group 1 remained untreated. Group 2 had an open surgery using suture of the defect. Groups 3 and 4 underwent defect coverage using a Gore®-polytetrafluoroethylene patch secured with surgical adhesive (Bioglue®), with an open approach (group 3) and a fetoscopic one (group 4). Lambs were killed at term, and histological examinations were performed.nnRESULTS: Fetoscopic patch coverage was achieved in all the lambs of group 4. All the fetuses of group 2 had a complete closure of the defect whereas only 38% in group 3 and 14% in group 4. Fetal loss rate seems to be lower in group 4 than in groups 2 and 3.nnCONCLUSION: Fetoscopic coverage of MMC defect can be performed using a sealed patch through a two-port access, but the patch and glue correction may not be the ideal technique to repair fetal MMC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Maurice, P; Dhombres, F; Blondiaux, E; Friszer, S; Guilbaud, L; Lelong, N; Khoshnood, B; Charlet, J; Perrot, N; Jauniaux, E; Jurkovic, D; Jouannic, J-M
In: J Gynecol Obstet Hum Reprod, vol. 46, no. 5, pp. 423–429, 2017, ISSN: 2468-7847.
@article{pmid28934086,
title = {Towards ontology-based decision support systems for complex ultrasound diagnosis in obstetrics and gynecology},
author = {P Maurice and F Dhombres and E Blondiaux and S Friszer and L Guilbaud and N Lelong and B Khoshnood and J Charlet and N Perrot and E Jauniaux and D Jurkovic and J-M Jouannic},
doi = {10.1016/j.jogoh.2017.03.004},
issn = {2468-7847},
year = {2017},
date = {2017-05-01},
journal = {J Gynecol Obstet Hum Reprod},
volume = {46},
number = {5},
pages = {423--429},
abstract = {INTRODUCTION: We have developed a new knowledge base intelligent system for obstetrics and gynecology ultrasound imaging, based on an ontology and a reference image collection. This study evaluates the new system to support accurate annotations of ultrasound images. We have used the early ultrasound diagnosis of ectopic pregnancies as a model clinical issue.nnMATERIAL AND METHODS: The ectopic pregnancy ontology was derived from medical texts (4260 ultrasound reports of ectopic pregnancy from a specialist center in the UK and 2795 Pubmed abstracts indexed with the MeSH term "Pregnancy, Ectopic") and the reference image collection was built on a selection from 106 publications. We conducted a retrospective analysis of the signs in 35 scans of ectopic pregnancy by six observers using the new system.nnRESULTS: The resulting ectopic pregnancy ontology consisted of 1395 terms, and 80 images were collected for the reference collection. The observers used the knowledge base intelligent system to provide a total of 1486 sign annotations. The precision, recall and F-measure for the annotations were 0.83, 0.62 and 0.71, respectively. The global proportion of agreement was 40.35% 95% CI [38.64-42.05].nnDISCUSSION: The ontology-based intelligent system provides accurate annotations of ultrasound images and suggests that it may benefit non-expert operators. The precision rate is appropriate for accurate input of a computer-based clinical decision support and could be used to support medical imaging diagnosis of complex conditions in obstetrics and gynecology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}