1. Head to pelvis alignment of adolescent idiopathic scoliosis patients both in and out of brace
- Author
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Eric Ebermeyer, Rapahaël Pietton, Claudio Vergari, Wafa Skalli, Houssam Bouloussa, Isabelle Courtois, Raphaël Vialle, Institut de Biomecanique Humaine Georges Charpak, Arts et Métiers ParisTech-Université Paris 13 (UP13), Laboratoire de biomécanique (LBM), Centre National de la Recherche Scientifique (CNRS)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Grenoble Alpes - UFR Langage, lettres et arts du spectacle, information et communication - Dpt Lettres et arts du spectacle (UGA UFR LLASIC LAS), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de chirurgie orthopédique et reconstructive pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de pédiatrie orthopédique [CHU Trousseau], Service des thérapies innovantes pour les maladies musculo-squelettiques [CHU Trousseau], Université Paris 13 (UP13)-Arts et Métiers ParisTech, Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Administrateur Ensam, Compte De Service, Université Grenoble Alpes (UGA), Service de chirurgie orthopédique pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Institut de Biomécanique Humaine Georges Charpak (IBHGC), Université Sorbonne Paris Nord-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM), and Hôpital Bellevue - CHU
- Subjects
Pelvic tilt ,Male ,Brace effect ,[SDV]Life Sciences [q-bio] ,[SPI]Engineering Sciences [physics] ,0302 clinical medicine ,Orthopedics and Sports Medicine ,Prospective Studies ,Child ,Orthodontics ,030222 orthopedics ,Cobb angle ,AIS ,musculoskeletal system ,Bracing ,Healthy Volunteers ,humanities ,3. Good health ,[SDV] Life Sciences [q-bio] ,medicine.anatomical_structure ,Scoliosis ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,Neurosurgery ,Compensation ,musculoskeletal diseases ,medicine.medical_specialty ,Sacrum ,Adolescent ,[SPI] Engineering Sciences [physics] ,Posture ,Pelvis ,03 medical and health sciences ,Young Adult ,Imaging, Three-Dimensional ,medicine ,Humans ,Kyphosis ,Balance (ability) ,Retrospective Studies ,Braces ,business.industry ,ingénierie bio-médicale [Sciences du vivant] ,equipment and supplies ,Brace ,Sagittal plane ,Spine ,Radiography ,Case-Control Studies ,Surgery ,business ,Head ,human activities ,030217 neurology & neurosurgery ,Sagittal balance - Abstract
International audience; 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.
- Published
- 2019
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