Variation in lumbar regional kyphosis between supine and standing positions. Implications for spinal fracture management.

Purpose: The variation of lumbar lordosis between standing and supine position is poorly explored in literature. This study sought to analyze variation of lumbar regional angulations (RA) in healthy volunteers between standing and supine positions, according to pelvic incidence (PI).

Methods: This study included 171 patients who had an abdominal CT-scan in supine position and 879 healthy volunteers with full-body stereoradiographs.

Digital vs Conventional OSCE in Orthopedic Surgery: A Feasibility Cross-Sectional Study.

Objective: Remote OSCEs (Objective Structured Clinical Examination) are an alternative evaluation method during pandemic periods but they have never been evaluated in orthopedic surgery. We aimed to evaluate whether remote OSCEs would be feasible, and efficient for assessment of undergraduate medical students.

Methods: A cross-sectional study was performed.

A comparison of idiopathic scoliosis surgery between teenage years and adulthood.

Purpose: Idiopathic scoliosis is an evolutive deformity during patient's life. In case of moderate deformity in a well aligned adolescent, it's a big concern to decide when to do the surgery. Objective of this work was to evaluate and compare clinical, radiological and surgical data of patients with adolescent idiopathic scoliosis operated in childhood (before 20 years) and those operated adults (after 35 years).

Defining threshold for sagittal correction in lumbar fractures.

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.

Does Spinal Surgery in Elderly Patients (Over 80 Years-Old) Lead to More Early Post-Operative Complications Than Lower Limb Prosthetic Surgery?

Patients and surgeons may be reluctant on spinal surgery over 80 years old, fearing medical complications despite the possible improvement on quality of life. However, fewer reservations for lower limb prosthetic surgery (LLPS) seem to be arisen in this population. Is spinal surgery after 80 years-old responsible of more complications than lower limb surgery? The consecutive files of 164 patients over 80 years that had spinal surgery or LLPS were analyzed.

The Whole-Exome Sequencing of a Cohort of 19 Families with Adolescent Idiopathic Scoliosis (AIS): Candidate Pathways.

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).

Kappa: Preliminary Results on a Novel Technique for Pelvic Fixation in Adult Spinal Deformity Correction.

Study Design: Retrospective cohort study.

Objectives: Pelvic fixation in degenerative spinal deformation is as crucial as demanding. Several pelvic anchoring technics have been described, but loosening rates remain high for most solutions.

Pregnancy and childbirth after adolescent idiopathic scoliosis surgery: A study of 80 pregnancies.

Background: Adolescent idiopathic scoliosis (AIS) is a common spinal disease affecting 2% of adolescents, and women in 90% of the cases. When a surgical treatment is opted for, many questions are frequently asked by families and patients about the course of pregnancy and childbirth after the spinal fusion. This subject remains little studied in the literature, especially with modern instrumentation techniques.

Lumbar scoliosis and stenosis: What outcomes for which treatment? Analysis of three surgical techniques in 154 patients with minimum two-year follow-up.

Study Design: Prospective multicentric study.

Objective: This study goal was to analyze the clinical and radiographic outcomes of lumbar stenosis and scoliosis (LSS) patients, treated with lumbar decompression (LD), short fusion and decompression (SF) or long fusion with deformity correction (LF).

Hypothesis: Procedures without correction lead to poorer long-term outcomes.

Loss of CSF-contacting neuron sensory function is associated with a hyper-kyphosis of the spine reminiscent of Scheuermann's disease.

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.

Spine Metastasis: Patients With Poor Performance Status (ECOG) Could benefit From Palliative Surgical Care! A Prospective Cohort Study.

Study Design: This study used a French prospective national multi-center database of patients with spine metastasis (SpM).

Objective: The main challenge was to clarify if SpM patients presenting poor ECOG-PS could benefit from a surgical intervention.

Background: Spine metastases (SpM) are debilitating lesions commonly found in the evolution of cancer.

Validation of the Total Disability Index (TDI) in French Version.

Introduction: The Total Disability Index (TDI) questionnaire has been developed to provide a more complete assessment of low back and neck pain, as they frequently co-occur. This study aimed at validating the TDI questionnaire in French, to determine if it could be used in France.

Hypothesis: The TDI French version is valid, reproducible and comparable to the English version.

Efficiency of a novel vertebral body augmentation system (Tektona™) in non-osteoporotic spinal fractures.

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.

Pre- and postoperative MRI analysis of central decompression in MIS fusion with lumbar stenosis.

Objectives: Mini-invasive approaches have grown substantially these last decades in spinal surgery, notably for lumbar decompressions and fusion, with advantages over open approaches in terms of morbidity reduction. However, to our knowledge, no study has measured on MRI the amount of central decompression obtained by MIS approach. The goal of this study was to precisely measure the decompression of central stenosis by unilateral MIS approaches.

Does the Distal Level Really Matter in the Setting of Health-Related Quality of Life? Assessment of a Series of Adolescent Idiopathic Scoliosis Patients at More Than 7 Years Following Surgery.

Study Design: Retrospective longitudinal study.

Objective: The main goal of this study was to measure the disability after AIS correction, according to the LIV.

Summary Of Background Data: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that may require surgical correction.

[Aging of an already pathological spine and its evaluation].

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.

Degenerative cervical myelopathy.

Degenerative cervical myelopathy (DCM) frequently leads to severe neurologic disability but is still frequently underdiagnosed. One explanation may be the variability of the symptoms presented by the patients, from paresthesia to quadriplegia, making it another great masquerader. What do we know? How can we manage better these patients? We will review the keys points concerning its challenging diagnosis (clinical and radiologic), some of the recent discoveries about DCM, notably the underlying genetic mutations identified, linked to its pathophysiology, before addressing the consensual points concerning its management and the major evolutive risk: acute decompensation.

Evaluation of disc degeneration adjacent to AOspine A fractures: pre- and post-operative MRI analysis.

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.

Management of thoracolumbar fracture in France. Analysis of practices and radiologic results of a cohort of 407 thoracolumbar fractures.

Background: Thoracolumbar fractures are a public health issue due to their severity and frequency. Management varies according to demographic, clinical and radiologic features, from non-operative treatment to extensive fusion. In the two last decades, improvements and new techniques have emerged, such as kyphoplasty and percutaneous approaches.

Screw Loosening in Posterior Spine Fusion: Prevalence and Risk Factors.

Study Design: Retrospective cohort study.

Objective: Screw loosening in spinal fusion is poorly defined. Accordingly, its prevalence rates range from 1% to 60%, and its risk factors remain undefined.

Two cases of deliberate implant mismatch in knee arthroplasty.

Cases: Knee arthroplasty is increasingly common with good clinical results. However, there is a cohort of patients whose native knee anatomy may not marry well with standard implants. The current authors describe two cases (one unicompartmental knee arthroplasty (UKA), one total knee arthroplasty (TKA)), during which deliberately implanting an implant designed for the contra-lateral distal femur (TKA) or contralateral femoral condyle (UKA) respectively, led to a better fit than correct-sided implants.

Minimal invasive management of early revision after minimal invasive posterior lumbar fusion.

Background: Minimally invasive spine (MIS) fusion is an increasingly common procedure, with advantages over open approach in the form of minimal dissection and superior early clinical outcome. The frequency of complications is known, but the most appropriate surgical revision for this technique remains unclear.

Hypothesis: The main hypothesis was that early revision surgery, for acute complications after MIS, was possible through mini-invasive approach.