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Publications (5)7.98 Total impact

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    ABSTRACT: One of the main goals of scoliosis surgery is to obtain a balanced fused spine. Although preoperative planning remains essential, intraoperative posteroanterior radiographs are the only available tool during the procedure to verify shoulder and coronal spinal balance and, if necessary, adjust the construct. The aim of this study was to quantify the direct influence of intraoperative radiographs on the surgical procedure itself during correction of adolescent idiopathic scoliosis. Retrospective analysis of prospectively collected data on a monocentric cohort of adolescent idiopathic scoliosis patients undergoing corrective surgery. A total 148 consecutive patients operated in the same department following the same validated preoperative planning method were included in this prospective radiologic study. The mean follow-up averaged 33 months. Frontal Cobb angles, T1 tilt, shoulder tilt, iliolumbar angle, and frontal balance were measured and compared on intraoperative, early postoperative, and latest follow-up radiographs. Any intraoperative modification of the correction performed after analysis of the intraoperative radiograph were recorded. The analysis of all radiologic parameters was possible in 90.5% of the cases. In 9.5% of the cases, shoulders could not be properly distinguished. Significant modifications on the upper thoracic curve to correct T1 tilt or shoulder balance were performed in 29% of the patients, and changes at the distal levels were recorded in 19%, underlining planification imperfections. On postoperative standing radiographs, the average coronal parameters were neutral, without loss of correction at follow-up. Intraoperative radiographs remain necessary to ensure compensation of the shortcomings of the modern preoperative planification method. Level IV.
    Journal of pediatric orthopedics 03/2015; DOI:10.1097/BPO.0000000000000428 · 1.43 Impact Factor
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    ABSTRACT: El objetivo de las osteotomías vertebrales es restituir un equilibrio raquídeo lo más próximo posible a la normalidad, evitando cualquier hipercorrección. El análisis del desequilibrio raquídeo es un prerrequisito obligatorio antes de realizar el procedimiento de corrección quirúrgica. Cada técnica de osteotomía vertebral tiene sus exigencias y sus limitaciones. Se distinguen las osteotomías posteriores por cierre, según la técnica descrita por Smith-Petersen, de las osteotomías de sustracción pediculodiscal. Las deformaciones de tipo cifosis marcada de la charnela cervicotorácica son una indicación de elección para la realización de una osteotomía de extensión por sustracción posterior ampliada. Sin embargo, las distintas técnicas descritas de corrección de las deformaciones de la columna son difíciles y requieren una buena experiencia en cirugía raquídea. Pueden producirse complicaciones neurológicas definitivas o temporales durante la realización de estas distintas técnicas.
    03/2014; 6(1):1–10. DOI:10.1016/S2211-033X(14)66968-1
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    ABSTRACT: Les tendinopathies calcifiantes périarticulaires ont été largement décrites, mais leur localisation rétropharyngée demeure méconnue dans la littérature orthopédique. Cette pathologie représente un piège diagnostique, source d’examens et de traitements invasifs inutiles. Si la clinique est trompeuse, l’imagerie pathognomonique doit permettre d’établir le diagnostic. Nous rapportons le cas d’un patient ayant présenté des cervicalgies postopératoires fébriles, ayant dans un premier temps fait évoqué une complication septique, mais dont l’imagerie a permis de conclure à un tableau de tendinopathie calcifiante rétropharyngée.
    Resuscitation 05/2011; 97(3):331-334. DOI:10.1016/j.rcot.2011.02.018 · 3.96 Impact Factor
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    ABSTRACT: Periarticular calcific tendinopathy has been well described, but no retropharyngeal locations have been reported in the surgical orthopedic literature. This pathology is a diagnostic pitfall, leading to fruitless invasive examinations and treatment. The clinical aspect is misleading, but pathognomic imaging can establish diagnosis. We report a case of febrile postoperative cervicalgia, initially suggestive of a septic complication, but in which imaging indicated retropharyngeal calcific tendinitis.
    Orthopaedics & Traumatology Surgery & Research 03/2011; 97(3):341-4. DOI:10.1016/j.otsr.2010.09.021 · 1.17 Impact Factor
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    ABSTRACT: Lumbosacral fusion is often needed in cases of pediatric neuromuscular spinal deformities. Despite the numerous fixation techniques described, the procedure remains challenging. Jackson has described a method of intrasacral fixation providing immediate 3-dimensional stability and promising clinical results. The purpose of this study was to report our experience with long spinal fusion using Jackson intrasacral fixation in pediatric patients. All patients with at least 5 years of follow-up were reviewed. No brace was used postoperatively. Clinical data and radiographs were collected and analyzed preoperatively, postoperatively, and at latest follow-up. Intraoperative and postoperative complications were reported. Paired t test was used for statistical analysis. Fifty-six patients were included. The average age at surgery was 15.3 years. Mean follow-up period was 10.3 years and no patient was lost to follow-up. All radiographic parameters (frontal balance, frontal Cobb angle of the primary curve, iliolumbar angle, pelvic obliquity, sagittal balance, lumbosacral lordosis, and sacral slope) were significantly improved postoperatively (P<0.001), without significant loss of correction at latest follow-up. Four early infections, 1 pressure sore, and 4 cases of radicular pain, which resolved without intervention, were reported postoperatively. At latest follow-up, no patient complained of lumbar pain, and neither ambulatory status nor activity level ability worsened in any case. Sixteen of the 20 patients who needed a sitting orthosis preoperatively achieved a functional sitting posture without bracing. Jackson fixation is a safe and reliable technique providing immediate stability. In our series, no mechanical complication occurred and no loss of correction was observed, despite immediate unprotected mobilization. The method provides reliable good sacral fixation for pediatric neuromuscular spinal deformities, especially when the correction of severe pelvic obliquity is necessary. This consecutive series provides level IV evidence.
    Journal of pediatric orthopedics 09/2009; 29(6):594-601. DOI:10.1097/BPO.0b013e3181b2b403 · 1.43 Impact Factor