Publications by authors named "Ayman Assi"

Background And Objective: Muscle fat infiltration (MFI) can be seen in several pathologies of various origin including neuromuscular, endocrinological, or musculoskeletal etiologies. Its evaluation is possible through medical imaging, especially MRI, using qualitative or quantitative methods. This paper is an overview of the techniques used to evaluate MFI in different pathologies.

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Background: Social distancing restrictions during the COVID-19 pandemic caused disruptions to sexual health services (SHS) worldwide. During the first year of the pandemic, Lebanon implemented multiple lockdowns during which SHS endured repetitive closures. We explore the impact of the pandemic on SHS delivery and the diagnosis rate of sexually transmitted infections (STIs) among attendees of a large sexual health clinic in Beirut, Lebanon.

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The aim was to study the validity of free-standing position using modifiers for assessing cervical spine alignment. A total of 26 asymptomatic subjects (45 ± 11years) and 13 with spinal deformities (30 ± 21years) underwent lateral radiographs using EOS®, while adopting 3 different positions, in 2 sequences, without mirror and then with mirror (m) placed in front of them: first, the neutral standing position (upper extremities positioned on the sides of the body, P1 and P1m), then free-standing (P2 and P2m) and modified free-standing (P3 and P3m) positions (shoulders flexed at 90° and fingers placed on clavicles then cheeks, respectively). Participants were asked not to move their trunk and shoulders when moving from P1 to P2 and then P3.

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Purpose: Our objective was to analysis the barycentremetry, obtained from the external envelope reconstruction of biplanar radiographs, in adolescent idiopathic scoliosis (AIS) and to determine whether assessing would help predict the distinction between progressive and stable AIS at the early stage.

Methods: A retrospective study with a multicentre cohort of 205 AIS was conducted. All AIS underwent a biplanar X-ray between 2013 and 2020.

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Study Design: Retrospective study of a multicentric prospective database.

Objective: This study aimed to determine, in a cohort of healthy volunteers, the impact of sacralized lumbo-sacral transitional vertebra (LSTV) on spinal alignment according to its grade, particularly regarding lumbar lordosis magnitude and distribution, and the implications for spinopelvic parameters measurement.

Summary Of Background Data: There is little data regarding spinopelvic alignment assessment in LSTV patients.

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Article Synopsis
  • This multicentric retrospective study aimed to establish normative values for proximal junctional angles (PJA) in adult spinal deformity (ASD) surgery patients, using data from healthy volunteers for comparison.
  • The study analyzed data from 721 healthy individuals and 824 ASD surgery patients, assessing the rates of abnormal PJA values and comparing them with the rates of proximal junctional kyphosis (PJK) using different definitions.
  • Findings revealed significant differences in PJK rates based on the criteria used, highlighting the need for more precise level-adjusted assessments of PJA values to better define abnormalities and challenge traditional definitions of PJK.
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Functional assessment is a key element in evaluating adult spinal deformity (ASD) patients. The multitude of 3D kinematic parameters provided by movement analysis can be confusing for spine surgeons. The aim was to investigate movement patterns of ASD based on key kinematic parameters.

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  • This study is a retrospective analysis of a database aiming to understand how vertebral bodies and discs contribute to lumbar lordosis, especially as people age and how this is affected by pelvic incidence.
  • 645 healthy volunteers were analyzed to track changes in lumbar lordosis, finding that as age increases, the lordosis from discs decreases while vertebral body kyphosis increases, particularly in older adults.
  • The findings suggest that the vertebral body's importance in lumbar lordosis rises with pelvic incidence and highlights the significance of these changes for surgical planning in the lumbar spine.
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Little is known about the adaption of community-based organizations (CBOs) during the COVID-19 crisis. This study aimed to study how HIV CBOs and their community health workers (CHWs) faced the COVID-19 outbreak. Semi-structured interviews (n = 53) were conducted among CHWs in Burundi, Mauritania, and Lebanon in 2021.

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Purpose: The goal of this study was to explore sex-related variations of global alignment parameters and their distinct evolution patterns across age groups.

Methods: This multicentric retrospective study included healthy volunteers with full-body biplanar radiographs in free-standing position. All radiographic data were collected from 3D reconstructions: global and lower limb parameters, pelvic incidence (PI) and sacral slope (SS).

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  • The study investigates the relationship between rod curvature and postoperative outcomes, aiming to provide a validated method for measuring rod curvature using X-rays and a regression algorithm to minimize manual errors.
  • Data from 20 adolescent and 35 adult patients with spine deformities were analyzed, involving the marking of rod points on X-rays and applying a polynomial regression to determine rod curvature equations.
  • Results show high reliability of the new measurement method, with intra-observer intraclass correlation coefficients exceeding 0.85 and excellent inter-observer reliability (0.98) particularly noted in the adolescent idiopathic scoliosis/Scheuermann kyphosis group.
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  • Clinical gait analysis (CGA) is essential for assessing gait patterns and planning interventions, but there are currently no international standards, leading to inconsistencies in practices across different countries.
  • A survey conducted by the European Society for Movement Analysis in Adults and Children (ESMAC) evaluated 97 gait laboratories across 16 European countries, focusing on equipment and methods used in CGA.
  • Results showed a general agreement on data collection methods and the use of the Conventional Gait Model, but highlighted differences in training and documentation practices, paving the way for standardized guidelines in the future.
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Introduction: Radiographic analysis is necessary for the assessment and the surgical planning in adults with spinal deformity (ASD). Restoration of global alignment is key to improving patient's quality of life. However, the large number of existing global alignment parameters can be confusing for surgeons.

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Study Design: A multicentric retrospective study.

Objective: The study of center of mass (COM) locations (ie, barycentremetry) can help us understand postural alignment. The goal of this study was to determine relationships between COM locations and global postural alignment x-ray parameters in healthy subjects.

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Article Synopsis
  • This study aimed to evaluate the odontoid-hip axis (OD-HA) angle in patients with mild scoliosis to predict whether adolescent idiopathic scoliosis (AIS) is progressing or stable.
  • Researchers used biplanar X-rays from 2013 to 2020 to analyze the OD-HA angle in 205 AIS patients and 83 non-scoliotic controls, identifying key differences in alignment.
  • The findings indicated that AIS patients are significantly more likely to have malalignment, suggesting the OD-HA measurement could help clinicians assess the stability of scoliosis in adolescents.
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Purpose: To investigate kinematic adaptations from self-selected to fast speed walking in ASD patients.

Methods: 115 primary ASD and 66 controls underwent biplanar radiographic X-rays and 3D gait analysis to calculate trunk, segmental spine and lower limb kinematics during self-selected and fast speed walking. Kinematic adaptation was calculated as the difference (Δ) between fast and self-selected speed walking.

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Introduction: Discrepancy between the clinical examination and the 2D/3D radiographs is a common concern in patients with angular or rotational deformities of the lower limbs, as it may alter clinical judgment and subsequent treatment. The aim was to identify such discrepancies and assess determinants that may contribute to their existence.

Materials And Methods: A retrospective chart review was conducted on 329 consecutive patients (658 lower limbs) who underwent physical examination and long-leg biplanar radiographs in our institution between 2013 and 2018 for limb length discrepancy or angular deformity of the knees (varus/valgus).

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Rationale: Hip-spine syndrome is a frequent finding in patients presenting with symptoms both at the level of the hip and spine.

Patient Concerns: Patient previously operated of lumbar laminectomy for supposed spinal stenosis presenting with persistent pain and disability.

Diagnoses: Clinical examination and imaging showed severe bilateral hip osteoarthritis.

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Article Synopsis
  • Children with X Linked Hypophosphatemia (XLH) experience significant bone issues and may also have distinct muscle characteristics compared to typically developed (TD) children.
  • A study used MRI to analyze muscle morphology in 11 XLH patients and 15 TD children, hypothesizing that XLH would show noticeable differences that could contribute to their limping.
  • Results indicated that most muscle lengths and volumes in XLH patients were smaller than in TD children, with the exception of the medius/minimus gluteus muscles, suggesting a varied muscle structure associated with the condition.
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Femoro-acetabular impingement (FAI) may present as alterations in the skeletal morphology of the hip. Repercussions of FAI can be witnessed in self-selected speed walking as well as physical exercise such as running or fast speed walking. The aim of this study was to investigate changes in kinematics at different gait speeds in subjects presenting with radiological findings invoking FAI.

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Purpose: Lumbar kyphosis occurs in approximately 8-20% of patients with myelomeningocele (MMC). The purpose of this article is to analyze the risks and benefits of vertebrectomy and spinal stabilization in MMC children with severe lumbar kyphosis and to establish treatment guidelines.

Methods: This is an IRB-approved retrospective analysis of 59 patients with MMC who underwent kyphectomy and posterior instrumentation in three centers.

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Background: The goal of this study was to better understand the variation of femoral neck version according to spinopelvic and lower limb 3D alignment using biplanar X-rays in standing position.

Methods: This multicentric study retrospectively included healthy subjects from previous studies who had free-standing position biplanar radiographs. Subjects were excluded if they presented spinal or any musculo-skeletal deformity, and reported pain in the spine, hip or knee.

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Introduction: The calcaneal lengthening procedure (CLP) is a well-known surgical technique used for the correction of symptomatic planovalgus foot deformities. Literature shows a significant rate of relapse and undercorrection of the foot post-operatively. Factors determining the failure or success of CLP are still not well understood.

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Introduction: It was hypothesized that pelvic retroversion in Adult Spinal Deformity (ASD) can be related to an increased hip loading explaining the occurrence of hip-spine syndrome.

Research Question: How pelvic retroversion can modify acetabular orientation in ASD during walking?

Methods: 89 primary ASD and 37 controls underwent 3D gait analysis and full-body biplanar X-rays. Classic spinopelvic parameters were calculated from 3D skeletal reconstructions in addition to acetabular anteversion, abduction, tilt, and coverage.

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