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.
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.
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.
[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.
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.
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.
[Prevention of dysraphism in France through mandatory food fortification with folic acid]
Dhombres, Ferdinand; Guilbaud, Lucie; de Saint-Denis, Timothée; Jouannic, Jean-Marie
Dans: Gynecol Obstet Fertil Senol, vol. 52, no. 1, p. 60–62, 2024, ISSN: 2468-7189.
@article{pmid37918686,
title = {[Prevention of dysraphism in France through mandatory food fortification with folic acid]},
author = {Ferdinand Dhombres and Lucie Guilbaud and Timothée de Saint-Denis and Jean-Marie Jouannic},
doi = {10.1016/j.gofs.2023.10.007},
issn = {2468-7189},
year = {2024},
date = {2024-01-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {52},
number = {1},
pages = {60--62},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Langlais, Tristan; Bouy, Alois; Eloy, Gauthier; Mainard, Nicolas; Skalli, Wafa; Vergari, Claudio; Vialle, Raphaël
Dans: Orthop Traumatol Surg Res, vol. 109, no. 6, p. 103654, 2023, ISSN: 1877-0568.
@article{pmid37399990,
title = {Sagittal plane assessment of manual concave rod bending for posterior correction in adolescents with idiopathic thoracic scoliosis (Lenke 1 and 3)},
author = {Tristan Langlais and Alois Bouy and Gauthier Eloy and Nicolas Mainard and Wafa Skalli and Claudio Vergari and Raphaël Vialle},
doi = {10.1016/j.otsr.2023.103654},
issn = {1877-0568},
year = {2023},
date = {2023-10-01},
journal = {Orthop Traumatol Surg Res},
volume = {109},
number = {6},
pages = {103654},
abstract = {OBJECTIVES: The objectives of this study were to evaluate the repeatability and reproducibility of a method for measuring freehand rod bending and to analyze the relationship between the rod's bend and the resulting sagittal correction.nnMATERIALS AND METHODS: All the children who underwent correction by posterior translation using pedicle screws at all levels were included prospectively in 2018 and 2019. The rod's sagittal parameters were measured retrospectively by three independent surgeons on two separate occasions using the same protocol. After the rods were bent but before they were inserted, the surgeon traced the contours of the rods on a sheet of paper that was later scanned and analyzed semiautomatically. The spinal parameters were calculated based on biplanar radiographs taken preoperatively, postoperatively and at the final follow-up visit. Patients who had less than 10° thoracic kyphosis (T5-T12) made up the "Lenke N-" subgroup.nnRESULTS: Thirty patients were included (14 of whom were Lenke N-) who had a Cobb angle of 59.2±11.3° preoperatively and 13.3±8.4° postoperatively (p<0.00001). The inter- and intrarater ICC for the rod measurements were>0.9 (excellent). The mean kyphosis of the concave rod was 48.4±5.7° (38.3-60.9°). The mean change in T5-T12 kyphosis was 9.7±10.8° (-14.3-30.8°) (p<0.0001) in the entire population, while it was 17.7±7.1° (5.5-30.8°) (p<0.0001) in the Lenke N- subgroup. The change in thoracic kyphosis was positively correlated with the kyphosis of the concave rod (rho=0.52; p=0.003).nnCONCLUSION: This study found excellent reproducibility and repeatability of measuring freehand rod bending. The kyphosis applied to the concave rod is positively correlated to the change in the resulting kyphosis and made it possible to restore satisfactory thoracic kyphosis.nnLEVEL OF EVIDENCE: III.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The objectives of this study were to evaluate the repeatability and reproducibility of a method for measuring freehand rod bending and to analyze the relationship between the rod’s bend and the resulting sagittal correction.nnMATERIALS AND METHODS: All the children who underwent correction by posterior translation using pedicle screws at all levels were included prospectively in 2018 and 2019. The rod’s sagittal parameters were measured retrospectively by three independent surgeons on two separate occasions using the same protocol. After the rods were bent but before they were inserted, the surgeon traced the contours of the rods on a sheet of paper that was later scanned and analyzed semiautomatically. The spinal parameters were calculated based on biplanar radiographs taken preoperatively, postoperatively and at the final follow-up visit. Patients who had less than 10° thoracic kyphosis (T5-T12) made up the « Lenke N- » subgroup.nnRESULTS: Thirty patients were included (14 of whom were Lenke N-) who had a Cobb angle of 59.2±11.3° preoperatively and 13.3±8.4° postoperatively (p<0.00001). The inter- and intrarater ICC for the rod measurements were>0.9 (excellent). The mean kyphosis of the concave rod was 48.4±5.7° (38.3-60.9°). The mean change in T5-T12 kyphosis was 9.7±10.8° (-14.3-30.8°) (p<0.0001) in the entire population, while it was 17.7±7.1° (5.5-30.8°) (p<0.0001) in the Lenke N- subgroup. The change in thoracic kyphosis was positively correlated with the kyphosis of the concave rod (rho=0.52; p=0.003).nnCONCLUSION: This study found excellent reproducibility and repeatability of measuring freehand rod bending. The kyphosis applied to the concave rod is positively correlated to the change in the resulting kyphosis and made it possible to restore satisfactory thoracic kyphosis.nnLEVEL OF EVIDENCE: III.
Mainard, Nicolas; Saghbini, Elie; Langlais, Tristan; Vialle, Raphael; Nectoux, Eric; de Gauzy, Jerome Sales; Fron, Damien; Canavese, Federico
Dans: Eur Spine J, vol. 32, no. 9, p. 3118–3132, 2023, ISSN: 1432-0932.
@article{pmid37382696,
title = {Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years},
author = {Nicolas Mainard and Elie Saghbini and Tristan Langlais and Raphael Vialle and Eric Nectoux and Jerome Sales de Gauzy and Damien Fron and Federico Canavese},
doi = {10.1007/s00586-023-07834-x},
issn = {1432-0932},
year = {2023},
date = {2023-09-01},
journal = {Eur Spine J},
volume = {32},
number = {9},
pages = {3118--3132},
abstract = {PURPOSE: The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.nnMETHODS: This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.nnRESULTS: A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.nnCONCLUSION: Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.nnLEVEL OF EVIDENCE: Level 4.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.nnMETHODS: This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.nnRESULTS: A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.nnCONCLUSION: Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.nnLEVEL OF EVIDENCE: Level 4.
Viallard, Lisa; Voiry, Caroline; Maze, Stéphanie; Fontaine, Sylvie; Kerdraon, Jacques; Bonan, Isabelle; Peyronnet, Benoît
Dans: Prog Urol, vol. 33, no. 8-9, p. 421–426, 2023, ISSN: 1166-7087.
@article{pmid36922295,
title = {[Uroflowmetry: A follow-up tool for neurogenic bladder patients treated by transcutaneous tibial posterior stimulation?]},
author = {Lisa Viallard and Caroline Voiry and Stéphanie Maze and Sylvie Fontaine and Jacques Kerdraon and Isabelle Bonan and Benoît Peyronnet},
doi = {10.1016/j.purol.2023.02.001},
issn = {1166-7087},
year = {2023},
date = {2023-08-01},
journal = {Prog Urol},
volume = {33},
number = {8-9},
pages = {421--426},
abstract = {OBJECTIVE: Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics. But it is an invasive, expensive and sometimes not patient-accepted examination, contrary to the uroflowmetry. The aim of this study is to assess the feasibility of a follow-up with a uroflowmetry when treated by TTNS and show that the maximum flow rate increased after treatment, displaying a better detrusor contraction.nnMETHODS: In total, 38 patients with neurogenic bladder undergoing a 12-weeks TTNS treatment and with 2 uroflowmetries interpretable before and after treatment were included. The maximum flow rate (Qmax), the urinated volume and the post-void residual (PVR) were retrieved from the uroflowmetry, and the USP-score and the urinary discomfort were asked at each appointment.nnRESULTS: Qmax is increased from 17,53ml/s to 18,26ml/s, as well as the PVR (from 76,97ml to 79,16ml). Urinated volume is decreased from 241,4ml to 193,66ml. Patients feel enhanced after TTNS according to the decrease in the USP-score and the urinary discomfort scale.nnCONCLUSION: The increase of the cystomanometric capacity and the delay of the detrusor overactivity due to TTNS explains the reduction of the urinated volume and the increase of PVR. Increased Qmax might show a better voluntary bladder contraction, with a restraint due to the lack of abdominal pressure measurement during voiding.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics. But it is an invasive, expensive and sometimes not patient-accepted examination, contrary to the uroflowmetry. The aim of this study is to assess the feasibility of a follow-up with a uroflowmetry when treated by TTNS and show that the maximum flow rate increased after treatment, displaying a better detrusor contraction.nnMETHODS: In total, 38 patients with neurogenic bladder undergoing a 12-weeks TTNS treatment and with 2 uroflowmetries interpretable before and after treatment were included. The maximum flow rate (Qmax), the urinated volume and the post-void residual (PVR) were retrieved from the uroflowmetry, and the USP-score and the urinary discomfort were asked at each appointment.nnRESULTS: Qmax is increased from 17,53ml/s to 18,26ml/s, as well as the PVR (from 76,97ml to 79,16ml). Urinated volume is decreased from 241,4ml to 193,66ml. Patients feel enhanced after TTNS according to the decrease in the USP-score and the urinary discomfort scale.nnCONCLUSION: The increase of the cystomanometric capacity and the delay of the detrusor overactivity due to TTNS explains the reduction of the urinated volume and the increase of PVR. Increased Qmax might show a better voluntary bladder contraction, with a restraint due to the lack of abdominal pressure measurement during voiding.