Cacioppo, Marine; Menard, Hélène; Philiponnet, Camille Olivari; Pabic, Estelle Le; Brochard, Charlène; Peyronnet, Benoit; Violas, Philippe; Riffaud, Laurent; Bonan, Isabelle
Dans: Ann Phys Rehabil Med, vol. 66, no. 2, p. 101685, 2023, ISSN: 1877-0665.
@article{pmid35717001,
title = {Prevalence and risk factors for scoliosis in adults with closed and open spina bifida: A large, cross-sectional study},
author = {Marine Cacioppo and Hélène Menard and Camille Olivari Philiponnet and Estelle Le Pabic and Charlène Brochard and Benoit Peyronnet and Philippe Violas and Laurent Riffaud and Isabelle Bonan},
doi = {10.1016/j.rehab.2022.101685},
issn = {1877-0665},
year = {2023},
date = {2023-03-01},
journal = {Ann Phys Rehabil Med},
volume = {66},
number = {2},
pages = {101685},
abstract = {BACKGROUND: Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB).nnOBJECTIVES: The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB.nnMETHODS: This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors.nnRESULTS: In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively).nnCONCLUSION: About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB).nnOBJECTIVES: The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB.nnMETHODS: This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors.nnRESULTS: In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively).nnCONCLUSION: About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.
Protocol for Electrical Conductivity Signal Collection and Processing in Scoliosis Surgery
Saghbiny, Elie; Silva, Jimmy Da; Chaimi, Celia; Chandanson, Thibault; Vialle, Raphael
Dans: Adv Orthop, vol. 2023, p. 9955520, 2023, ISSN: 2090-3464.
@article{pmid38024482b,
title = {Protocol for Electrical Conductivity Signal Collection and Processing in Scoliosis Surgery},
author = {Elie Saghbiny and Jimmy Da Silva and Celia Chaimi and Thibault Chandanson and Raphael Vialle},
doi = {10.1155/2023/9955520},
issn = {2090-3464},
year = {2023},
date = {2023-01-01},
journal = {Adv Orthop},
volume = {2023},
pages = {9955520},
abstract = {INTRODUCTION: Pedicle screw placement is a common procedure in spinal surgery. The misplacement rate with lateral and medial cortical perforation is 5-11%. Several techniques are used to decrease this rate. Many studies proved that electrical conductivity increases accuracy during pedicle screw placement but no study has interpreted conductivity values.nnMETHODS: The data are collected from patients operated for scoliosis in a single university hospital. After the posterior surgical approach is made, each pedicle is prepared classically. Instead of the classic curved pedicle probe, the surgeon uses a probe with the same shape that measures the conductivity at its tip. Conductivity values are recorded through a Bluetooth application. Each pedicle trajectory is then qualified after manual palpation with a feeler. A trajectory is qualified as optimal when palpation shows a bone tunnel without any breach, breached when there was a breach, and a modification of the probe direction was needed. A trajectory that does not meet the abovementioned definitions is excluded from the statistical analysis.nnRESULTS: 21 patients with 457 pedicles are recorded. The average age of the population is 14.71 ± 1.86 years. 17 patients (81%) have idiopathic adolescent scoliosis. One patient has Rett syndrome, one has hypotonia, one has cerebral palsy, and one has congenital malformation. The depth of the instrument is measured semiautomatically. This technique is validated when compared with the manual technique using the Bland-Altman agreement method (mean differences = -0.279 mm, upper limit = 2.2 mm, and lower limit = -2.7 mm) and Deming regression (slope = 1.06 ± 0.004).nnCONCLUSION: This study establishes a protocol to collect electrical conductivity signals in spine surgery with synchronization to the depth of the instrument. Real-time conductivity signal feedback alerts the surgeon of a probable breach in the spinal canal, so he can change the direction of the pedicle aim.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Pedicle screw placement is a common procedure in spinal surgery. The misplacement rate with lateral and medial cortical perforation is 5-11%. Several techniques are used to decrease this rate. Many studies proved that electrical conductivity increases accuracy during pedicle screw placement but no study has interpreted conductivity values.nnMETHODS: The data are collected from patients operated for scoliosis in a single university hospital. After the posterior surgical approach is made, each pedicle is prepared classically. Instead of the classic curved pedicle probe, the surgeon uses a probe with the same shape that measures the conductivity at its tip. Conductivity values are recorded through a Bluetooth application. Each pedicle trajectory is then qualified after manual palpation with a feeler. A trajectory is qualified as optimal when palpation shows a bone tunnel without any breach, breached when there was a breach, and a modification of the probe direction was needed. A trajectory that does not meet the abovementioned definitions is excluded from the statistical analysis.nnRESULTS: 21 patients with 457 pedicles are recorded. The average age of the population is 14.71 ± 1.86 years. 17 patients (81%) have idiopathic adolescent scoliosis. One patient has Rett syndrome, one has hypotonia, one has cerebral palsy, and one has congenital malformation. The depth of the instrument is measured semiautomatically. This technique is validated when compared with the manual technique using the Bland-Altman agreement method (mean differences = -0.279 mm, upper limit = 2.2 mm, and lower limit = -2.7 mm) and Deming regression (slope = 1.06 ± 0.004).nnCONCLUSION: This study establishes a protocol to collect electrical conductivity signals in spine surgery with synchronization to the depth of the instrument. Real-time conductivity signal feedback alerts the surgeon of a probable breach in the spinal canal, so he can change the direction of the pedicle aim.
Rougereau, Grégoire; Langlais, Tristan; Vigan, Marie; Hardy, Alexandre; Vialle, Raphaël; Marty-Diloy, Thibault; Cambon-Binder, Adeline
Dans: Foot Ankle Surg, vol. 28, no. 8, p. 1279–1285, 2022, ISSN: 1460-9584.
@article{pmid35717494,
title = {Ankle syndesmosis biomechanical evaluation by shear-waves elastography in healthy young adults: Assessment of the reliability and accuracy of the measurements and definition of a corridor of normality},
author = {Grégoire Rougereau and Tristan Langlais and Marie Vigan and Alexandre Hardy and Raphaël Vialle and Thibault Marty-Diloy and Adeline Cambon-Binder},
doi = {10.1016/j.fas.2022.05.003},
issn = {1460-9584},
year = {2022},
date = {2022-12-01},
journal = {Foot Ankle Surg},
volume = {28},
number = {8},
pages = {1279--1285},
abstract = {BACKGROUND: Aims of this study were: 1/ to evaluate the shear wave speed (SWS) properties of the anteroinferior tibiofibular ligament (AITFL) and the distal interosseous membrane (DIOM) in neutral, dorsal flexion and plantar flexion positions in a cohort of healthy adult volunteers; 2/ to assess the reliability and reproducibility of these measurements.nnMETHODS: Both ankles were analyzed by shear wave elastography (SWE) in 20 healthy patients (10 females/10 males) standing on a hinge support with their ankles in neutral, 20° dorsal flexion and 30° plantar flexion positions. Stiffness of AITFL and DIOM was evaluated by SWS measurement.nnRESULTS: The SWS of AITFL and DIOM were minimal in the plantar flexion position (4.28 m/s [2.65-5.11] and 3.35 m/s [1.69-4.55], respectively). It increased significantly for both ligaments in neutral position (4.69 m/s [3.53-5.71] and 3.81 m/s [1.91-4.74], respectively; p < 0.0001), and reached their maximum values in dorsal flexion (6.58 m/s [5.23-8.34] and 4.79 m/s [3.07-6.19], respectively; p < 0.0001). There was no correlation between each ligament regardless the positions. SWS of AITFL was independent of demographic characteristics analyzed. SWS of DIOM was negatively correlated with height in dorsal flexion (ρ = -0.35; p = 0.03) and in plantar flexion (ρ = -0.37; p = 0.02). Female gender was associated with increased DIOM SWS in neutral (p = 0.005), dorsal flexion (p = 0.003), and plantar flexion (p = 0.001) positions. Moreover, foot morphology (foot arch, hind foot frontal deviation) did not impact AITFL nor DIOM SWS. Inter- and intra-observer measurements were all good or excellent.nnCONCLUSION: The AITFL and DIOM, stabilizers of the distal tibiofibular syndesmosis, increase in stiffness while dorsal flexion increases. This study describes a reliable and reproducible protocol to assess their stiffness by SWE, and defines a corridor of normality.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Aims of this study were: 1/ to evaluate the shear wave speed (SWS) properties of the anteroinferior tibiofibular ligament (AITFL) and the distal interosseous membrane (DIOM) in neutral, dorsal flexion and plantar flexion positions in a cohort of healthy adult volunteers; 2/ to assess the reliability and reproducibility of these measurements.nnMETHODS: Both ankles were analyzed by shear wave elastography (SWE) in 20 healthy patients (10 females/10 males) standing on a hinge support with their ankles in neutral, 20° dorsal flexion and 30° plantar flexion positions. Stiffness of AITFL and DIOM was evaluated by SWS measurement.nnRESULTS: The SWS of AITFL and DIOM were minimal in the plantar flexion position (4.28 m/s [2.65-5.11] and 3.35 m/s [1.69-4.55], respectively). It increased significantly for both ligaments in neutral position (4.69 m/s [3.53-5.71] and 3.81 m/s [1.91-4.74], respectively; p < 0.0001), and reached their maximum values in dorsal flexion (6.58 m/s [5.23-8.34] and 4.79 m/s [3.07-6.19], respectively; p < 0.0001). There was no correlation between each ligament regardless the positions. SWS of AITFL was independent of demographic characteristics analyzed. SWS of DIOM was negatively correlated with height in dorsal flexion (ρ = -0.35; p = 0.03) and in plantar flexion (ρ = -0.37; p = 0.02). Female gender was associated with increased DIOM SWS in neutral (p = 0.005), dorsal flexion (p = 0.003), and plantar flexion (p = 0.001) positions. Moreover, foot morphology (foot arch, hind foot frontal deviation) did not impact AITFL nor DIOM SWS. Inter- and intra-observer measurements were all good or excellent.nnCONCLUSION: The AITFL and DIOM, stabilizers of the distal tibiofibular syndesmosis, increase in stiffness while dorsal flexion increases. This study describes a reliable and reproducible protocol to assess their stiffness by SWE, and defines a corridor of normality.
Rougereau, Grégoire; Marty-Diloy, Thibault; Vigan, Marie; Vialle, Raphaël; Soubeyrand, Marc; Langlais, Tristan
Dans: J Hand Surg Eur Vol, vol. 47, no. 11, p. 1134–1141, 2022, ISSN: 2043-6289.
@article{pmid35953882,
title = {Biomechanical assessment of the central band of the interosseous membrane using shear wave elastography: reliability and reproducibility},
author = {Grégoire Rougereau and Thibault Marty-Diloy and Marie Vigan and Raphaël Vialle and Marc Soubeyrand and Tristan Langlais},
doi = {10.1177/17531934221114301},
issn = {2043-6289},
year = {2022},
date = {2022-12-01},
journal = {J Hand Surg Eur Vol},
volume = {47},
number = {11},
pages = {1134--1141},
abstract = {The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults. IV.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The interosseous membrane of the forearm is an essential structure for the stability of the forearm skeleton, the most important part being the central band. The purpose of this study was to determine if shear wave elastography, a non-invasive ultrasound technique, can be used to measure shear wave speed in the central band and quantify stiffness. Fifteen healthy adult subjects were included (30 forearms). The participants forearms were positioned on an articulated plate, with their hand in neutral, pronated and then supinated positions of 30°, 60° and 90°. The shear wave speed was highest in 90° pronation (4.4 m/s (SD 0.3)) and 90° supination (4.4 m/s (SD 0.27)) indicating maximum stiffness in these positions. Its minimum value was in the neutral position, and either in 30° pronation or supination (3.5 m/s (SD 0.3)). Intra- and interobserver agreement was excellent, regardless of probe positioning or forearm mobilization. This study presents a reliable shear wave elastography measurement protocol to describe the physiological function of the central band of the interosseous membrane in healthy adults. IV.
Impact of sleep-disordered breathing on the management of children with Chiari malformation type I
Vagianou, Foteini; Khirani, Sonia; Denis, Timothée De Saint; Beccaria, Kevin; Amaddeo, Alessandro; Breton, Sylvain; James, Syril; Paternoster, Giovanna; Arnaud, Eric; Zerah, Michel; Fauroux, Brigitte
Dans: Pediatr Pulmonol, vol. 57, no. 12, p. 2954–2962, 2022, ISSN: 1099-0496.
@article{pmid35962649,
title = {Impact of sleep-disordered breathing on the management of children with Chiari malformation type I},
author = {Foteini Vagianou and Sonia Khirani and Timothée De Saint Denis and Kevin Beccaria and Alessandro Amaddeo and Sylvain Breton and Syril James and Giovanna Paternoster and Eric Arnaud and Michel Zerah and Brigitte Fauroux},
doi = {10.1002/ppul.26113},
issn = {1099-0496},
year = {2022},
date = {2022-12-01},
journal = {Pediatr Pulmonol},
volume = {57},
number = {12},
pages = {2954--2962},
abstract = {OBJECTIVES: Children with Chiari malformation type I (CM-I) have an increased risk of sleep apnea. The aim of the study was to describe the management of CM-I patients in relation to symptoms, magnetic resonance imaging (MRI) findings and sleep apnea syndrome (SAS).nnMETHODS: We performed a retrospective analysis of clinical charts of all 57 CM-I patients seen between September 2013 and April 2017.nnRESULTS: A total of 45 patients had isolated CM-I or associated co-morbidity (CM-Iia), 5 had craniosynostosis (CM-Ics), and 7 a polymalformative syndrome (CM-Ipm). The prevalence of SAS, defined as an apnea-hypopnea index >1 event/h, was high in CM-I ranging from 50% to 80% according to the CM-I group. The prevalence of central sleep apnea (CSA) was low, with 5 (9%) patients having CSA and only 3 patients with CM-Iia having isolated CSA. A total of 17 patients (30%) had foramen magnum decompression (FMD). Neither positive symptoms of CM-I nor MRI findings alone, nor both combined were good indicators for FMD. No correlation was observed between the cerebellar tonsil descent and SAS in CM-I. But all 5 patients with CSA had a FMD. The combination of MRI findings and/or symptoms of CM-I together with moderate-to-severe SAS best discriminated patients who needed a FMD.nnCONCLUSION: Our findings highlight the importance of a combined evaluation of symptoms, MRI and polygraphy results in the management of CM-I patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Children with Chiari malformation type I (CM-I) have an increased risk of sleep apnea. The aim of the study was to describe the management of CM-I patients in relation to symptoms, magnetic resonance imaging (MRI) findings and sleep apnea syndrome (SAS).nnMETHODS: We performed a retrospective analysis of clinical charts of all 57 CM-I patients seen between September 2013 and April 2017.nnRESULTS: A total of 45 patients had isolated CM-I or associated co-morbidity (CM-Iia), 5 had craniosynostosis (CM-Ics), and 7 a polymalformative syndrome (CM-Ipm). The prevalence of SAS, defined as an apnea-hypopnea index >1 event/h, was high in CM-I ranging from 50% to 80% according to the CM-I group. The prevalence of central sleep apnea (CSA) was low, with 5 (9%) patients having CSA and only 3 patients with CM-Iia having isolated CSA. A total of 17 patients (30%) had foramen magnum decompression (FMD). Neither positive symptoms of CM-I nor MRI findings alone, nor both combined were good indicators for FMD. No correlation was observed between the cerebellar tonsil descent and SAS in CM-I. But all 5 patients with CSA had a FMD. The combination of MRI findings and/or symptoms of CM-I together with moderate-to-severe SAS best discriminated patients who needed a FMD.nnCONCLUSION: Our findings highlight the importance of a combined evaluation of symptoms, MRI and polygraphy results in the management of CM-I patients.
Athiel, Y; Jouannic, J-M; Guilbaud, L
Dans: Gynecol Obstet Fertil Senol, vol. 50, no. 11, p. 744–745, 2022, ISSN: 2468-7189.
@article{pmid35940530,
title = {[Surgical experimental protocol of fetal myelomeningocele creation and repair in the ovine model (with video)]},
author = {Y Athiel and J-M Jouannic and L Guilbaud},
doi = {10.1016/j.gofs.2022.07.005},
issn = {2468-7189},
year = {2022},
date = {2022-11-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {50},
number = {11},
pages = {744--745},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Benayoun, Marie; Langlais, Tristan; Laurent, Romain; Hanneur, Malo Le; Vialle, Raphaël; Bachy, Manon; Fitoussi, Franck
Dans: Orthop Traumatol Surg Res, vol. 108, no. 6, p. 102925, 2022, ISSN: 1877-0568.
@article{pmid33845175,
title = {3D planning and patient-specific surgical guides in forearm osteotomy in children: Radiographic accuracy and clinical morbidity},
author = {Marie Benayoun and Tristan Langlais and Romain Laurent and Malo Le Hanneur and Raphaël Vialle and Manon Bachy and Franck Fitoussi},
doi = {10.1016/j.otsr.2021.102925},
issn = {1877-0568},
year = {2022},
date = {2022-10-01},
journal = {Orthop Traumatol Surg Res},
volume = {108},
number = {6},
pages = {102925},
abstract = {INTRODUCTION: Three-dimensional (3D) planning and patient-specific surgical guides are increasingly used in the treatment of skeletal deformities. The present study hypothesis was that they are reliable in forearm osteotomy in children, with low morbidity.nnMATERIAL AND METHODS: Twenty-there children with one or several osteotomies to correct forearm deformities were retrospectively included: 9 (20 osteotomies) with surgical guide (G+), and 14 (28 osteotomies) without (G-). Etiologies comprised 8 cases of Madelung disease (3G+, 5G-) and 15 of post-traumatic malunion (6G+, 9G-). Mean age at surgery was 14.8±1.9 years. The patient-specific 3D-printed polyamide guides were produced from 3D virtual models based on 3D CT reconstruction. Mean follow-up was 22.1±13.6 months.nnRESULTS: Mean correction error was 5.3°±4.1 and 4.2°±4.1 in the frontal and sagittal planes respectively in G+ (p=0.6). Surgery time was significantly shorter in G+, by a mean 42min (p=0.02). Mean total radiation dose (preoperative CT+intraoperative fluoroscopy) was significantly higher in G+ (p<0.0001). Complications rates were similar between groups. Improvement in PRWE score was significantly greater in G+.nnCONCLUSION: The present preliminary results were encouraging. 3D planning and patient-specific surgical guides can be used in the treatment of forearm deformity in children.nnLEVEL OF EVIDENCE: III; retrospective cohort study.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: Three-dimensional (3D) planning and patient-specific surgical guides are increasingly used in the treatment of skeletal deformities. The present study hypothesis was that they are reliable in forearm osteotomy in children, with low morbidity.nnMATERIAL AND METHODS: Twenty-there children with one or several osteotomies to correct forearm deformities were retrospectively included: 9 (20 osteotomies) with surgical guide (G+), and 14 (28 osteotomies) without (G-). Etiologies comprised 8 cases of Madelung disease (3G+, 5G-) and 15 of post-traumatic malunion (6G+, 9G-). Mean age at surgery was 14.8±1.9 years. The patient-specific 3D-printed polyamide guides were produced from 3D virtual models based on 3D CT reconstruction. Mean follow-up was 22.1±13.6 months.nnRESULTS: Mean correction error was 5.3°±4.1 and 4.2°±4.1 in the frontal and sagittal planes respectively in G+ (p=0.6). Surgery time was significantly shorter in G+, by a mean 42min (p=0.02). Mean total radiation dose (preoperative CT+intraoperative fluoroscopy) was significantly higher in G+ (p<0.0001). Complications rates were similar between groups. Improvement in PRWE score was significantly greater in G+.nnCONCLUSION: The present preliminary results were encouraging. 3D planning and patient-specific surgical guides can be used in the treatment of forearm deformity in children.nnLEVEL OF EVIDENCE: III; retrospective cohort study.
Compagnon, Roxane; Brun-Cottan, Baptiste; Abelin-Genevois, Kariman; Angelliaume, Audrey; Ferrero, Emmanuelle; Garin, Christophe; Ilharreborde, Brice; Jouve, Jean-Luc; Lefevre, Yan; Morin, Christian; Vialle, Raphaël; Accadbled, Franck; de Gauzy, Jérôme Sales; Pesenti, Sébastien; Langlais, Tristan
Dans: Orthop Traumatol Surg Res, vol. 108, no. 6, p. 103350, 2022, ISSN: 1877-0568.
@article{pmid35716985,
title = {Side bending radiographs and lowest instrumented vertebra in adolescent idiopathic scoliosis: A French quality-of-care study},
author = {Roxane Compagnon and Baptiste Brun-Cottan and Kariman Abelin-Genevois and Audrey Angelliaume and Emmanuelle Ferrero and Christophe Garin and Brice Ilharreborde and Jean-Luc Jouve and Yan Lefevre and Christian Morin and Raphaël Vialle and Franck Accadbled and Jérôme Sales de Gauzy and Sébastien Pesenti and Tristan Langlais},
doi = {10.1016/j.otsr.2022.103350},
issn = {1877-0568},
year = {2022},
date = {2022-10-01},
journal = {Orthop Traumatol Surg Res},
volume = {108},
number = {6},
pages = {103350},
abstract = {BACKGROUND: Determining which spinal levels to instrument during surgical treatment of Lenke Type 1 adolescent idiopathic scoliosis (AIS) depends on the reducibility of the primary and secondary curve patterns. This reducibility can be evaluated in several ways, with the most popular being radiographs in bending for moderate thoracic and lumbar curvatures. Hypothesis Side-bending radiographs will alter the choice of the lowest instrumented vertebra (LIV) for the surgical treatment of AIS.nnMETHODS: Thirteen experienced French spine surgeons were invited to perform surgical planning on 23 patients based on stereoradiographs with and without (standing) side-bending views. The surgical planning was repeated a second time to assess the intra- and inter-rater reliability. Variations in the choice of LIV were analyzed for each evaluation.nnRESULTS: The intra-rater reliability was moderate to substantial. The inter-rater reliability was low to moderate. The study compared 879 surgical plans. Selective fusion was chosen in 0.3% of the plans. The median LIV was L2. The availability of side bending views changed the plan in 39% of cases. However, 36% of the plans were changed in the control (test-retest) condition. No significant difference was found between the variations with side-bending radiographs and "control" variations (p>0.05).nnCONCLUSION: The use of radiographs in bending has no significant effect on the LIV choice in this study. This result is derived from statistically robust analysis made possible by one of the largest datasets available on this topic. Large inter-rater variability was observed and will be explored further in a future study.nnLEVEL OF EVIDENCE: II; non-randomized controlled comparative study.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Determining which spinal levels to instrument during surgical treatment of Lenke Type 1 adolescent idiopathic scoliosis (AIS) depends on the reducibility of the primary and secondary curve patterns. This reducibility can be evaluated in several ways, with the most popular being radiographs in bending for moderate thoracic and lumbar curvatures. Hypothesis Side-bending radiographs will alter the choice of the lowest instrumented vertebra (LIV) for the surgical treatment of AIS.nnMETHODS: Thirteen experienced French spine surgeons were invited to perform surgical planning on 23 patients based on stereoradiographs with and without (standing) side-bending views. The surgical planning was repeated a second time to assess the intra- and inter-rater reliability. Variations in the choice of LIV were analyzed for each evaluation.nnRESULTS: The intra-rater reliability was moderate to substantial. The inter-rater reliability was low to moderate. The study compared 879 surgical plans. Selective fusion was chosen in 0.3% of the plans. The median LIV was L2. The availability of side bending views changed the plan in 39% of cases. However, 36% of the plans were changed in the control (test-retest) condition. No significant difference was found between the variations with side-bending radiographs and « control » variations (p>0.05).nnCONCLUSION: The use of radiographs in bending has no significant effect on the LIV choice in this study. This result is derived from statistically robust analysis made possible by one of the largest datasets available on this topic. Large inter-rater variability was observed and will be explored further in a future study.nnLEVEL OF EVIDENCE: II; non-randomized controlled comparative study.
Athiel, Yoann; Nasone, Justine; Arakelian, Lousineh; Faivre, Lionel; Dugas, Anaïs; Jouannic, Jean-Marie; Larghero, Jérôme; Guilbaud, Lucie
Dans: Stem Cell Res Ther, vol. 13, no. 1, p. 300, 2022, ISSN: 1757-6512.
@article{pmid35841029,
title = {Biodistribution of allogenic umbilical cord-derived mesenchymal stromal cells after fetal repair of myelomeningocele in an ovine model},
author = {Yoann Athiel and Justine Nasone and Lousineh Arakelian and Lionel Faivre and Anaïs Dugas and Jean-Marie Jouannic and Jérôme Larghero and Lucie Guilbaud},
doi = {10.1186/s13287-022-02991-0},
issn = {1757-6512},
year = {2022},
date = {2022-07-01},
journal = {Stem Cell Res Ther},
volume = {13},
number = {1},
pages = {300},
abstract = {BACKGROUND: Myelomeningocele (MMC) is a spinal cord congenital defect that leads to paraplegia, sphincter disorders and potential neurocognitive disabilities. Prenatal surgery of MMC provides a significant benefit compared to surgery at birth. Mesenchymal stromal cell (MSC) therapy as an adjuvant treatment for prenatal surgery showed promising results in animal experiments which could be considered for clinical use in human fetuses. Despite numerous reassuring studies on the safety of MSCs administration in humans, no study focused on MSCs biodistribution after a local MSCs graft on the fetal spinal cord.nnAIM: The purpose of our study was to assess the biodistribution of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) at birth in lambs who had a prenatal myelomeningocele repair using a fibrin patch seeded with allogenic UC-MSCs.nnMETHODS: After isolation, UC-MSCs were tagged using a green fluorescent protein (GFP)-containing lentiviral vector. MMC defects were surgically created at 75 days of gestation and repaired 15 days later using UC-MSCs patch. Lambs were delivered at 142 days and sacrificed. DNA extraction was performed among biopsies of the different organs and q-PCR analysis was used to detect the expression of GFP (GFP DNA coding sequence).nnRESULTS: In our 6 surviving lambs grafted with UC-MSCs, GFP lentivirus genomic DNA was not detected in the organs.nnCONCLUSION: These reassuring data will support translational application in humans, especially since the first human clinical trial using mesenchymal stromal cells for in-utero treatment of MMC started recently in U.S.A.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Myelomeningocele (MMC) is a spinal cord congenital defect that leads to paraplegia, sphincter disorders and potential neurocognitive disabilities. Prenatal surgery of MMC provides a significant benefit compared to surgery at birth. Mesenchymal stromal cell (MSC) therapy as an adjuvant treatment for prenatal surgery showed promising results in animal experiments which could be considered for clinical use in human fetuses. Despite numerous reassuring studies on the safety of MSCs administration in humans, no study focused on MSCs biodistribution after a local MSCs graft on the fetal spinal cord.nnAIM: The purpose of our study was to assess the biodistribution of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) at birth in lambs who had a prenatal myelomeningocele repair using a fibrin patch seeded with allogenic UC-MSCs.nnMETHODS: After isolation, UC-MSCs were tagged using a green fluorescent protein (GFP)-containing lentiviral vector. MMC defects were surgically created at 75 days of gestation and repaired 15 days later using UC-MSCs patch. Lambs were delivered at 142 days and sacrificed. DNA extraction was performed among biopsies of the different organs and q-PCR analysis was used to detect the expression of GFP (GFP DNA coding sequence).nnRESULTS: In our 6 surviving lambs grafted with UC-MSCs, GFP lentivirus genomic DNA was not detected in the organs.nnCONCLUSION: These reassuring data will support translational application in humans, especially since the first human clinical trial using mesenchymal stromal cells for in-utero treatment of MMC started recently in U.S.A.
Rougereau, Grégoire; Marty-Diloy, Thibault; Vigan, Marie; Donadieu, Kalinka; Hardy, Alexandre; Vialle, Raphaël; Langlais, Tristan
Dans: Foot Ankle Int, vol. 43, no. 6, p. 840–849, 2022, ISSN: 1944-7876.
@article{pmid35373593,
title = {A Preliminary Study to Assess the Relevance of Shear-Wave Elastography in Characterizing Biomechanical Changes in the Deltoid Ligament Complex in Relation to Ankle Position},
author = {Grégoire Rougereau and Thibault Marty-Diloy and Marie Vigan and Kalinka Donadieu and Alexandre Hardy and Raphaël Vialle and Tristan Langlais},
doi = {10.1177/10711007221079829},
issn = {1944-7876},
year = {2022},
date = {2022-06-01},
journal = {Foot Ankle Int},
volume = {43},
number = {6},
pages = {840--849},
abstract = {BACKGROUND: The purpose of this study was (1) to evaluate the biomechanical properties of the different bundles of the deltoid ligament in various ankle positions in a cohort of healthy adult volunteers; (2) describe the impact of demographic and hindfoot morphology characteristics on their stiffness; (3) to assess the reliability and reproducibility of these measurements.nnMETHODS: Deltoid ligament complex of both ankles were assessed by shear-wave elastography (SWE) in 20 healthy patients resting on hinge support. The propagation shear-wave speed (SWS) in ligaments was measured, which is related to the tissue's elastic modulus. The following ligaments were analyzed in a neutral position and then in varus, valgus, dorsal, and plantar flexions: tibionavicular ligament (TNL), tibiocalcaneal ligament (TCL), the superficial posterior tibiotalar ligament (SPTL), the anterior tibiotalar ligament (ATTL), and the deep posterior tibiotalar ligament (DPTTL).nnRESULTS: The mean SWS increased between neutral and 20 degrees valgus position for TCL (4.08 ± 0.78 m/s vs 5.56 ± 0.62 m/s, respectively; < .0001) and for DPTTL (2.58 ± 0.52 m/s vs 3.59 ± 0.87 m/s, respectively; < .0001). The mean SWS increased between neutral and 30 degrees plantarflexion for ATTL (2.11 ± 0.44 m/s vs 3.1 ± 0.5 m/s, respectively; < .0001) and TNL (2.96 ± 0.66 m/s vs 4.99 ± 0.69 m/s, respectively; < .0001). The mean SWS increased between neutral and 20 degrees dorsal flexion for SPTL (4.2 ± 1 m/s vs 5.45 ± 0.65 m/s, respectively; < .0001).Women had less DPTTL SWS than men in the neutral position (2.37 ± 0.35 m/s vs 2.71 ± 0.49 m/s, respectively; = .007). Other demographics had no impact on the SWS value of other ligaments. All inter- and intraobserver agreements were good to excellent.nnCONCLUSION: This study presents a reliable and reproducible SWE measurement protocol to describe the physiological function of all bundles of the medial collateral ligament in healthy adults.nnCLINICAL RELEVANCE: This examination technique can be available to orthopaedic surgeons, allowing reliable and reproducible monitoring of the SWS of the various ligaments constituting the medial collateral plane. The biomechanical values described in this study may give insight into in what position medial ankle ligament reconstruction should be tensioned.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: The purpose of this study was (1) to evaluate the biomechanical properties of the different bundles of the deltoid ligament in various ankle positions in a cohort of healthy adult volunteers; (2) describe the impact of demographic and hindfoot morphology characteristics on their stiffness; (3) to assess the reliability and reproducibility of these measurements.nnMETHODS: Deltoid ligament complex of both ankles were assessed by shear-wave elastography (SWE) in 20 healthy patients resting on hinge support. The propagation shear-wave speed (SWS) in ligaments was measured, which is related to the tissue’s elastic modulus. The following ligaments were analyzed in a neutral position and then in varus, valgus, dorsal, and plantar flexions: tibionavicular ligament (TNL), tibiocalcaneal ligament (TCL), the superficial posterior tibiotalar ligament (SPTL), the anterior tibiotalar ligament (ATTL), and the deep posterior tibiotalar ligament (DPTTL).nnRESULTS: The mean SWS increased between neutral and 20 degrees valgus position for TCL (4.08 ± 0.78 m/s vs 5.56 ± 0.62 m/s, respectively; < .0001) and for DPTTL (2.58 ± 0.52 m/s vs 3.59 ± 0.87 m/s, respectively; < .0001). The mean SWS increased between neutral and 30 degrees plantarflexion for ATTL (2.11 ± 0.44 m/s vs 3.1 ± 0.5 m/s, respectively; < .0001) and TNL (2.96 ± 0.66 m/s vs 4.99 ± 0.69 m/s, respectively; < .0001). The mean SWS increased between neutral and 20 degrees dorsal flexion for SPTL (4.2 ± 1 m/s vs 5.45 ± 0.65 m/s, respectively; < .0001).Women had less DPTTL SWS than men in the neutral position (2.37 ± 0.35 m/s vs 2.71 ± 0.49 m/s, respectively; = .007). Other demographics had no impact on the SWS value of other ligaments. All inter- and intraobserver agreements were good to excellent.nnCONCLUSION: This study presents a reliable and reproducible SWE measurement protocol to describe the physiological function of all bundles of the medial collateral ligament in healthy adults.nnCLINICAL RELEVANCE: This examination technique can be available to orthopaedic surgeons, allowing reliable and reproducible monitoring of the SWS of the various ligaments constituting the medial collateral plane. The biomechanical values described in this study may give insight into in what position medial ankle ligament reconstruction should be tensioned.