Publications by authors named "Jean Charles Le Huec"
Article Synopsis
- The choice of the lower vertebra for spinal fixation in adult spinal deformity, particularly around the lumbosacral junction, is debated, with options including stopping fixation at S1 or using lower points like S2AI or iliac screws to prevent implant pullout.
- A new technique for posterior fixation combines S1 screws, iliac screws, and sacro-iliac implants, inspired by triangular pelvic fixation methods used for trauma.
- This study outlines the operative technique using fluoroscopic guidance and shares preliminary results from treating 15 patients, labeled as level IV evidence.
Study Design: Cross-sectional Cohort Study.
Objective: To determine the cervicothoracic inflection point in an asymptomatic, adult population.
Introduction: The cervicothoracic inflection point (CTIP) is an important sagittal marker to understand for patients with cervical deformities.
Study Design: Cross-sectional cohort study.
Objective: To classify spinal morphology using the "current" and "theoretical" Roussouly systems and assess sagittal alignment in an asymptomatic cohort.
Methods: 467 asymptomatic volunteers were recruited from 5 countries.
Article Synopsis
- The study aimed to evaluate the distribution of GAP scores among a diverse group of healthy volunteers and assess spinal shape differences based on alignment categories, age, and geography.
- The research involved 467 asymptomatic participants from five countries, measuring various spinal parameters through advanced imaging techniques.
- The findings indicated significant age-related differences in spinal alignment, with older individuals showing a higher rate of severe disproportionality and notable differences in key spinal metrics compared to younger participants.
Objectives: To prospectively evaluate the feasibility and safety of a polyetheretherketone (PEEK) polymer transpedicular vertebral system to treat vertebral compression fracture (VCF).
Methods: Nine consecutive patients (4 men and 5 women; median age 59 [interquartile range: 58-64 years]) were included. The procedure duration, length of hospital stay, and complications were reported.
Study Design: Prospective, cross-sectional study.
Objective: In a geographically diverse population of asymptomatic volunteers, we sought to report the incidence of pelvic obliquity (PO), establish normative values of PO across patient factors, and assess the correlation of PO with radiographic parameters.
Summary Of Background Data: PO is defined as the misalignment of the pelvis and can be assessed through several anatomic landmarks.
Objective: To define a novel radiographic measurement, the posterior cranial vertical line (PCVL), in an asymptomatic adult population to better understand global sagittal alignment.
Methods: We performed a multicenter retrospective review of prospectively collected radiographic data on asymptomatic volunteers aged 20-79. The PCVL is a vertical plumb line drawn from the posterior-most aspect of the occiput.
Study Design: Prospective cohort study.
Objectives: To show population variance in the Inflection Point (IP) and its role in defining maximum Thoracic Kyphosis (TK) and Lumbar Lordosis (LL).
Methods: 468 asymptomatic adult volunteers were included in the Multi-Ethnic Normative Alignment Study (MEANS).
Purpose: To compare the biomechanical behavior of vertebrae with vertebral compression fractures (VCF) treated by a novel system with pedicular anchorage (dowelplasty) versus balloon kyphoplasty.
Methods: Four cadaveric spines (T12-L5) were harvested, cleaned from soft tissues, and separated into vertebrae. Axial compressive loads were applied to each vertebra until a VCF was generated.
Background Context: Current definition of lumbar lordosis uses the L1-S1 angle. Prevailing classification of sagittal spinal morphology, derived from a young adult population, classifies the spine into four subtypes defined by their sacral slope (SS) and curve morphology.
Purpose: To describe physiological sagittal alignment of the lumbar spine across age groups using three main parameters that dictate the lumbar curve: angular magnitude, span, and apex.
Purpose: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers of three difference races.
Methods: Asymptomatic volunteers between the ages of 18-80 years were enrolled prospectively and then analyzed retrospectively from six different centers. Volunteers included reported no significant neck or back pain, nor any known spinal disorder(s).
Purpose: To examine inherent differences adjusted for age and clinical score in whole-body sagittal (WBS) alignment involving the lower extremities between Asians and Caucasians, and to determine the relationship between age and WBS parameters by race and sex.
Methods: A total of 317 individuals consisting of 206 Asians and 111 Caucasians participated. WBS parameters including C2-7 lordotic angle, lower lumbar lordosis (lower LL, L4-S), pelvic incidence (PI), pelvic thickness, knee flexion (KF), sagittal vertical axis (SVA), and T1 pelvic angle (TPA) were evaluated radiologically.
Article Synopsis
- - The study analyzed the accuracy and repeatability of Cobb angle measurements from different imaging methods like radiographs and EOS (stereo-radiographs), following systematic review guidelines and a thorough literature search.
- - Out of nearly 3000 records, 14 studies were included, showing that Cobb angle measurements can vary significantly based on the imaging method and patient position, with standing radiographs often giving higher angles than supine MRI and CT scans.
- - The findings highlight significant agreements across imaging methods but also caution that differences in angles (up to 11º) may affect scoliosis diagnosis, urging clinicians to be cautious when comparing results from different modalities and positions.
Background: Staphylococcus aureus is a global pathogen that is frequently responsible for healthcare-associated infections, including surgical site infections (SSIs). Current infection prevention and control approaches may be limited, with S. aureus antibiotic resistance remaining problematic.
View Article and Find Full Text PDFStudy Design: Prospective, cross-sectional cohort study.
Objective: To determine the relationship between lumbar shape and sagittal parameters.
Summary Of Background Data: Understanding the lumbar shape is vital for deformity surgery.
Correction to: Can artificial intelligence support or even replace physicians in measuring sagittal balance? A validation study on preoperative and postoperative full spine images of 170 patients.
Eur Spine J
March 2023
Objective: The role of the craniocervical complex in spinal sagittal alignment has rarely been analyzed but it may play a fundamental role in postoperative mechanical complications. The aim of the study is to analyze the normative value of the cervical inclination angle (CIA) in an adult asymptomatic multiethnic population.
Methods: Standing full-spine EOS of adult asymptomatic volunteers from 5 different countries were analyzed.
Article Synopsis
- The study aimed to identify age-specific normative values for whole-body sagittal alignment (WBSA) and global balance parameters in healthy adults, utilizing data from three international centers.
- A total of 317 healthy subjects, aged 20-84, were examined using biplanar X-ray imaging, assessing various spinopelvic and alignment parameters to understand age-related changes and correlations.
- Findings revealed significant age-related increases in local parameters like the C2-7 angle and knee flexion, while changes in global parameters linked to center of gravity were mild, indicating a compensatory mechanism within lower limbs was at play.
Study Design: National cross-sectional study.
Objective: Thoracic kyphosis (TK) is related to sagittal parameters as pelvic tilt (PT), lumbar lordosis (LL) and pelvic incidence (PI). The equation TK = 2 (PT+LL-PI) was validated for adolescents.
Purpose: The objective is to analyse peri-operative blood loss (BL) and hidden blood loss (HBL) rates in spinal deformity complex cases surgery, with a focus on the strategies to prevent major bleeding.
Methods: We retrospectively analysed surgical and anaesthesiologic data of patients who had been operated for adolescent idiopathic scoliosis (AIS) or adult spinal deformities (ASD) with a minimum of five levels fused. A statistical comparison among AIS, ASD without a pedicle subtraction osteotomy (PSO) (ASD-PSO( -)) and ASD with PSO (ASD-PSO( +)) procedures was performed with a view to identifying patient- and/or surgical-related factors affecting peri-operative BL and HBL.
Background: Patient radiation exposure associated with the use of computed tomography (CT) navigation during spinal surgeries was widely compared with other intraoperative imaging techniques. The aim of this study is to explore the use of navigation with regard to current spinal surgery practices and the technical limitations of such imaging systems.
Methods: Dosimetric data from 101 patients who underwent intraoperative, CT-navigated spine surgery were retrospectively collected.
Article Synopsis
- The study is a cross-sectional cohort aimed at understanding sagittal plane alignment and balance in asymptomatic adults from various countries.
- It challenges existing sagittal alignment guidelines, showing they were based on data from spinal deformity patients, making them less applicable to the general population.
- The results identified four key parameters that can help define normal spinal alignment in healthy individuals, ultimately improving surgical outcomes.
Study Design: Multicenter Cohort.
Objective: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers stratified by age and gender.
Summary Of Background Data: Our understanding of ideal sagittal alignment is still evolving.
Article Synopsis
- The study was a retrospective cross-sectional analysis aimed at understanding how pelvic incidence (PI) and age influence spinopelvic alignment types, comparing results between pediatric and adult groups according to the Roussouly classification.
- A total of 1,706 non-pathologic individuals aged 5-49 were examined using radiographs, revealing significant differences in global and spinopelvic alignment parameters as individuals grow, particularly noting that certain alignment types are less common in younger populations.
- The findings concluded that global and spinopelvic alignment evolves throughout growth, with specific trends in pelvic incidence observed, particularly highlighting that Type 4 alignment shows the largest increase in PI with age.
Background: Spinal alignment can have a significant impact on a patient's overall quality of life. Predicting the ideal sagittal spinal alignment of a specific individual is still a difficult task. The Multi-Ethnic Alignment Normative Study (MEANS) investigated skeletal alignment, including the spine and lower extremities, of the largest multi-ethnic cohort of asymptomatic adult volunteers.
View Article and Find Full Text PDF