https://sam.ensam.eu:443 The DSpace digital repository system captures, stores, indexes, preserves, and distributes digital research material. Sun, 17 May 2026 02:50:30 GMT 2026-05-17T02:50:30Z http://hdl.handle.net/10985/14979 Quasi-automatic early detection of progressive idiopathic scoliosis from biplanar radiography: a preliminary validation COURTOIS, Isabelle; EBERMEYER, Eric; ABELIN-GENEVOIS, Kariman; KIM, Youngwoo; LANGLAIS, Tristan; VIALLE, Raphaël; ASSI, Ayman; GHANEM, Ismat; DUBOUSSET, Jean; SKALLI, Wafa; GAJNY, Laurent; VERGARI, Claudio Purpose To validate the predictive power and reliability of a novel quasi-automatic method to calculate the severity index of adolescent idiopathic scoliosis (AIS). Methods Fifty-five AIS patients were prospectively included (Age: 10-15, Cobb: 16° ± 4°). Patients underwent low-dose biplanar x-rays and a novel fast method for 3D reconstruction of the spine was performed. They were followed until skeletal maturity (stable patients) or brace prescription (progressive patients). The severity index was calculated at the first exam, based on 3D parameters of the scoliotic curve, and it was compared with the patient’s final outcome (progressive or stable). Three operators have repeated the 3D reconstruction twice for a subset of 30 patients to assess reproducibility (through Cohen’s kappa and intraclass correlation coefficient). Results 85% of the patients were correctly classified as stable or progressive by the severity index, with a sensitivity of 92% and specificity of 74%. Substantial intra-operator agreement and good inter-operator agreement were observed, with 80% of the progressive patients correctly detected at the first exam. The novel severity index assessment took less than 4 minutes of operator time. Conclusions The fast and semi-automatic method for 3D reconstruction developed in this work allowed for a fast and reliable calculation of the severity index. The method is fast and user friendly. Once extensively validated, this severity index could allow very early initiation of conservative treatment for progressive patients, thus increasing treatment efficacy and therefore reducing the need for corrective surgery. Tue, 01 Jan 2019 00:00:00 GMT http://hdl.handle.net/10985/14979 2019-01-01T00:00:00Z COURTOIS, Isabelle EBERMEYER, Eric ABELIN-GENEVOIS, Kariman KIM, Youngwoo LANGLAIS, Tristan VIALLE, Raphaël ASSI, Ayman GHANEM, Ismat DUBOUSSET, Jean SKALLI, Wafa GAJNY, Laurent VERGARI, Claudio Purpose To validate the predictive power and reliability of a novel quasi-automatic method to calculate the severity index of adolescent idiopathic scoliosis (AIS). Methods Fifty-five AIS patients were prospectively included (Age: 10-15, Cobb: 16° ± 4°). Patients underwent low-dose biplanar x-rays and a novel fast method for 3D reconstruction of the spine was performed. They were followed until skeletal maturity (stable patients) or brace prescription (progressive patients). The severity index was calculated at the first exam, based on 3D parameters of the scoliotic curve, and it was compared with the patient’s final outcome (progressive or stable). Three operators have repeated the 3D reconstruction twice for a subset of 30 patients to assess reproducibility (through Cohen’s kappa and intraclass correlation coefficient). Results 85% of the patients were correctly classified as stable or progressive by the severity index, with a sensitivity of 92% and specificity of 74%. Substantial intra-operator agreement and good inter-operator agreement were observed, with 80% of the progressive patients correctly detected at the first exam. The novel severity index assessment took less than 4 minutes of operator time. Conclusions The fast and semi-automatic method for 3D reconstruction developed in this work allowed for a fast and reliable calculation of the severity index. The method is fast and user friendly. Once extensively validated, this severity index could allow very early initiation of conservative treatment for progressive patients, thus increasing treatment efficacy and therefore reducing the need for corrective surgery. http://hdl.handle.net/10985/11887 Experimental validation of a patient-specific model of orthotic action in adolescent idiopathic scoliosis COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphaël; BOULOUSSA, Houssam; SKALLI, Wafa; VERGARI, Claudio Purpose Personalized modeling of brace action have potential in improving brace efficacy in adolescent idiopathic scoliosis (AIS). Model validation and simulation uncertainty are rarely addressed, limiting the clinical implementation of personalized models. We hypothesized that a thorough validation of a personalized finite element model (FEM) of brace action would highlight potential means of improving the model. Methods 42 AIS patients were included retrospectively and prospectively. Personalized FEMs of pelvis, spine and ribcage were built from stereoradiographies. Brace action was simulated through soft cylindrical pads acting on the ribcage and through displacements applied to key vertebrae. Simulation root mean squared errors (RMSEs) were calculated by comparison with the actual brace action (quantified through clinical indices, vertebral positions and orientations) observed in in-brace stereoradiographies. Results Simulation RMSEs of Cobb angle and vertebral apical axial rotation was lower than measurement uncertainty in 79% of the patients. Pooling all patients and clinical indices, 87 % of the indices had lower RMSEs than the measurement uncertainty. Conclusions In-depth analysis suggests that personalization of spinal functional units mechanical properties could improve the simulation’s accuracy, but the model gave good results, thus justifying further research on its clinical application. Fri, 01 Jan 2016 00:00:00 GMT http://hdl.handle.net/10985/11887 2016-01-01T00:00:00Z COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphaël BOULOUSSA, Houssam SKALLI, Wafa VERGARI, Claudio Purpose Personalized modeling of brace action have potential in improving brace efficacy in adolescent idiopathic scoliosis (AIS). Model validation and simulation uncertainty are rarely addressed, limiting the clinical implementation of personalized models. We hypothesized that a thorough validation of a personalized finite element model (FEM) of brace action would highlight potential means of improving the model. Methods 42 AIS patients were included retrospectively and prospectively. Personalized FEMs of pelvis, spine and ribcage were built from stereoradiographies. Brace action was simulated through soft cylindrical pads acting on the ribcage and through displacements applied to key vertebrae. Simulation root mean squared errors (RMSEs) were calculated by comparison with the actual brace action (quantified through clinical indices, vertebral positions and orientations) observed in in-brace stereoradiographies. Results Simulation RMSEs of Cobb angle and vertebral apical axial rotation was lower than measurement uncertainty in 79% of the patients. Pooling all patients and clinical indices, 87 % of the indices had lower RMSEs than the measurement uncertainty. Conclusions In-depth analysis suggests that personalization of spinal functional units mechanical properties could improve the simulation’s accuracy, but the model gave good results, thus justifying further research on its clinical application. http://hdl.handle.net/10985/25124 Assessment of malalignment at early stage in adolescent idiopathic scoliosis: a longitudinal cohort study LANGLAIS, Tristan; VERGARI, Claudio; ROUGEREAU, Grégoire; GAUME, Mathilde; GAJNY, Laurent; ABELIN-GENEVOIS, Kariman; BERNARD, Jean-Claude; HU, Zongshan; CHENG, Jack Chun Yiu; CHU, Winnie Chiu Wing; ASSI, Ayman; KARAM, Mohamad; GHANEM, Ismat; BASSANI, Tito; GALBUSERA, Fabio; SCONFIENZA, Luca Maria; BRAYDA-BRUNO, Marco; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphaël; DUBOUSSET, Jean; SKALLI, Wafa Introduction Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage. Materials and methods All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th–95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value. Results Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and −2.5°, whereas in AIS values were 0.3° and −0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%. Conclusion Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis. Thu, 01 Feb 2024 00:00:00 GMT http://hdl.handle.net/10985/25124 2024-02-01T00:00:00Z LANGLAIS, Tristan VERGARI, Claudio ROUGEREAU, Grégoire GAUME, Mathilde GAJNY, Laurent ABELIN-GENEVOIS, Kariman BERNARD, Jean-Claude HU, Zongshan CHENG, Jack Chun Yiu CHU, Winnie Chiu Wing ASSI, Ayman KARAM, Mohamad GHANEM, Ismat BASSANI, Tito GALBUSERA, Fabio SCONFIENZA, Luca Maria BRAYDA-BRUNO, Marco COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphaël DUBOUSSET, Jean SKALLI, Wafa Introduction Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage. Materials and methods All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th–95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value. Results Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and −2.5°, whereas in AIS values were 0.3° and −0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%. Conclusion Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis. http://hdl.handle.net/10985/20319 Simulation of orthotic treatment in adolescent idiopathic scoliosis using a subject-specific finite element model COURTOIS, Isabelle; EBERMEYER, Eric; BOULOUSSA, Houssam; VIALLE, Raphaël; SKALLI, Wafa; VERGARI, Claudio Adolescent idiopathic scoliosis (AIS) is a threedimensional deformity of the spine, often progressing rapidly during the growth spurt. Severe scoliosis can lead to significant degradation of quality of life and functional impairment; the aim of early orthotic treatment is to slow down curvature progression until skeletal maturity. Efficacy of bracing has often been questioned (Negrini et al., 2010; Weinstein et al., 2013), and often relies on the orthotist’s experience since objective methods to design and predict brace action are still in development (Cobetto et al., 2014). A clinically-relevant method for the evaluation of brace simulation in AIS was recently presented (Vergari et al., 2015) and applied to preliminarily validate a finite element model (FEM) of the trunk. The aim of this work was to improve the simulation of brace action on scoliotic trunks and to validate the model on a larger cohort Thu, 01 Jan 2015 00:00:00 GMT http://hdl.handle.net/10985/20319 2015-01-01T00:00:00Z COURTOIS, Isabelle EBERMEYER, Eric BOULOUSSA, Houssam VIALLE, Raphaël SKALLI, Wafa VERGARI, Claudio Adolescent idiopathic scoliosis (AIS) is a threedimensional deformity of the spine, often progressing rapidly during the growth spurt. Severe scoliosis can lead to significant degradation of quality of life and functional impairment; the aim of early orthotic treatment is to slow down curvature progression until skeletal maturity. Efficacy of bracing has often been questioned (Negrini et al., 2010; Weinstein et al., 2013), and often relies on the orthotist’s experience since objective methods to design and predict brace action are still in development (Cobetto et al., 2014). A clinically-relevant method for the evaluation of brace simulation in AIS was recently presented (Vergari et al., 2015) and applied to preliminarily validate a finite element model (FEM) of the trunk. The aim of this work was to improve the simulation of brace action on scoliotic trunks and to validate the model on a larger cohort http://hdl.handle.net/10985/23045 Spine slenderness is not an early sign of progression in adolescent idiopathic scoliosis VERGARI, Claudio; SKALLI, Wafa; ABELIN-GENEVOIS, Kariman; BERNARD, Jean-Claude; HU, Zongshan; CHENG, Jack Chun Yiu; CHU, Winnie Chiu Wing; ASSI, Ayman; KARAM, Mohammad; GHANEM, Ismat; BASSANI, Tito; GALBUSERA, Fabio; SCONFIENZA, Luca Maria; BRAYDA-BRUNO, Marco; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphael; LANGLAIS, Tristan; DUBOUSSET, Jean Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine. Spine slenderness, which represents its potential instability to buckling under compressive loads, was shown to be higher in AIS patients than non-scoliotic subjects, but it is not clear at what stage of the progression this difference appeared, nor if slenderness could be used as an early sign of progression. In this study, we hypothesized that slenderness could be an early sign of progression. One-hundred thirty-eight patients and 93 non-scoliotic subjects were included. They underwent standing biplanar radiography and 3D reconstruction of the spine, which allowed computing vertebra and disc slenderness ratio. Then, patients were followed until progression of the deformity or skeletal maturity (stable patients). Vertebral slenderness ratio in AIS patients varied between 2.9 [2.7; 3.0] (T9) and 3.4 [3.2; 3.6] (T1), while disc slenderness ranged from 0.6 [0.6; 0.7] at T6-T7 to 1.2 [1.1; 1.3] at L4-L5. Slenderness ratio increased with age, while disc slenderness tended to decrease with age and Cobb angle. Slenderness was similar between progressive and stable patients, and also between patients and non-scoliotic subjects. In conclusion, spinal slenderness does not appear to be an early sign of progression. Further studies should analyse the development of slenderness during growth, and how it could be affected by non-operative treatment. Mon, 01 Aug 2022 00:00:00 GMT http://hdl.handle.net/10985/23045 2022-08-01T00:00:00Z VERGARI, Claudio SKALLI, Wafa ABELIN-GENEVOIS, Kariman BERNARD, Jean-Claude HU, Zongshan CHENG, Jack Chun Yiu CHU, Winnie Chiu Wing ASSI, Ayman KARAM, Mohammad GHANEM, Ismat BASSANI, Tito GALBUSERA, Fabio SCONFIENZA, Luca Maria BRAYDA-BRUNO, Marco COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphael LANGLAIS, Tristan DUBOUSSET, Jean Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine. Spine slenderness, which represents its potential instability to buckling under compressive loads, was shown to be higher in AIS patients than non-scoliotic subjects, but it is not clear at what stage of the progression this difference appeared, nor if slenderness could be used as an early sign of progression. In this study, we hypothesized that slenderness could be an early sign of progression. One-hundred thirty-eight patients and 93 non-scoliotic subjects were included. They underwent standing biplanar radiography and 3D reconstruction of the spine, which allowed computing vertebra and disc slenderness ratio. Then, patients were followed until progression of the deformity or skeletal maturity (stable patients). Vertebral slenderness ratio in AIS patients varied between 2.9 [2.7; 3.0] (T9) and 3.4 [3.2; 3.6] (T1), while disc slenderness ranged from 0.6 [0.6; 0.7] at T6-T7 to 1.2 [1.1; 1.3] at L4-L5. Slenderness ratio increased with age, while disc slenderness tended to decrease with age and Cobb angle. Slenderness was similar between progressive and stable patients, and also between patients and non-scoliotic subjects. In conclusion, spinal slenderness does not appear to be an early sign of progression. Further studies should analyse the development of slenderness during growth, and how it could be affected by non-operative treatment. http://hdl.handle.net/10985/20226 Effect of curve location on the severity index for adolescent idiopathic scoliosis: a longitudinal cohort study VERGARI, Claudio; SKALLI, Wafa; ABELIN-GENEVOIS, Kariman; BERNARD, Jean Claude; HU, Zongshan; CHENG, Jack Chun Yiu; CHU, Winnie Chiu Wing; ASSI, Ayman; KARAM, Mohammad; GHANEM, Ismat; BASSANI, Tito; GALBUSERA, Fabio; SCONFIENZA, Luca Maria; BRAYDA-BRUNO, Marco; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphael; LANGLAIS, Tristan; DUBOUSSET, Jean Objectives Adolescent idiopathic scoliosis (AIS) is the most common spinal disorder in children. A severity index was recently proposed to identify the stable from the progressive scoliosis at the first standardized biplanar radiographic exam. The aim of this work was to extend the validation of the severity index and to determine if curve location influences its predictive capabilities. Methods AIS patients with Cobb angle between 10° and 25°, Risser 0–2, and no previous treatment were included. They underwent standing biplanar radiography and 3D reconstruction of the spine and pelvis, which allowed to calculate their severity index. Patients were grouped by curve location (thoracic, thoracolumbar, lumbar). Patients were followed up until skeletal maturity (Risser ≥ 3) or brace prescription. Their outcome was compared to the prediction made by the severity index. Results In total, 205 AIS patients were included; 82% of them (155/189, 95% confidence interval [74–90%]) were correctly classified by the index, while 16 patients were unclassified. Positive predictive ratio was 78% and negative predictive ratio was 86%. Specificity (78%) was not significantly affected by curve location, while patients with thoracic and lumbar curves showed higher sensitivity (≥ 89%) than those with thoracolumbar curves (74%). Conclusions In this multicentric cohort of 205 patients, the severity index was used to predict the risk of progression from mild to moderate scoliosis, with similar results of typical major curve types. This index represents a novel tool to aid the clinician and the patient in the modulation of the follow-up and, for progressive patients, their decision for brace treatment. Fri, 01 Jan 2021 00:00:00 GMT http://hdl.handle.net/10985/20226 2021-01-01T00:00:00Z VERGARI, Claudio SKALLI, Wafa ABELIN-GENEVOIS, Kariman BERNARD, Jean Claude HU, Zongshan CHENG, Jack Chun Yiu CHU, Winnie Chiu Wing ASSI, Ayman KARAM, Mohammad GHANEM, Ismat BASSANI, Tito GALBUSERA, Fabio SCONFIENZA, Luca Maria BRAYDA-BRUNO, Marco COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphael LANGLAIS, Tristan DUBOUSSET, Jean Objectives Adolescent idiopathic scoliosis (AIS) is the most common spinal disorder in children. A severity index was recently proposed to identify the stable from the progressive scoliosis at the first standardized biplanar radiographic exam. The aim of this work was to extend the validation of the severity index and to determine if curve location influences its predictive capabilities. Methods AIS patients with Cobb angle between 10° and 25°, Risser 0–2, and no previous treatment were included. They underwent standing biplanar radiography and 3D reconstruction of the spine and pelvis, which allowed to calculate their severity index. Patients were grouped by curve location (thoracic, thoracolumbar, lumbar). Patients were followed up until skeletal maturity (Risser ≥ 3) or brace prescription. Their outcome was compared to the prediction made by the severity index. Results In total, 205 AIS patients were included; 82% of them (155/189, 95% confidence interval [74–90%]) were correctly classified by the index, while 16 patients were unclassified. Positive predictive ratio was 78% and negative predictive ratio was 86%. Specificity (78%) was not significantly affected by curve location, while patients with thoracic and lumbar curves showed higher sensitivity (≥ 89%) than those with thoracolumbar curves (74%). Conclusions In this multicentric cohort of 205 patients, the severity index was used to predict the risk of progression from mild to moderate scoliosis, with similar results of typical major curve types. This index represents a novel tool to aid the clinician and the patient in the modulation of the follow-up and, for progressive patients, their decision for brace treatment. http://hdl.handle.net/10985/19917 Towards a predictive simulation of brace action in adolescent idiopathic scoliosis CHEN, Zhuowei; ROBICHON, Léopold; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphaël; LANGLAIS, Tristan; PIETTON, Raphaël; SKALLI, Wafa; VERGARI, Claudio Bracing is the most common treatment to stop the progression of adolescent idiopathic scoliosis. Finite element modeling could help improve brace design, but model validation is still a challenge. In this work, the clinical relevance of a predictive and subject-specific model for bracing was evaluated in forty-six AIS patients. The model reproduces brace action and the patient’s spinopelvic adjustments to keep balance. The model simulated 70% or more patients with geometrical parameters within a preselected tolerance level. Although the model simulation of the sagittal plane could be improved, the approach is promising for a realistic and predictive simulation of brace action. The data collection was approved of by the ethical commit-tee (CPP 6001 Ile de France V), and patients and their parents signed an informed consent. Wed, 01 Jan 2020 00:00:00 GMT http://hdl.handle.net/10985/19917 2020-01-01T00:00:00Z CHEN, Zhuowei ROBICHON, Léopold COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphaël LANGLAIS, Tristan PIETTON, Raphaël SKALLI, Wafa VERGARI, Claudio Bracing is the most common treatment to stop the progression of adolescent idiopathic scoliosis. Finite element modeling could help improve brace design, but model validation is still a challenge. In this work, the clinical relevance of a predictive and subject-specific model for bracing was evaluated in forty-six AIS patients. The model reproduces brace action and the patient’s spinopelvic adjustments to keep balance. The model simulated 70% or more patients with geometrical parameters within a preselected tolerance level. Although the model simulation of the sagittal plane could be improved, the approach is promising for a realistic and predictive simulation of brace action. http://hdl.handle.net/10985/11806 Early detection of progressive adolescent idiopathic scoliosis : a severity index SKALLI, Wafa; EBERMEYER, Eric; COURTOIS, Isabelle; DREVELLE, Xavier; ABELIN-GENEVOIS, Kariman; KOHLER, Remi; DUBOUSSET, Jean; VERGARI, Claudio Study Design. Early detection of progressive adolescent idiopathic scoliosis (AIS) was assessed based on 3D quantification of the deformity. Objective. Based on 3D quantitative description of scoliosis curves, the aim is to assess a specific deformation pattern that could be an early detectable severity index for progressive AIS. Summary of Background Data. Early detection of progressive scoliosis is important for adapted treatment to limit progression. However, progression risk assessment is mainly based on the follow up, waiting for signs of rapid progression that generally occur during the growth peak. Methods. 65 mild scoliosis (16 boys, 49 girls, Cobb Angle between 10 and 20°) with a Risser between 0 and 2 were followed from their first exam until a decision was made by the clinician, either considering the spine as stable at the end of growth (26 patients) or planning to brace because of progression (39 patients). Calibrated biplanar X-rays were performed and 3D reconstructions of the spine allowed to calculate six local parameters related to main curve deformity. For progressive curve 3D phenotype assessment, data were compared to those previously assessed for 30 severe scoliosis (Cobb Angle > 35°), 17 scoliosis before brace (Cobb Angle > 29°) and 53 spines of non-scoliosis subjects. A predictive discriminant analysis was performed to assess similarity of mild scoliosis curves either to those of scoliosis or non-scoliosis spines, yielding a severity index (S-index). S-index value at first exam was compared to clinical outcome. Results. At the first exam, 53 out of 65 predictions (82%) were in agreement with actual clinical outcome. 89 % of the curves that were predicted as progressive proved accurate Conclusion. Although still requiring large scale validation, results are promising for early detection of progressive curves. Sun, 01 Jan 2017 00:00:00 GMT http://hdl.handle.net/10985/11806 2017-01-01T00:00:00Z SKALLI, Wafa EBERMEYER, Eric COURTOIS, Isabelle DREVELLE, Xavier ABELIN-GENEVOIS, Kariman KOHLER, Remi DUBOUSSET, Jean VERGARI, Claudio Study Design. Early detection of progressive adolescent idiopathic scoliosis (AIS) was assessed based on 3D quantification of the deformity. Objective. Based on 3D quantitative description of scoliosis curves, the aim is to assess a specific deformation pattern that could be an early detectable severity index for progressive AIS. Summary of Background Data. Early detection of progressive scoliosis is important for adapted treatment to limit progression. However, progression risk assessment is mainly based on the follow up, waiting for signs of rapid progression that generally occur during the growth peak. Methods. 65 mild scoliosis (16 boys, 49 girls, Cobb Angle between 10 and 20°) with a Risser between 0 and 2 were followed from their first exam until a decision was made by the clinician, either considering the spine as stable at the end of growth (26 patients) or planning to brace because of progression (39 patients). Calibrated biplanar X-rays were performed and 3D reconstructions of the spine allowed to calculate six local parameters related to main curve deformity. For progressive curve 3D phenotype assessment, data were compared to those previously assessed for 30 severe scoliosis (Cobb Angle > 35°), 17 scoliosis before brace (Cobb Angle > 29°) and 53 spines of non-scoliosis subjects. A predictive discriminant analysis was performed to assess similarity of mild scoliosis curves either to those of scoliosis or non-scoliosis spines, yielding a severity index (S-index). S-index value at first exam was compared to clinical outcome. Results. At the first exam, 53 out of 65 predictions (82%) were in agreement with actual clinical outcome. 89 % of the curves that were predicted as progressive proved accurate Conclusion. Although still requiring large scale validation, results are promising for early detection of progressive curves. http://hdl.handle.net/10985/26197 3D external shape analysis and barycentremetry can provide early signs of progression in adolescent idiopathic scoliosis LANGLAIS, Tristan; VERGARI, Claudio; MAINARD, Nicolas; DU CLUZEL, Xavier; BAUDOUX, Matthieu; GAJNY, Laurent; ABELIN-GENEVOIS, Kariman; BERNARD, Jean-Claude; HU, Zongshan; CHENG, Jack Chun-Yiu; CHU, Winnie Chiu-Wing; ASSI, Ayman; KARAM, Mohamad; GHANEM, Ismat; BASSANI, Tito; GALBUSERA, Fabio; SCONFIENZA, Luca Maria; BRAYDA-BRUNO, Marco; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphaël; DUBOUSSET, Jean; SKALLI, Wafa 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. Inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the barycentremetry parameters were computed, i.e., the center of mass position at the apex and the axial torque at the apex, the upper and lower junction. A severity index, helping to distinguish stable and progressive AIS, was computed on the first radiograph, and weighted according to these parameters. A clinical and radiographic monitoring determined if AIS were classified such a stable or progressive scoliosis. Results One hundred and sixty-two AIS were included (i.e., 87 were classified as stable and 75 as progressive). The apex center of mass position was different between the stable and progressive AIS groups (6 mm, SD = 4 mm for the whole cohort; 5 mm, SD = 4 mm for stable AIS versus 7 mm, SD = 4 mm for progressive AIS; p = 0.02). In AIS thoracic, the specificity and positive predictive value of the severity index increased by 19% and 16%, respectively, by adding the apex vertebral axial torque. Conclusion Early assessment of the external envelope from biplanar X-ray reconstruction of idiopathic scoliosis showed that the apex centre of mass position was significantly different between progressive and stable scoliosis. The inclusion of the axial torque of the apex vertebra in the severity index is promising to help the clinician distinguish between stable and progressive thoracic AIS at an early stage. Fri, 01 Nov 2024 00:00:00 GMT http://hdl.handle.net/10985/26197 2024-11-01T00:00:00Z LANGLAIS, Tristan VERGARI, Claudio MAINARD, Nicolas DU CLUZEL, Xavier BAUDOUX, Matthieu GAJNY, Laurent ABELIN-GENEVOIS, Kariman BERNARD, Jean-Claude HU, Zongshan CHENG, Jack Chun-Yiu CHU, Winnie Chiu-Wing ASSI, Ayman KARAM, Mohamad GHANEM, Ismat BASSANI, Tito GALBUSERA, Fabio SCONFIENZA, Luca Maria BRAYDA-BRUNO, Marco COURTOIS, Isabelle EBERMEYER, Eric VIALLE, Raphaël DUBOUSSET, Jean SKALLI, Wafa 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. Inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the barycentremetry parameters were computed, i.e., the center of mass position at the apex and the axial torque at the apex, the upper and lower junction. A severity index, helping to distinguish stable and progressive AIS, was computed on the first radiograph, and weighted according to these parameters. A clinical and radiographic monitoring determined if AIS were classified such a stable or progressive scoliosis. Results One hundred and sixty-two AIS were included (i.e., 87 were classified as stable and 75 as progressive). The apex center of mass position was different between the stable and progressive AIS groups (6 mm, SD = 4 mm for the whole cohort; 5 mm, SD = 4 mm for stable AIS versus 7 mm, SD = 4 mm for progressive AIS; p = 0.02). In AIS thoracic, the specificity and positive predictive value of the severity index increased by 19% and 16%, respectively, by adding the apex vertebral axial torque. Conclusion Early assessment of the external envelope from biplanar X-ray reconstruction of idiopathic scoliosis showed that the apex centre of mass position was significantly different between progressive and stable scoliosis. The inclusion of the axial torque of the apex vertebra in the severity index is promising to help the clinician distinguish between stable and progressive thoracic AIS at an early stage. http://hdl.handle.net/10985/18977 Head to Pelvis Alignment of Adolescent Idiopathic Scoliosis Patients Both in and Out of Brace COURTOIS, Isabelle; EBERMEYER, Eric; PIETTON, Raphaël; BOULOUSSA, Houssam; VIALLE, Raphaël; SKALLI, Wafa; VERGARI, Claudio Purpose: To determine the short-term effect of bracing of adolescent idiopathic scoliotic (AIS) patients on the relationships between spinopelvic parameters related to balance, by comparing their in and out-of-brace geometry and versus healthy subjects. Methods: Forty-two AIS patients (Cobb angle 29° ± 12°, ranging from 16° to 61°) with a prescription of orthotic treatment were included retrospectively and prospectively. They all underwent biplanar radiography and 3D reconstruction of the spine and pelvis before bracing as well as less than 9 months after bracing. Eighty-three age-matched healthy adolescents were also included as control group and underwent biplanar radiography and 3D reconstruction. Results: Sacral slope was higher in AIS than healthy patients (p = 0.005). Bracing induced large changes of pelvic tilt (between - 9° and 9°), although patients' sagittal spinopelvic alignment tended to remain within the normality corridors defined by the healthy patients. Patients had flatter backs compared to healthy subjects and bracing further reduced their spinal curves. The head tended to remain above the pelvis in-brace. Conclusion: Analysis of sagittal alignment from head to pelvis showed that bracing further flattened the patients' backs and induced large compensating reorientations of the pelvis. Sagittal balance should be included in the planning and evaluation of brace treatment, since it could play a role in its outcome. These slides can be retrieved under Electronic Supplementary Material. Tue, 01 Jan 2019 00:00:00 GMT http://hdl.handle.net/10985/18977 2019-01-01T00:00:00Z COURTOIS, Isabelle EBERMEYER, Eric PIETTON, Raphaël BOULOUSSA, Houssam VIALLE, Raphaël SKALLI, Wafa VERGARI, Claudio Purpose: To determine the short-term effect of bracing of adolescent idiopathic scoliotic (AIS) patients on the relationships between spinopelvic parameters related to balance, by comparing their in and out-of-brace geometry and versus healthy subjects. Methods: Forty-two AIS patients (Cobb angle 29° ± 12°, ranging from 16° to 61°) with a prescription of orthotic treatment were included retrospectively and prospectively. They all underwent biplanar radiography and 3D reconstruction of the spine and pelvis before bracing as well as less than 9 months after bracing. Eighty-three age-matched healthy adolescents were also included as control group and underwent biplanar radiography and 3D reconstruction. Results: Sacral slope was higher in AIS than healthy patients (p = 0.005). Bracing induced large changes of pelvic tilt (between - 9° and 9°), although patients' sagittal spinopelvic alignment tended to remain within the normality corridors defined by the healthy patients. Patients had flatter backs compared to healthy subjects and bracing further reduced their spinal curves. The head tended to remain above the pelvis in-brace. Conclusion: Analysis of sagittal alignment from head to pelvis showed that bracing further flattened the patients' backs and induced large compensating reorientations of the pelvis. Sagittal balance should be included in the planning and evaluation of brace treatment, since it could play a role in its outcome. These slides can be retrieved under Electronic Supplementary Material.