Langlais, Tristan; Skalli, Wafa; du Cluzel, Xavier; Mainard, Nicolas; George, Samuel; Gajny, Laurent; Vialle, Raphael; Dubousset, Jean; Vergari, Claudio
Dans: Spine Deform, vol. 12, no. 3, p. 689–697, 2024, ISSN: 2212-1358.
@article{pmid38347377,
title = {Spinal axial torque assessment after surgical correction in adolescent idiopathic scoliosis: a new approach to 3D barycentremetry and mass distribution based on biplanar radiographs},
author = {Tristan Langlais and Wafa Skalli and Xavier du Cluzel and Nicolas Mainard and Samuel George and Laurent Gajny and Raphael Vialle and Jean Dubousset and Claudio Vergari},
doi = {10.1007/s43390-023-00816-5},
issn = {2212-1358},
year = {2024},
date = {2024-05-01},
journal = {Spine Deform},
volume = {12},
number = {3},
pages = {689--697},
abstract = {PURPOSE: Barycentremetry in adolescent idiopathic scoliosis (AIS) allows the distribution of masses and their loading of the spine to be studied. In particular, the axial torque on the spine has been studied in AIS, but not after surgical correction. Spinal axial torque was studied in AIS before and after surgery.nnMETHODS: All AIS (Lenke 1 and 3) who underwent posterior spinal fusion surgery at our center in 2019 were included retrospectively. AIS underwent frontal and sagittal biplanar radiographs in the free-standing position before surgery, 4 months after surgery, and at the last follow-up. Their spine and external envelope were reconstructed with validated methods. Spinal axial torque at the apex and the upper and lower end vertebra was calculated. Finally, the preoperative and postoperative values were compared to a previously published reference corridor for asymptomatic subjects.nnRESULTS: Twenty-nine patients were included (54 ± 11° Cobb angle, 15 ± 2 years old at surgery). The surgical procedure decreased the Cobb angle by 36° ± 11° and decreased the spinal axial torque at the upper end vertebra by 2.5 N/m (95% CI = [1.9; 3]; p < 0.001), at the apex by 0.6 N/m (95% CI = [0.4; 1]; p = 0.004), at the lower end vertebra by 2 N/m (95% CI = [1.5; 2.8]; p < 0.001). Compared to 95th percentile of torque, which was previously evaluated in asymptomatic subjects, more than 90% of patients had higher values at the upper and lower end vertebrae before surgery. Postoperatively, 62% of patients still had higher torque at the upper end vertebra than asymptomatic subjects, while only 38% patients showed abnormal values at the lower junction.nnCONCLUSION: Results of this study confirm that AIS patients show abnormally high spinal axial torque, especially at the end vertebrae, and that this parameter is normalized postoperatively for only a small number of patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Barycentremetry in adolescent idiopathic scoliosis (AIS) allows the distribution of masses and their loading of the spine to be studied. In particular, the axial torque on the spine has been studied in AIS, but not after surgical correction. Spinal axial torque was studied in AIS before and after surgery.nnMETHODS: All AIS (Lenke 1 and 3) who underwent posterior spinal fusion surgery at our center in 2019 were included retrospectively. AIS underwent frontal and sagittal biplanar radiographs in the free-standing position before surgery, 4 months after surgery, and at the last follow-up. Their spine and external envelope were reconstructed with validated methods. Spinal axial torque at the apex and the upper and lower end vertebra was calculated. Finally, the preoperative and postoperative values were compared to a previously published reference corridor for asymptomatic subjects.nnRESULTS: Twenty-nine patients were included (54 ± 11° Cobb angle, 15 ± 2 years old at surgery). The surgical procedure decreased the Cobb angle by 36° ± 11° and decreased the spinal axial torque at the upper end vertebra by 2.5 N/m (95% CI = [1.9; 3]; p < 0.001), at the apex by 0.6 N/m (95% CI = [0.4; 1]; p = 0.004), at the lower end vertebra by 2 N/m (95% CI = [1.5; 2.8]; p < 0.001). Compared to 95th percentile of torque, which was previously evaluated in asymptomatic subjects, more than 90% of patients had higher values at the upper and lower end vertebrae before surgery. Postoperatively, 62% of patients still had higher torque at the upper end vertebra than asymptomatic subjects, while only 38% patients showed abnormal values at the lower junction.nnCONCLUSION: Results of this study confirm that AIS patients show abnormally high spinal axial torque, especially at the end vertebrae, and that this parameter is normalized postoperatively for only a small number of patients.
Athiel, Yoann; Jouannic, Jean-Marie; Mauffré, Vincent; Dehan, Coralie; Adam, Clovis; Blot, Stéphane; Lallemant, Pauline; Denis, Timothé De Saint; Larghero, Jérôme; Nasone, Justine; Guilbaud, Lucie
Dans: BJOG, vol. 131, no. 6, p. 759–767, 2024, ISSN: 1471-0528.
@article{pmid37492999,
title = {Allogenic umbilical cord-derived mesenchymal stromal cells improve motor function in prenatal surgical repair of myelomeningocele: An ovine model study},
author = {Yoann Athiel and Jean-Marie Jouannic and Vincent Mauffré and Coralie Dehan and Clovis Adam and Stéphane Blot and Pauline Lallemant and Timothé De Saint Denis and Jérôme Larghero and Justine Nasone and Lucie Guilbaud},
doi = {10.1111/1471-0528.17624},
issn = {1471-0528},
year = {2024},
date = {2024-05-01},
journal = {BJOG},
volume = {131},
number = {6},
pages = {759--767},
abstract = {OBJECTIVE: To investigate the effects of an adjuvant allogenic umbilical cord mesenchymal stromal cell (UC-MSC) patch applied during fetal surgery on motor and sphincter function in the ovine MMC model.nnDESIGN: MMC defects were surgically created at 75 days of gestation and repaired 14 days later.nnPOPULATION: Ovine MMC model: fetal lambs.nnMETHODS: We compared lambs that received a UC-MSC patch with a control group of lambs that received an acellular patch.nnMAIN OUTCOME MEASURES: Clinical neurological assessment was performed at 2 and 24 hours of life and included determination of the Sheep Locomotor Rating scale (SLR), which has been validated in the ovine MMC model. Electrophysical examinations, spine scans and histological analyses were also performed.nnRESULTS: Of the 13 operated lambs, nine were born alive: five had of these had received a UC-MSC patch and four an acellular patch. At 24 hours of life, lambs in the UC-MSC group had a significantly higher score (14 versus 5, P = 0.04). Amyotrophy was significantly more common in the control group (75% versus 0%, P = 0.02). All the lambs in the control group and none of those in the UC-MSC group were incontinent. No significant differences were observed between the UC-MSC and control groups in terms of the presence of spontaneous EMG activity, nerve conduction or spinal evoked potentials. In the microscopic examination, lambs in the UC-MSC group had less fibrosis between the spinal cord and the dermis (mean thickness, 453 versus 3921 μm, P = 0.03) and around the spinal cord (mean thickness, 47 versus 158 μm, P < 0.001). Examination of the spinal cord in the area of the MMC defect showed a higher large neuron density in the UC-MSC group (14.5 versus 5.6 neurons/mm, P < 0.001). No tumours were observed.nnCONCLUSIONS: Fetal repair of MMC using UC-MSC patches improves motor and sphincter function as well as spinal preservation and reduction of fibrosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To investigate the effects of an adjuvant allogenic umbilical cord mesenchymal stromal cell (UC-MSC) patch applied during fetal surgery on motor and sphincter function in the ovine MMC model.nnDESIGN: MMC defects were surgically created at 75 days of gestation and repaired 14 days later.nnPOPULATION: Ovine MMC model: fetal lambs.nnMETHODS: We compared lambs that received a UC-MSC patch with a control group of lambs that received an acellular patch.nnMAIN OUTCOME MEASURES: Clinical neurological assessment was performed at 2 and 24 hours of life and included determination of the Sheep Locomotor Rating scale (SLR), which has been validated in the ovine MMC model. Electrophysical examinations, spine scans and histological analyses were also performed.nnRESULTS: Of the 13 operated lambs, nine were born alive: five had of these had received a UC-MSC patch and four an acellular patch. At 24 hours of life, lambs in the UC-MSC group had a significantly higher score (14 versus 5, P = 0.04). Amyotrophy was significantly more common in the control group (75% versus 0%, P = 0.02). All the lambs in the control group and none of those in the UC-MSC group were incontinent. No significant differences were observed between the UC-MSC and control groups in terms of the presence of spontaneous EMG activity, nerve conduction or spinal evoked potentials. In the microscopic examination, lambs in the UC-MSC group had less fibrosis between the spinal cord and the dermis (mean thickness, 453 versus 3921 μm, P = 0.03) and around the spinal cord (mean thickness, 47 versus 158 μm, P < 0.001). Examination of the spinal cord in the area of the MMC defect showed a higher large neuron density in the UC-MSC group (14.5 versus 5.6 neurons/mm, P < 0.001). No tumours were observed.nnCONCLUSIONS: Fetal repair of MMC using UC-MSC patches improves motor and sphincter function as well as spinal preservation and reduction of fibrosis.
Langlais, Tristan; Vergari, Claudio; Rougereau, Gregoire; Gaume, Mathilde; Gajny, Laurent; Abelin-Genevois, Kariman; Bernard, Jean Claude; Hu, Zongshan; Cheng, Jack Chun Yiu; Chu, Winnie Chiu Wing; Assi, Ayman; Karam, Mohamad; Ghanem, Ismat; Bassani, Tito; Galbusera, Fabio; Sconfienza, Luca Maria; Brayda-Bruno, Marco; Courtois, Isabelle; Ebermeyer, Eric; Vialle, Raphael; Dubousset, Jean; Skalli, Wafa
Dans: Eur Spine J, vol. 33, no. 4, p. 1665–1674, 2024, ISSN: 1432-0932.
@article{pmid38407613,
title = {Assessment of malalignment at early stage in adolescent idiopathic scoliosis: a longitudinal cohort study},
author = {Tristan Langlais and Claudio Vergari and Gregoire Rougereau and Mathilde Gaume and Laurent Gajny and Kariman Abelin-Genevois and Jean Claude Bernard and Zongshan Hu and Jack Chun Yiu Cheng and Winnie Chiu Wing Chu and Ayman Assi and Mohamad Karam and Ismat Ghanem and Tito Bassani and Fabio Galbusera and Luca Maria Sconfienza and Marco Brayda-Bruno and Isabelle Courtois and Eric Ebermeyer and Raphael Vialle and Jean Dubousset and Wafa Skalli},
doi = {10.1007/s00586-024-08178-w},
issn = {1432-0932},
year = {2024},
date = {2024-04-01},
journal = {Eur Spine J},
volume = {33},
number = {4},
pages = {1665--1674},
abstract = {INTRODUCTION: Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage.nnMATERIALS AND METHODS: All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th-95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value.nnRESULTS: Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and -2.5°, whereas in AIS values were 0.3° and -0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%.nnCONCLUSION: Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage.nnMATERIALS AND METHODS: All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th-95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value.nnRESULTS: Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and -2.5°, whereas in AIS values were 0.3° and -0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%.nnCONCLUSION: Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis.
Garel, Juliette; Rossi, Andrea; Blondiaux, Eléonore; Cassart, Marie; Hoffmann, Chen; Garel, Catherine
Dans: Pediatr Radiol, vol. 54, no. 4, p. 548–561, 2024, ISSN: 1432-1998.
@article{pmid37803194,
title = {Prenatal imaging of the normal and abnormal spinal cord: recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee},
author = {Juliette Garel and Andrea Rossi and Eléonore Blondiaux and Marie Cassart and Chen Hoffmann and Catherine Garel},
doi = {10.1007/s00247-023-05766-8},
issn = {1432-1998},
year = {2024},
date = {2024-04-01},
journal = {Pediatr Radiol},
volume = {54},
number = {4},
pages = {548--561},
abstract = {Spinal dysraphisms are amenable to diagnosis in utero. The prognosis and the neonatal management of these conditions differ significantly depending on their types, mainly on the distinction between open and closed defects. A detailed evaluation not only of the fetal spine, but also of the brain, skull, and lower limbs is essential in allowing for the right diagnosis. In this article, recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee will be presented. The aim of this paper is to review the imaging features of the normal and abnormal fetal spinal cord, to clarify the prenatal classification of congenital spinal cord anomalies and to provide guidance in their reporting.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Spinal dysraphisms are amenable to diagnosis in utero. The prognosis and the neonatal management of these conditions differ significantly depending on their types, mainly on the distinction between open and closed defects. A detailed evaluation not only of the fetal spine, but also of the brain, skull, and lower limbs is essential in allowing for the right diagnosis. In this article, recommendations from the Fetal Task Force of the European Society of Paediatric Radiology (ESPR) and the European Society of Neuroradiology (ESNR) Pediatric Neuroradiology Committee will be presented. The aim of this paper is to review the imaging features of the normal and abnormal fetal spinal cord, to clarify the prenatal classification of congenital spinal cord anomalies and to provide guidance in their reporting.
Mailho, Camille; Peyronnet, Benoit; Seze, Marianne De; Even, Alexia; Perrouin-Verbe, Maire-Aimée; Amarenco, Gérard; Chartier-Kastler, Emmanuel; Normand, Loic Le; Manunta, Andrea; Karsenty, Gilles; Kerdraon, Jacques; Ruffion, Alain; Saussine, Christian; Breton, Frédérique Le; Bernuz, Benjamin; Castel-Lacanal, Evelyne; Denys, Pierre; Phé, Véronique; Gamé, Xavier
Dans: Neurourol Urodyn, vol. 43, no. 4, p. 811–817, 2024, ISSN: 1520-6777.
@article{pmid38451038,
title = {How to define failure of intradetrusor injections of botulinum toxin A for neurogenic detrusor overactivity},
author = {Camille Mailho and Benoit Peyronnet and Marianne De Seze and Alexia Even and Maire-Aimée Perrouin-Verbe and Gérard Amarenco and Emmanuel Chartier-Kastler and Loic Le Normand and Andrea Manunta and Gilles Karsenty and Jacques Kerdraon and Alain Ruffion and Christian Saussine and Frédérique Le Breton and Benjamin Bernuz and Evelyne Castel-Lacanal and Pierre Denys and Véronique Phé and Xavier Gamé},
doi = {10.1002/nau.25427},
issn = {1520-6777},
year = {2024},
date = {2024-04-01},
journal = {Neurourol Urodyn},
volume = {43},
number = {4},
pages = {811--817},
abstract = {INTRODUCTION: Neurogenic detrusor overactivity (NDO) has a major impact on patients' quality of life and can lead to upper urinary tract complications. Intradetrusor botulinum toxin type A injections are administered as second-line treatment to these patients following the failure of anticholinergic agents. The aim of the DETOX 2 study is to propose a consensus definition of the failure of intradetrusor botulinum toxin injections for NDO in patients presenting spinal cord injury, spina bifida, or multiple sclerosis (MS) with self-catheterization.nnMETHOD: This study followed the method adopted by the French National Authority for Health for recommendations by consensus. Based on a review of the literature and a preliminary survey, a steering committee compiled a questionnaire and selected a rating group comprising 16 experts from the Neuro-Urology Committee of the French Urology Association (cnuAFU) and Genulf. The experts were asked to complete the online questionnaire. At the end of the first round, all participants came together to discuss any disagreements and a second-round online questionnaire was completed to reach a consensus.nnRESULTS: Thirteen of the 16 experts approached completed both rounds of questionnaires. A strong consensus was reached for two proposals (median score = 9/10) which were therefore included in the definition from the first round: at least one repeat injection of the same botulinum toxin at the same dose must be given to rule out failure on technical grounds and a duration of efficacy <3 months must be considered a failure. At the end of round 2, a relative consensus was reached regarding the clinical criterion defining failure (median score = 7/10) and the urodynamic criterion of failure (median score = 8/10). An additional proposal was selected during this second round on the need for a voiding diary (median score = 8/10).nnCONCLUSION: The first consensus definition of failure of an intradetrusor injection of TB-A for NDO has been achieved with this study: persistence of detrusor overactivity with maximum detrusor pressures >40 cm HO and/or a compliance issue and/or persistence of urinary incontinence and/or urgency and/or a number of daily self-catheterizations >8/day and/or efficacy <3 months. This study will help to standardize research on the failure of the intradetrusor botulinum toxin for NDO in clinical practice and clinical research.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Neurogenic detrusor overactivity (NDO) has a major impact on patients’ quality of life and can lead to upper urinary tract complications. Intradetrusor botulinum toxin type A injections are administered as second-line treatment to these patients following the failure of anticholinergic agents. The aim of the DETOX 2 study is to propose a consensus definition of the failure of intradetrusor botulinum toxin injections for NDO in patients presenting spinal cord injury, spina bifida, or multiple sclerosis (MS) with self-catheterization.nnMETHOD: This study followed the method adopted by the French National Authority for Health for recommendations by consensus. Based on a review of the literature and a preliminary survey, a steering committee compiled a questionnaire and selected a rating group comprising 16 experts from the Neuro-Urology Committee of the French Urology Association (cnuAFU) and Genulf. The experts were asked to complete the online questionnaire. At the end of the first round, all participants came together to discuss any disagreements and a second-round online questionnaire was completed to reach a consensus.nnRESULTS: Thirteen of the 16 experts approached completed both rounds of questionnaires. A strong consensus was reached for two proposals (median score = 9/10) which were therefore included in the definition from the first round: at least one repeat injection of the same botulinum toxin at the same dose must be given to rule out failure on technical grounds and a duration of efficacy <3 months must be considered a failure. At the end of round 2, a relative consensus was reached regarding the clinical criterion defining failure (median score = 7/10) and the urodynamic criterion of failure (median score = 8/10). An additional proposal was selected during this second round on the need for a voiding diary (median score = 8/10).nnCONCLUSION: The first consensus definition of failure of an intradetrusor injection of TB-A for NDO has been achieved with this study: persistence of detrusor overactivity with maximum detrusor pressures >40 cm HO and/or a compliance issue and/or persistence of urinary incontinence and/or urgency and/or a number of daily self-catheterizations >8/day and/or efficacy <3 months. This study will help to standardize research on the failure of the intradetrusor botulinum toxin for NDO in clinical practice and clinical research.
Langlais, Tristan; Josse, Antoine; and, Philippe Violas
Dans: Eur Spine J, vol. 33, no. 2, p. 713–722, 2024, ISSN: 1432-0932.
@article{pmid38135731,
title = {Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study},
author = {Tristan Langlais and Antoine Josse and Philippe Violas and },
doi = {10.1007/s00586-023-08062-z},
issn = {1432-0932},
year = {2024},
date = {2024-02-01},
journal = {Eur Spine J},
volume = {33},
number = {2},
pages = {713--722},
abstract = {PURPOSE: Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS).nnMETHODS: Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed.nnRESULTS: Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group (p = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days (p = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group (p = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% (p = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group (p = 0.9).nnCONCLUSION: HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS).nnMETHODS: Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed.nnRESULTS: Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group (p = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days (p = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group (p = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% (p = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group (p = 0.9).nnCONCLUSION: HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.
Pelvic Fixation Technique Using the Ilio-Sacral Screw for 173 Neuromuscular Scoliosis Patients
Gaumé, Mathilde; Saghbiny, Elie; Richard, Lou; Thouement, Clélia; Vialle, Raphaël; Miladi, Lotfi
Dans: Children (Basel), vol. 11, no. 2, 2024, ISSN: 2227-9067.
@article{pmid38397311,
title = {Pelvic Fixation Technique Using the Ilio-Sacral Screw for 173 Neuromuscular Scoliosis Patients},
author = {Mathilde Gaumé and Elie Saghbiny and Lou Richard and Clélia Thouement and Raphaël Vialle and Lotfi Miladi},
doi = {10.3390/children11020199},
issn = {2227-9067},
year = {2024},
date = {2024-02-01},
journal = {Children (Basel)},
volume = {11},
number = {2},
abstract = {Pelvic fixation remains one of the main challenging issues in non-ambulatory neuromuscular scoliosis (NMS) patients, between clinical effectiveness and a high complication rate. The objective of this multicenter and retrospective study was to evaluate the outcomes of a technique that was applied to treat 173 NMS patients. The technique is not well-known but promising; it uses the ilio-sacral screw, combined with either the posterior spinal fusion or fusionless bipolar technique, with a minimum follow-up of two years. The mean operative age of the patients was 13 ± 7 years. The mean preoperative main coronal curve was 64° and improved by a mean of -39° postoperatively. The mean preoperative pelvic obliquity was 23°, which improved by a mean of -14° postoperatively. No decrease in the frontal or sagittal correction was observed during the last follow-up. The sitting posture improved in all cases. Twenty-nine patients (17%) had a postoperative infection: twenty-six were treated with local debridement and antibiotics, and three required hardware removal. Fourteen mechanical complications (8%) occurred: screw malposition ( = 6), skin prominence ( = 1), and connector failure ( = 1). This type of surgery is associated with a high risk for infection. Comorbidities, rather than the surgery itself, were the main risk factors that led to complications. The ilio-sacral screw was reliable and effective in correcting pelvic obliquity in NMS patients. The introduction of intraoperative navigation should minimize the risk of screw misplacement and facilitate revision or primary fixation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pelvic fixation remains one of the main challenging issues in non-ambulatory neuromuscular scoliosis (NMS) patients, between clinical effectiveness and a high complication rate. The objective of this multicenter and retrospective study was to evaluate the outcomes of a technique that was applied to treat 173 NMS patients. The technique is not well-known but promising; it uses the ilio-sacral screw, combined with either the posterior spinal fusion or fusionless bipolar technique, with a minimum follow-up of two years. The mean operative age of the patients was 13 ± 7 years. The mean preoperative main coronal curve was 64° and improved by a mean of -39° postoperatively. The mean preoperative pelvic obliquity was 23°, which improved by a mean of -14° postoperatively. No decrease in the frontal or sagittal correction was observed during the last follow-up. The sitting posture improved in all cases. Twenty-nine patients (17%) had a postoperative infection: twenty-six were treated with local debridement and antibiotics, and three required hardware removal. Fourteen mechanical complications (8%) occurred: screw malposition ( = 6), skin prominence ( = 1), and connector failure ( = 1). This type of surgery is associated with a high risk for infection. Comorbidities, rather than the surgery itself, were the main risk factors that led to complications. The ilio-sacral screw was reliable and effective in correcting pelvic obliquity in NMS patients. The introduction of intraoperative navigation should minimize the risk of screw misplacement and facilitate revision or primary fixation.
[Urinary incontinence in children]
Simonnet, Hina; Lallemant-Dudek, Pauline
Dans: Rev Prat, vol. 74, no. 2, p. 179–184, 2024, ISSN: 2101-017X.
@article{pmid38415424,
title = {[Urinary incontinence in children]},
author = {Hina Simonnet and Pauline Lallemant-Dudek},
issn = {2101-017X},
year = {2024},
date = {2024-02-01},
journal = {Rev Prat},
volume = {74},
number = {2},
pages = {179--184},
abstract = {URINARY INCONTINENCE IN CHILDREN. Urinary incontinence in children and adolescents is most often of functional origin. Questioning and clinical examination with a bladder diary should look for underlying urological or neurological causes. The type of incontinence, daytime or nocturnal, must be specified to adapt treatments. Renal and bladder ultrasound is recommended, and urodynamic studies are not routinely used. Lifestyle advice and bowel management are prerequisites for treatment. Depending on the type of symptoms, drug treatment, pelvic floor treatment, behavioral measures or stimulation of the posterior tibial nerve can be proposed. The evolution can sometimes be slow with a significant impact on quality of life, and neurocognitive aspects need to be considered.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
URINARY INCONTINENCE IN CHILDREN. Urinary incontinence in children and adolescents is most often of functional origin. Questioning and clinical examination with a bladder diary should look for underlying urological or neurological causes. The type of incontinence, daytime or nocturnal, must be specified to adapt treatments. Renal and bladder ultrasound is recommended, and urodynamic studies are not routinely used. Lifestyle advice and bowel management are prerequisites for treatment. Depending on the type of symptoms, drug treatment, pelvic floor treatment, behavioral measures or stimulation of the posterior tibial nerve can be proposed. The evolution can sometimes be slow with a significant impact on quality of life, and neurocognitive aspects need to be considered.
Vagianou, Foteini; Khirani, Sonia; de Saint Denis, Timothée; Beccaria, Kevin; Amaddeo, Alessandro; Breton, Sylvain; James, Syril; Paternoster, Giovanna; Arnaud, Eric; Zerah, Michel; Fauroux, Brigitte
Dans: Br J Neurosurg, vol. 38, no. 1, p. 125–127, 2024, ISSN: 1360-046X.
@article{pmid34747686,
title = {The utility of poly(somno)graphy in evaluating children with Chiari malformation type II before and after surgical intervention: a case series},
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 = {10.1080/02688697.2021.1999392},
issn = {1360-046X},
year = {2024},
date = {2024-02-01},
journal = {Br J Neurosurg},
volume = {38},
number = {1},
pages = {125--127},
abstract = {BACKGROUND: Children with Chiari Malformation type II (CM-II) have an increased risk of sleep apnoea. The aim of the study was to describe the management of patients with CM-II in relation to sleep apnoea syndrome, clinical symptoms and magnetic resonance imaging (MRI) findings.nnCASE SERIES PRESENTATION: The paper reports 8 consecutive patients with CM-II followed between September 2013 and April 2017. The prevalence of sleep apnoea syndrome was high with 6 out of 8 patients having mild-to-severe sleep apnoea. Patients with severe sleep apnoea syndrome (3 patients) were treated with upper airway surgery and/or noninvasive ventilation.nnCONCLUSION: Our findings highlight the importance of respiratory polygraphy in the management of patients with CM-ΙΙ. Poly(somno)graphy is recommended in the follow-up care of children with CM-II.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Children with Chiari Malformation type II (CM-II) have an increased risk of sleep apnoea. The aim of the study was to describe the management of patients with CM-II in relation to sleep apnoea syndrome, clinical symptoms and magnetic resonance imaging (MRI) findings.nnCASE SERIES PRESENTATION: The paper reports 8 consecutive patients with CM-II followed between September 2013 and April 2017. The prevalence of sleep apnoea syndrome was high with 6 out of 8 patients having mild-to-severe sleep apnoea. Patients with severe sleep apnoea syndrome (3 patients) were treated with upper airway surgery and/or noninvasive ventilation.nnCONCLUSION: Our findings highlight the importance of respiratory polygraphy in the management of patients with CM-ΙΙ. Poly(somno)graphy is recommended in the follow-up care of children with CM-II.
Levy, Stephan; Dequirez, Pierre-Luc; Mercier, Jeremy; Taha, Fayek; Goujon, Anna; Seguier, Denis; Mesnard, Benoît; de Mazancourt, Emilien Seizilles; Joussen, Guillaume; Margue, Gaelle; Berchiche, William; Anastay, Vassili; Deleuze, Claire; Kaulanjan, Kevin; Cotte, Juliette; Peyrottes, Arthur; Gamé, Xavier; Peyronnet, Benoit
Dans: Fr J Urol, vol. 34, no. 3, p. 102580, 2024, ISSN: 2950-3930.
@article{pmid38417189,
title = {[Current state of knowledge of urology residents and fellows on the neuro-urological management of spina bifida patients in France]},
author = {Stephan Levy and Pierre-Luc Dequirez and Jeremy Mercier and Fayek Taha and Anna Goujon and Denis Seguier and Benoît Mesnard and Emilien Seizilles de Mazancourt and Guillaume Joussen and Gaelle Margue and William Berchiche and Vassili Anastay and Claire Deleuze and Kevin Kaulanjan and Juliette Cotte and Arthur Peyrottes and Xavier Gamé and Benoit Peyronnet},
doi = {10.1016/j.fjurol.2024.102580},
issn = {2950-3930},
year = {2024},
date = {2024-02-01},
journal = {Fr J Urol},
volume = {34},
number = {3},
pages = {102580},
abstract = {OBJECTIVE: To assess the current knowledge of French urology residents and fellows about neurogenic lower urinary tract dysfunction and their management in patients with spina bifida.nnMATERIAL AND METHOD: A 7-question questionnaire, covering the responder's experience and the various stages in the neuro-urological management of spina bifida, was drafted by an expert urologist. Responses were collected within 5days of being e-mailed to members of the Association française des urologues en formation (AFUF), and a descriptive analysis was carried out.nnRESULTS: Of the 448 members, 155 completed the questionnaire. Of the participants, 83.8% said they knew the definition of spina bifida, and 76.8% had already had to care for a spina bifida patient. Of the participants, 48.4% correctly estimated the number of spina bifida patients in France. Neurogenic lower urinary tract dysfunction to look for and the specificities of management seemed to have been acquired by a majority of respondents (correct response rates of 70.7% and 75.4%, respectively), unlike the extra-urological aspects (53.9%), and the choice of examinations useful for the initial work-up and follow-up (55.8%).nnCONCLUSION: While the expected neurogenic lower urinary tract dysfunction and the specificities of therapeutic management of spina bifida patients appear to be well known to urologists in training, knowledge of extra-urological symptoms and the choice of examinations could be improved. These results could be used to adjust the teaching given to French urologists in training on the urological management of spina bifida patients.nnLEVEL OF EVIDENCE: Grade 4.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To assess the current knowledge of French urology residents and fellows about neurogenic lower urinary tract dysfunction and their management in patients with spina bifida.nnMATERIAL AND METHOD: A 7-question questionnaire, covering the responder’s experience and the various stages in the neuro-urological management of spina bifida, was drafted by an expert urologist. Responses were collected within 5days of being e-mailed to members of the Association française des urologues en formation (AFUF), and a descriptive analysis was carried out.nnRESULTS: Of the 448 members, 155 completed the questionnaire. Of the participants, 83.8% said they knew the definition of spina bifida, and 76.8% had already had to care for a spina bifida patient. Of the participants, 48.4% correctly estimated the number of spina bifida patients in France. Neurogenic lower urinary tract dysfunction to look for and the specificities of management seemed to have been acquired by a majority of respondents (correct response rates of 70.7% and 75.4%, respectively), unlike the extra-urological aspects (53.9%), and the choice of examinations useful for the initial work-up and follow-up (55.8%).nnCONCLUSION: While the expected neurogenic lower urinary tract dysfunction and the specificities of therapeutic management of spina bifida patients appear to be well known to urologists in training, knowledge of extra-urological symptoms and the choice of examinations could be improved. These results could be used to adjust the teaching given to French urologists in training on the urological management of spina bifida patients.nnLEVEL OF EVIDENCE: Grade 4.