Clinical and stereoradiographic analysis of adult spinal deformity with and without rotatory subluxation
TypeArticles dans des revues avec comité de lecture
Introduction: In degenerative adult spinal deformity (ASD), sagittal malalignment and rotatory sublux-ation (RS) correlate with clinical symptomatology. RS is defined as axial rotation with lateral listhesis.Stereoradiography, recently developed for medical applications, provides full-body standing radiographsand 3D reconstruction of the spine, with low radiation dose.Hypothesis: 3D stereoradiography improves analysis of RS and of its relations with transverse plane andspinopelvic parameters and clinical impact.Material and methods: One hundred and thirty adults with lumbar ASD and full-spine EOS®radiographs(EOS Imaging, Paris, France) were included. Spinopelvic sagittal parameters and lateral listhesis in thecoronal plane were measured. The transverse plane study parameters were: apical axial vertebral rotation(apex AVR), axial intervertebral rotation (AIR) and torsion index (TI). Two groups were compared: with RS(lateral listhesis > 5 mm) and without RS (without lateral listhesis exceeding 5 mm: non-RS). Correlationsbetween radiologic and clinical data were assessed.Results: RS patients were significantly older, with larger Cobb angle (37.4◦vs. 26.6◦, P = 0.0001), moresevere sagittal deformity, and greater apex AVR and TI (respectively: 22.9◦vs. 11.3◦, P < 0.001; and 41.0◦vs. 19.9◦, P < 0.001). Ten percent of patients had AIR > 10◦without visible RS on 2D radiographs. RS patientsreported significantly more frequent low back pain and radiculalgia.Discussion: In this EOS®study, ASD patients with RS had greater coronal curvature and sagittal and trans-verse deformity, as well as greater pain. Further transverse plane analysis could allow earlier diagnosisand prognosis to guide management.Level of evidence: 4, retrospective study.
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Three-dimensional reconstruction using stereoradiography for evaluating adult spinal deformity: a reproducibility study. FERRERO, Emmanuelle; LAFAGE, Renaud; VIRA, Shaleen; ROHAN, Pierre-Yves; OREN, Jonathan; DELSOLE, Edward; GUIGUI, Pierre; SCHWAB, Frank; LAFAGE, Virginie; SKALLI, Wafa (Springer, 2016)PURPOSE: In addition to the sagittal alignment, impact of transverse plane parameters (TPP) and rotatory subluxation on patients reported outcomes were highlighted. One of the hypotheses for genesis of degenerative scoliosis ...
Relationships between radiographic parameters and spinopelvic muscles in adult spinal deformity patients FERRERO, Emmanuelle; SKALLI, Wafa; LAFAGE, Virginie; MAILLOT, Cédric; CARLIER, Robert; FEYDY, Antoie; FELTER, Adrien; KHALIFE, Marc; GUIGUI, Pierre (Springer, 2019)Introduction While the clinical impact of coronal and sagittal alignment in adult spinal deformity (ASD) patients (pts) is established, there is a paucity of data in terms of axial plane deformity and potential association ...
Clinical Improvement Through Surgery for Adult Spinal Deformity: What Can Be Expected and Who Is Likely to Benefit Most ? MOAL, Bertrand; LAFAGE, Virginie; SMITH, Justin.S; AMES, Christopher P.; MUNDIS, Gregory; TERRAN, Jamie S.; KLINEBERG, Eric; HART, Robert; BOACHIE-ADJEI, Oheneba; SHAY, Bess; SKALLI, Wafa; SCHWAB, Frank (Scoliosis Research Society, 2015)Study Design: Multicenter, prospective, nonconsecutive, surgical case series from the International Spine Study Group. Objectives: To evaluate the extent of clinical improvement after surgery for adult spinal deformity ...
MOAL, Bertrand; BRONSARD, Nicolas; RAYA, Jose G.; VITAL, Jean-Marc; SCHWAB, Frank; SKALLI, Wafa; LAFAGE, Virginie (Baishideng Publishing Group, 2015)AIM: To investigate fat infiltration and volume of spino-pelvic muscles in adults spinal deformity (ASD) with magnetic resonance imaging (MRI) and 3D reconstructions. METHODS: Nineteen female ASD patients (mean age 60 ± ...
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