Publications by authors named "Hugues Pascal-Moussellard"

Achieving Return to Sport (RTS) is crucial in managing ankle fractures for athletes. This study aimed to identify RTS factors post-surgical fixation of ankle fractures. A retrospective analysis was conducted on 93 active patients with surgically treated displaced or unstable ankle fractures from January 2020 to January 2021.

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Background: Cyclops syndrome is loss of terminal knee extension caused by a fibrous nodule developed in the anterior intercondylar notch. The many known risk factors include preoperative motion-range limitation, tibial tunnel malposition, and tight hamstrings. The primary objective of this study was to assess whether intercondylar notch size was associated with the risk of cyclops syndrome or graft tear after anterior cruciate ligament (ACL) reconstruction using a quadruple semi-tendinosis autograft.

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Article Synopsis
  • The study aimed to validate a scale called ALR-RSI to help surgeons assess athletes' psychological readiness to return to sports after peroneal tendon surgery.
  • Involving 57 patients, the research found a strong correlation between the ALR-RSI scale and established outcome measures (FAOS and FAAM), indicating its effectiveness.
  • ALR-RSI proved to be a valid tool for predicting athletes' postoperative success, with a high internal consistency and strong discrimination ability, aiding surgeons in evaluating recovery.
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Purpose: Surgical indications for thoraco-lumbar fractures are driven both by neurological status, fractures instability and kyphotic deformity. Regarding kyphotic deformity, an angulation superior to 20° is considered by many surgeons as a surgical indication to reduce the disability induced by post-traumatic kyphosis. However, there is a lack of data reporting the ideal or theoretical lordosis that one must have in a particular lumbar segment on CT-scan.

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Article Synopsis
  • * The study involved 93 patients using the ALR-RSI scale along with two other assessment tools (OMAS and SEFAS), revealing strong correlations between ALR-RSI and the other scales, indicating its effectiveness in measuring psychological readiness.
  • * ALR-RSI demonstrated excellent reproducibility and valid discriminant capacity, showing high sensitivity and specificity at an optimal cutoff, suggesting it can help surgeons predict athletes' readiness and potential postoperative outcomes.
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  • - Thoracic disc herniation is rare, making up less than 1% of spinal herniations, and while often asymptomatic, it can lead to spinal cord ischemia.
  • - A case involving a 43-year-old man showed Brown-Sequard syndrome, where spinal cord ischemia was linked to a thoracic disc extrusion, initially not compressing the cord on MRI.
  • - The patient was treated conservatively, and after a few months, he recovered as the disc extrusion decreased on its own, illustrating the complexities in diagnosis and management of this condition.
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A significant genetic involvement has been known for decades to exist in adolescent idiopathic scoliosis (AIS), a spine deformity affecting 1-3% of the world population. However, though biomechanical and endocrinological theories have emerged, no clear pathophysiological explanation has been found. Data from the whole-exome sequencing performed on 113 individuals in 19 multi-generational families with AIS have been filtered and analyzed via interaction pathways and functional category analysis (Varaft, Bingo and Panther).

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Scheuermann's disease, also referred to as Scheuermann's kyphosis, is the second most frequent spine deformity occurring in humans after adolescent idiopathic scoliosis (AIS), both with an unclear etiology. Recent genetic studies in zebrafish unraveled new mechanisms linked to AIS, highlighting the role of the Reissner fiber, an acellular polymer bathing in the cerebrospinal fluid (CSF) in close proximity with ciliated cells and mechanosensory neurons lining the central canal of the spinal cord (CSF-cNs). However, while the Reissner fiber and ciliary beating have been linked to AIS-like phenotypes in zebrafish, the relevance of the sensory functions of CSF-cNs for human spine disorders remains unknown.

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Objective: Spinal surgery is among the specialities with the highest rates of complications and of peri-operative morbidity and mortality. The number of spinal surgeries performed is rising year on year in France. The objectives of this study were to identify the main reasons for malpractice claims after spinal surgery in France, to evaluate the impact of avoidable errors, and to examine differences between civil lawsuits (private institutions) and administrative lawsuits (public institutions).

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Background: During total knee arthroplasty (TKA), most surgeons align the femoral component along the surgical epicondylar axis (SEA) considering it as orthogonal to the femoral mechanical axis. However, it is still unclear how SEA coronal alignment varies according to the native coronal knee alignment. The main goal of this study was to analyze the SEA orientation according to the native coronal knee morphotype.

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Background: Femoral antetorsion in uncemented hip replacement hardly can be modified and the restoration of the anatomic anteversion might be difficult with standard stems. We compared femoral anteversion restoration of a generic straight stem with a proximally fixed anatomic stem that included a dual sagittal curvature and a proximal torsion. It was hypothesised that the restoration of the anteversion was more accurate with the anatomic stem.

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Background: The restauration of the local kyphosis is crucial to thoracolumbar fractures outcomes. Recently, the Tektona™ (Spine Art) system, constituted by a flexible lamella for corporeal reduction has emerged as a promising solution for osteoporotic fractures. However, no study has yet focused on its results on traumatic fractures.

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Aging of an already pathological spine and its evaluation. The spine can be subject to different pathologies, starting from the beginning of its growth. Among these, scoliosis is relatively frequent and the question of what happens to unoperated scoliosis patients as they get older and are added to an already patho¬logical spine disc degeneration, posterior osteoarthritis or yellow ligament hypertrophy.

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Background: Spinal metastases (SpMs) from thyroid cancers (TC) significantly reduce quality of life by causing pain, neurological deficits in addition to increasing mortality. Moreover, prognosis factors including surgery remain debated.

Methods: Data were stored in a prospective French national multicenter database of patients treated for SpM between January 2014 and 2017.

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Article Synopsis
  • The study looked at how well different scoring systems predict survival for patients with spine metastasis (SPM) and found that they often underestimate how long patients actually live after diagnosis.
  • Out of the scores tested, the Tokuhashi score was the best at predicting survival, while the Tomita score performed the worst with much less accuracy.
  • The findings suggest that doctors shouldn't rely only on these scoring systems for treatment decisions; they should also consider each patient's symptoms and other important factors.
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Background: Instrumented posterior lumbar fusion with top-loading pedicle screw systems (PSS) requires fully tightened set screws to achieve a secure fixation and symmetric load condition. This assumes a complete reduction of the rod by 90°, which is not always attainable in situ, especially under constraint. The objective of this work is to compare the mechanical performance of different innovative set screw technologies, which should improve the tightening process.

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Cerebrospinal fluid (CSF) circulation relies on the beating of motile cilia projecting in the lumen of the brain and spinal cord cavities Mutations in genes involved in cilia motility disturb cerebrospinal fluid circulation and result in scoliosis-like deformities of the spine in juvenile zebrafish. However, these defects in spine alignment have not been validated with clinical criteria used to diagnose adolescent idiopathic scoliosis (AIS). The aim of this study was to describe, using orthopaedic criteria the spinal deformities of a zebrafish mutant model of AIS targeting a gene involved in cilia polarity and motility, cfap298.

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Background: Standard balloon kyphoplasty represents a well-established treatment option for osteoporotic vertebral compression fractures. Aim of the present study was to evaluate two different methods of percutaneous augmentation (standard balloon kyphoplasty (BKP) versus Tektona® (TEK)) with respect to height restoration.

Methods: Four-teen vertebral bodies of two female cadavers were examined.

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The incidence of spinal metastasis (SpM) is increasing, and life expectancy for patients with malignancy is also rising. The "elderly" represent a population with steady growth in SpM proportion. Bracing is associated with lower survival.

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Article Synopsis
  • This study looks at patients with prostate cancer that has spread to their spine, called spine metastasis (SpM), to see how long they might live after that.
  • They found that on average, patients survived for about 28.8 months after developing SpM.
  • Important factors that help predict longer survival include having a good health status and receiving radiation treatment specifically for the spine, while having certain types of spine lesions could also affect survival time.
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Purpose: Some clinical situations, such as great sagittal imbalance, high-grade isthmic spondylolisthesis or sacral malunion could require a sacral osteotomy to decrease pelvic parameters, horizontalize the sacrum or correct sacral malunion. Here is described a novel technique to perform a sacral osteotomy to decrease pelvic parameters with a lumbo-pelvic construct, with first a sacral slope decrease, then a pelvic tilt decrease.

Methods: Simulations have been performed using tridimensional reconstructions of the lumbar spine and pelvis, made from CT-scan images of a healthy individual.

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Article Synopsis
  • * A study of 210 NSCLC patients identified that the median overall survival (OS) for those with spinal metastases was 5.9 months, with factors like WHO performance status and EGFR mutation significantly influencing survival outcomes.
  • * The findings indicate that surgical prognostic models should integrate genotype information while emphasizing the importance of overall health and neurological status over immunotherapy or surgery alone in predicting survival.
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Introduction: The management of type A thoracolumbar fractures varies from conservative treatment to multiple level fusion. Indeed, although Magerl defined the type A fracture as a strictly bone injury, several authors suggested associated disc lesions or degeneration after trauma. However, the preservation of mobility of the adjacent discs should be a major issue.

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