Hubert Labelle

Centre Hospitalier Sainte Anne, Lutetia Parisorum, Île-de-France, France

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Publications (264)419.3 Total impact

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    ABSTRACT: : Posterior spinal surgical correction is performed to correct severe or highly progressive spinal deformities in adolescent idiopathic scoliosis. Although it is known that the relative spino-pelvic alignment changes during the progression of scoliosis and after spinal surgery, pelvis mainly remains unfused in idiopathic scoliosis surgery. To this date the impact of the spinal fusion on the biomechanical loading of the sacrum and the transferred load to the pelvis via sacrum is not documented in the scoliotic subgroups.
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    ABSTRACT: Background: Back pain has often been associated with adolescent idiopathic scoliosis (AIS), which is a three-dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well-being. Back pain in this population tends to be persistent and may be a predictor of back pain in adulthood. Objective: To document the prevalence and management of back pain (BP) in AIS patients. Methods: We conducted a retrospective chart review of AIS patients who were referred to Sainte-Justine University Teaching Hospital from 2006 to 2011. Results: We reviewed 300 randomly selected charts. Close to half the patients (47.3%) mentioned that they suffered back pain, most commonly in the lumbar (19.7%) and thoracic regions (7.7%). The type of back pain was documented in only 36% (112) of the charts. Pain intensity was specified in only 21% (65) of the charts. In approximately 80% (248) of the charts, no pain management treatment plan was documented. Conclusions: Back pain prevalence was moderately high among our sample of adolescents with AIS. An improved system for documenting BP assessment, type, treatment plan and treatment effectiveness would improve pain management for these patients.
    Pain research & management: the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur 04/2015; · 1.39 Impact Factor
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    ABSTRACT: A biomechanical spine model was used to evaluate the impact of screw design on screw–vertebra interface loading during simulated surgical corrections of adult scoliosis.
    03/2015; 3(2):114-121. DOI:10.1016/j.jspd.2014.07.004
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    ABSTRACT: Introduction: The quantification of internal joint efforts could be essential in the development of rehabilitation tools for patients with musculo-skeletal pathologies, such as scoliosis. In this context, the aim of this study was to compare the hips joint mediolateral forces during gait, between healthy subjects and adolescents with left lumbar or thoracolumbar scoliosis (AIS), categorized by their Cobb angle (CA). Material and methods: Twelve healthy subjects, 12 AIS with CA between 20° and 40° and 16 AIS in pre-operative condition (CA : > 40°) walked at 4 km/h on an instrumented treadmill. The experimental set-up include six infrared cameras allow the computation of the tridimensional (3D) angular displacement and strain gauges located under the motor-driven treadmill allow the computation of ground reaction forces (GRF). The hips joint mediolateral forces were calculated using a 3D inverse dynamic of human body. One-way ANOVA was performed for the maximum, the minimum and the range of medio-lateral forces at each joint of the lower limbs. When appropriate, a Tukey’s post hoc was performed to determine the differences. Results: The mediolateral forces were significantly lower at the right hip for AIS with CA between 20° and 40° compared to healthy subject. Conclusion: The spinal deformation leads to a reduced medio-lateral force at the right hip, which could gradually change the scheme of postural adjustments for AIS during gait. Further research on the quantification of the joint lower limb efforts should include the knee and ankle joints to evaluate the impact of spinal deformation on the lower limb dynamic behaviour in AIS patients.
    Scoliosis 02/2015; 10(Suppl 2):S3. DOI:10.1186/1748-7161-10-S2-S3 · 1.31 Impact Factor
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    ABSTRACT: Study Design. A replication association study that used genomic data generated from French-Canadian case and control cohorts.Objectives. To determine whether the 53 single nucleotide polymorphisms (SNPs) that were previously associated with spinal deformity progression in an American Caucasian cohort, are similarly associated in French-Canadian population.Summary of Background Data. It is widely accepted that genetic factors contribute to AIS. The identification of genetic variants associated with the predisposition or progression of curvature could facilitate diagnostic/prognostic tool development. Although 53 SNPs have been associated with spinal curve progression in Caucasian cohorts in the USA, these associations were not replicated in a large Japanese-population study, arguing that such a discrepancy could be explained by ethnicity, thus raising the importance of a replication study in an independent Caucasian population of European descent.Methods. Genomic data was collected from the French-Canadian population, using the Illumina HumanOmni 2.5M BeadChip. Fifty-two SNPs, tested in ScoliScore or in high linkage disequilibrium (LD) with SNPs in the test, were selected to assess their association with scoliosis generally, and with spinal curve progression. One SNP in ScoliScore, rs16909285, could not be evaluated in our GWAS.Results. None of the SNPs used in ScoliScore were associated with AIS curve progression or curve occurrence in French-Canadian population. We evaluated 52 SNPs in severe patients by comparing risk allele frequencies with those in non-severe patients and with those in control individuals. There was no significant difference between the severe group and the non-severe group or between the severe group and the control group.Conclusions. Although the 52 SNPs studied here were previously associated with curve progression in an American population of European descent, we found no association in French-Canadian AIS patients. This second replication cohort suggests that the lack of association of these SNPs in a Japanese cohort is not due to ethnicity.
    Spine 02/2015; 40(8). DOI:10.1097/BRS.0000000000000807 · 2.45 Impact Factor
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    ABSTRACT: Study Design. Retrospective review of prospective multicenter database of adolescent idiopathic scoliosis (AIS) patients who underwent posterior spinal fusion.Objective. To analyze implant distribution in surgically instrumented Lenke 1 patients and evaluate how it impacts curve correction.Summary of Background Data. While pedicle screw constructs have demonstrated successful surgical results, the optimal pedicle screw density and configuration remain unclear.Methods. 279 AIS patients treated with pedicle screws were reviewed. Implant density was computed for each side of the instrumented segment, which was divided into five regions: distal and proximal ends (upper/lower instrumented vertebra +1 adjacent vertebra), apical region (apex +/-1 vertebra) and the two regions in between (upper/lower periapical). Centralized measurement of Cobb angle and thoracic kyphosis was performed on pre-operative and at one-year post-operative radiographs as well as percent curve flexibility.Results. The mean implant density was 1.66 implants per level fused (1.08 to 2) with greater available pedicles filled on the concavity (92%, 53 to 100%) compared to the convex side (73%, 23 to 100%, p<0.01). The concave distal end region had the highest density with 99% of pedicles filled (p<0.01), followed by the other concave regions and the convex distal end region (88 to 94%) (p>0.05). Other convex regions of the construct had less instrumentation with only 54 to 78% of pedicles instrumented (p<0.01). Implant density in the concave apical region (p = 0.002, R = 0.19) had a positive effect on curve correction (69%, 23 to 100%).Conclusions. Significant variability exists in implant distribution with the greatest variation on the convex side and lowest implant density used in the periapical convex regions. Only instrumentation at the concave side, particularly at the apical region, was associated with curve correction. This suggests that for a low implant density construct the best regions for planned screw drop may be in the periapical convexity.
    Spine 01/2015; 40(7). DOI:10.1097/BRS.0000000000000793 · 2.45 Impact Factor
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    ABSTRACT: Background Variability in surgical strategies for the treatment of adolescent idiopathic scoliosis (AIS) has been demonstrated despite the existence of classifications to guide selection of AIS curves to include in fusion. Decision trees and rule-based algorithms have demonstrated their potential to improve reliability of AIS classification because of their systematic approach and they have also been proposed in algorithms for selection of instrumentation levels in scoliosis. Our working hypothesis is that a rule-based algorithm with a knowledge base extracted from the literature can efficiently output surgical strategies alternatives for a given AIS case. Our objective is to develop a rule-based algorithm based on peer-reviewed literature to output alternative surgical strategies for approach and levels of fusion. Methods A literature search of all English Manuscripts published between 2000 and December 2009 with Pubmed and Google scholar electronic search using the following keywords: “adolescent idiopathic scoliosis” and “surgery” alternatively with “levels of fusion” or “approach”. All returned abstracts were screened for contents that could contain rules to include in the knowledge base. A dataset of 1,556 AIS cases treated surgically was used to test the surgical strategy rule-based algorithm (SSRBA) and evaluate how many surgical treatments are covered by the algorithm. The SSRBA was programmed using Matlab. Descriptive statistic was used to evaluate the ability of the rule-based algorithm to cover all treatment alternatives. Results A SSRBA was successfully developed following Lenke classification’s concept that the spine is divided into three curve segments [proximal thoracic (PT), main thoracic (MT) and thoracolumbar/lumbar (TL)]. Each of the 1,556 AIS patients in the dataset was ran through the SSRBA. It proposed an average of 3.78 (±2.06) surgical strategies per case. Overall, the SSRBA is able to match the treatment offered by the surgeon in approach and level of fusion 70 % of the time (with one vertebral level leeway). Conclusion This study is to the author’s knowledge the first attempt at proposing an algorithm to output all surgical alternatives for a given AIS case. It uses a rule-based algorithm with a knowledge base extracted from peer-reviewed literature in an area with great variability. When tested against a database of AIS patients treated surgically, the SSRBA developed has the ability to propose a surgical plan with respect to approach and levels of fusion that match the surgeon’s plan in a great majority of cases. Since this SSRBA seems to output multiple valid surgical strategies, it could allow the comparisons of various strategies and the outcomes achieved in similar cases in large databases for a given case and guide surgical treatment.
    European Spine Journal 01/2015; DOI:10.1007/s00586-014-3736-6 · 2.47 Impact Factor
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    ABSTRACT: Study Design Cross-sectional descriptive study. Objectives To characterize breast asymmetry (BA), as defined by breast volume difference, in girls with significant adolescent idiopathic scoliosis (AIS), using magnetic resonance imaging (MRI). Summary and Background BA is a frequent concern among girls with AIS. It is commonly believed that this results from chest wall deformity. Although many women exhibit physiological BA, the prevalence is not known in adolescents and it remains unclear if it is more frequent in AIS. Breasts vary in shape and size and many ways of measuring them have been explored. MRI shows the highest precision at defining breast tissue. Methods Thirty patients were enrolled on the basis of their thoracic curvature, skeletal and breast maturity, without regard to their perception on their BA. MRI acquisitions were performed in prone with a 1.5-Tesla system using a 16-channel breast coil. Segmentation was achieved using the ITK-SNAP 2.4.0 software and subsequently manually refined. Results The mean left breast volume (528.32 ± 205.96 cc) was greater compared with the mean right breast volume (495.18 ± 170.16 cc) with a significant difference between them. The mean BA was found to be 8.32% ± 6.43% (p < .0001). A weak positive correlation was observed between BA and thoracic Cobb angle (0.177, p = .349) as well as thoracic gibbosity angle (0.289, p = .122). The left breast was consistently larger in 65.5% of the patients. Twenty patients (66.7%) displayed BA ≥5%. Conclusions We have described BA in patients with significant AIS using MRI. This method is feasible, objective, and very precise. The majority of patients had a larger left breast, which could compound the apparent BA secondary to trunk rotation. In many cases, BA is present independently of thoracic deformity. This knowledge will assist in counseling AIS patients in regards to their concerns with BA.
    09/2014; 2(5):374–379. DOI:10.1016/j.jspd.2014.05.002
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    ABSTRACT: Background Mobile smartphones are equipped with inclinometers enabling them to acquire angular clinical measures. The Scolioscreen has been developed in conjunction with a smartphone APP to enable the measure of the angle of trunk inclination (ATI) thus offering a convenient and reliable means to measure and screen for spinal deformities. The objective was to compare the reliability and accuracy of a Scolioscreen-smartphone combination, a smartphone alone, and a Scoliometer, for measuring the angle of trunk inclination in spinal deformities under blinded conditions for intra- and inter-observer analyses. Methods A cohort of 39 patients with adolescent idiopathic scoliosis were recruited. Each had maximum ATI measured by 3 observers: attending spine surgeon, nurse, and parent presenting with patient. Two series of measurements were performed by each observer using Scolioscreen-smartphone, smartphone alone and Scoliometer. Intra-class correlation coefficients (ICC) from two-way mixed model based on absolute agreement were used to assess intra- and inter-observer reliability as well as consistency between measurement techniques. Results Intra- and inter-observer reliability for measuring maximum ATI was 0.94-0.89 with Scolioscreen-smartphone, decreased to 0.89-0.75 for smartphone alone, and was 0.95- 0.89 for Scoliometer. Considering Scoliometer measurement taken by surgeon the gold standard, there was excellent consistency with measurements from Scolioscreen-smartphone taken by surgeon (ICC = 0.99), nurse (ICC = 0.95), and parent (ICC = 0.91). Conversely, consistency decreased when surgeon (ICC = 0.86), nurse (ICC = 0.86) and parent (ICC = 0.85) used smartphone alone. Conclusion Study shows the Scolioscreen-smartphone to overcome limitations associated with ATI measurements using smartphones alone. The Scolioscreen-smartphone provides a reliability and consistency similar to the gold standard (use of Scoliometer by spine surgeon) and enables a parent to take reliable measurements on their own thus offering an accessible and convenient tool for all to use.
    Scoliosis 07/2014; 9:10. DOI:10.1186/1748-7161-9-10 · 1.31 Impact Factor
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    ABSTRACT: Study Design Feasibility study to compare the effectiveness of 2 brace design and fabrication methods for treatment of adolescent idiopathic scoliosis: a standard plaster-cast method and a computational method combining computer-aided design and fabrication and finite element simulation. Objectives To improve brace design using a new brace design method. Summary of Background Data Initial in-brace correction and patient's compliance to treatment are important factors for brace efficiency. Negative cosmetic appearance and functional discomfort resulting from pressure points, humidity, and restriction of movement can cause poor compliance with the prescribed wearing schedule. Methods A total of 15 consecutive patients with brace prescription were recruited. Two braces were designed and fabricated for each patient: a standard thoracolumbo-sacral orthosis brace fabricated using plaster-cast method and an improved brace for comfort (NewBrace) fabricated using a computational method combining computer-aided design and fabrication software (Rodin4D) and a simulation platform. Three-dimensional reconstructions of the torso and the trunk skeleton were used to create a personalized finite element model, which was used for brace design and predict correction. Simulated pressures on the torso and distance between the brace and patient's skin were used to remove ineffective brace material situated at more than 6 mm from the patient's skin. Biplanar radiographs of the patient wearing each brace were taken to compare their effectiveness. Patients filled out a questionnaire to compare their comfort. Results NewBraces were 61% thinner and had 32% less material than standard braces with equivalent correction. NewBraces were more comfortable (11 of 15 patients) or equivalent to (4 of 15 cases) standard braces. Simulated correction was simulated within 5° compared with in-brace results. Conclusions This study demonstrates the feasibility of designing lighter and more comfortable braces with correction equivalent to standard braces. This design platform has the potential to further improve brace correction efficiency and its compliance.
    07/2014; 2(4):276–284. DOI:10.1016/j.jspd.2014.03.005
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    ABSTRACT: Objective To compare the medio-lateral joint forces in the lower limbs during gait between healthy subjects and patients with different scoliotic severities, to develop indicators of quality and comfort during gait. Material and methods Twelve healthy subjects, 12 adolescents with idiopathic scoliosis (AIS) with Cobb angle (CA) between 20 and 40 and 16 AIS in pre-operative condition (Cobb : > 40) performed gait at 4 km/h on an instrumented treadmill. The acquisition system included optokinetic sensors (BTS, Italy) recording the 3D joint coordinates and a treadmill equipped with force sensors (UCL, Belgium) measuring the 3D external forces independently applied to each feet. The hip, knee, and ankle joint forces at the left and right lower limbs were calculated using a tridi-mensional inverse dynamic model of the human body. One-way ANOVA was performed for the maximum, the minimum and the range of medio-lateral forces at each joint of the lower limbs. When appropriate, a Tukey's post hoc was performed to determine the differences. Results The maxima and the magnitudes of the medio-lateral forces at the right hips and knees were significantly lower in AIS having a CA between 20 and 40 compared to healthy subjects. At both left and right ankle joints, the medio-lateral forces showed significant differences between healthy subjects and the two AIS subgroups. Conclusion The medio-lateral joint forces in the lower limbs are sig-nificantly different between AIS and healthy subjects. The spinal deformity correlates to a decrease of hip, knee, and ankle medio-lateral forces. This force decrease can be explained by the reduced muscle efficiency that results from the longer contraction time of the lumbar and pelvic muscles. This force decrease could gradually change the pattern of postural adjustments in AIS during gait. Espe-cially at the hip, the decreased medio-lateral force corre-sponds to a postural adjustment balancing the increased pelvic moment generated by the medio-lateral shift of the thoracic mass during gait. Consequently, the evaluation of the medio-lateral forces in the lower limbs could help to select specific postural rehabilitation exercises around each lower limb joint to develop indicators of quality and comfort during gait.
    The 10th Meeting of the International Research Society of Spinal Deformities (IRSSD 2014 Sapporo) Sapporo, Japan. 29 June - 2 July 2014; 06/2014
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    ABSTRACT: In both scoliosis and spondylolisthesis, the progression of the spine deformation leads to the degeneration of intervertebral discs characterized by a change in its structure and biochemical composition. The MRI images of 79 patients (32 with scoliosis, 32 with spondylolisthesis and 15 with herniated discs) were analysed using texture parameters extracted from the intensity histograms of the grey level, contrast, correlation, energy and homogeneity images. The results validated our hypothesis: the calculated tissue-specific texture features can effectively discriminate the pathologies and some of their severities. This method has the advantage of supporting the interesting possibility of developing robust non-invasive predictive methods for the diagnosis of the severities of spine pathologies.
    Joint Annual Meeting ISMRM-ESMRMB 2014, Milan; 05/2014
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    11th International Conference on Conservative Management of Spinal Deformities, 9th SOSORT Annual Meeting, Wiesbaden, Germany; 05/2014
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    ABSTRACT: This is a prospective case-control study. The objective of this study was to compare 3-dimensional (3D) morphological parameters of the spine at the first visit between a nonprogressive (NP) and a progressive (P) group of immature adolescent idiopathic scoliosis (AIS). Prediction of curve progression remains challenging in AIS at the first visit. Prediction of progression is based on curve type, curve magnitude, and skeletal or chronological age. A prospective cohort of 133 AIS was followed from skeletal immaturity to maturity (mean, 37 mo). The first group was made up of patients with AIS with a minimum 6-degree progression of the major curve between the first and last follow-up (P) (n = 53) and the second group was composed of patients with NP who reached maturity with less than 6-degree progression (n = 81). Computerized measurements were taken on reconstructed 3-dimensional (3D) spine radiographs of the first visit. There were 6 categories of measurements: angle of plane of maximum curvature, Cobb angles (kyphosis, lordosis), 3D wedging (apical vertebra, apical disks), rotation (upper and lower junctional vertebra, apical vertebra, and thoracolumbar junction), torsion, and slenderness (height/width ratio). t tests were also conducted. There was no statistical difference between the 2 groups for age and initial Cobb angle. P presented significant hypokyphosis, and parameters related to rotation presented significant statistical differences between NP and P (plane of maximal curvature, torsion, and apical axial rotation). Depth slenderness also presented statistical differences. This study confirms that even at the initial visit, 3D morphological differences exist between P and NP AIS. It supports the use of 3D reconstructions of the spine in the initial evaluation of AIS to help predict outcome.Level of Evidence: 3.
    Spine 05/2014; 39(10):E601-6. DOI:10.1097/BRS.0000000000000284 · 2.45 Impact Factor
  • K.C. Assi, Hubert Labelle, Farida Cheriet
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    ABSTRACT: The main objective of this letter is to formulate a new approach of learning a Mahalanobis distance metric for nearest neighbor regression from a training sample set. We propose a modified version of the large margin nearest neighbor metric learning method to deal with regression problems. As an application, the prediction of post-operative trunk 3-D shapes in scoliosis surgery using nearest neighbor regression is described. Accuracy of the proposed method is quantitatively evaluated through experiments on real medical data.
    IEEE Signal Processing Letters 03/2014; 21(3):292-296. DOI:10.1109/LSP.2014.2301037 · 1.64 Impact Factor
  • Samuel Kadoury, Hubert Labelle, Stefan Parent
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    ABSTRACT: The quantitative assessment of surgical outcomes using personalized anatomical models is an essential task for the treatment of spinal deformities such as adolescent idiopathic scoliosis. However an accurate 3D reconstruction of the spine from postoperative X-ray images remains challenging due to presence of instrumentation (metallic rods and screws) occluding vertebrae on the spine. In this paper, we formulate the reconstruction problem as an optimization over a manifold of articulated spine shapes learned from pathological training data. The manifold itself is represented using a novel data structure, a multi-level manifold ensemble, which contains links between nodes in a single hierarchical structure, as well as links between different hierarchies, representing overlapping partitions. We show that this data structure allows both efficient localization and navigation on the manifold, for on-the-fly building of local nonlinear models (manifold charting). Our reconstruction framework was tested on pre- and postoperative X-ray datasets from patients who underwent spinal surgery. Compared to manual ground-truth, our method achieves a 3D reconstruction accuracy of 2.37 +/- 0.85 mm for postoperative spine models and can deal with severe cases of scoliosis.
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    01/2014; DOI:10.1177/2333392814550527
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    ABSTRACT: Study Design. 3D analysis of the spino-pelvic alignment in adolescent idiopathic scoliosis (AIS).Objective. To study the 3D pelvic alignment with respect to the spinal deformities in AIS subgroups.Summary of Background Data. Spino-pelvic alignment is subject to change in scoliosis. Many sacro-pelvic parameters were developed to characterize spino-pelvic alignment in sagittal plane. However not much is known about the 3D pelvic alignment with respect to the thoracic and lumbar spinal deformities in AIS.Methods. Eighty AIS subjects with right main thoracic curves (MT), 80 AIS with left thoracolumbar-lumbar curves (TL/L), and 35 asymptomatic controls were included. Thoracic and lumbar Cobb angles, kyphosis, lordosis, pelvic incidence, pelvic tilt, and sacral slope were measured. Pelvic tilt and axial rotation in the coronal and transverse planes respectively were computed using the ipsilateral anterior and posterior iliac spine (ASIS and PSIS) positions. Leg length discrepancy was determined by the vertical difference in the position of the center of the femoral heads in the coronal plane.Results. In 59% of the MT subjects and 79% of the TL/L subjects in the erect position, the pelvis was tilted toward the convex side of the major curve in the coronal plane. The direction of the pelvic axial rotation in the transverse plane was in the same direction as the main thoracic apical vertebra rotation in 84% of the MT subjects and 55% of the TL/L group. The pelvic incidence correlated to the lumbar lordosis in AIS (r = 0.41, p<0.001). Pelvic coronal tilt correlated significantly to the leg length discrepancy in MT (r = 0.67) and TL/L (r = 0.61) subjects (p<0.001).Conclusion. Novel pelvic parameters were introduced to characterize the spino-pelvic relative alignment in scoliotic subgroups. The proposed method related the orientation of the pelvis in the coronal and transverse planes to both thoracic and lumbar spinal deformities.
    Spine 12/2013; 39(7). DOI:10.1097/BRS.0000000000000193 · 2.45 Impact Factor
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    ABSTRACT: Cross-sectional evaluation of sacro-pelvic morphology and orientation as well as spondylolisthesis prevalence in a cohort of young gymnasts. To evaluate the prevalence of spondylolisthesis in a cohort of gymnasts, as well as the associated demographic characteristics and sacro-pelvic morphology and orientation. Numerous studies have shown that sagittal sacro-pelvic morphology and orientation is abnormal in spondylolisthesis. Sacro-pelvic morphology and orientation in gymnasts and their relationship with spondylolisthesis have never been analyzed. Radiological evaluation of 92 gymnasts was performed to identify spondylolisthesis, and to measure pelvic incidence, pelvic tilt, sacral slope and sacral table angle. In the presence of spondylolisthesis, the slip percentage was measured. Different demographic and training characteristics were evaluated. Radiographic parameters were compared with reference values published for asymptomatic children and adolescents, and for subjects with spondylolisthesis. A 6.5% prevalence of spondylolisthesis was found in our cohort. The weekly training schedule was the only statistically significant different demographic characteristic between the two groups, at 20.6±5.4 vs 14.4±5.6 hours per week for subjects with and without spondylolisthesis, respectively. Pelvic incidence, pelvic tilt, sacral slope and sacral table angle were respectively 69±20°, 15±13°, 54±11° and 88±7° in gymnasts with spondylolisthesis, and 53±11°, 10±6°, 43±9° and 94±6° in gymnasts without spondylolisthesis. When compared to asymptomatic individuals, pelvic incidence and pelvic tilt were slightly superior in gymnasts without spondylolisthesis. Pelvic incidence, sacral slope and sacral table angle were significantly different between gymnasts with and without spondylolisthesis. The prevalence of spondylolisthesis in young gymnasts was similar to that observed in the general population. Sagittal sacropelvic morphology and orientation was abnormal in gymnasts with spondylolisthesis. Sagittal sacropelvic morphology and orientation was also slightly different in gymnasts without spondylolisthesis when compared to the normal population. The present study supports an association between spondylolisthesis and abnormal sacro-pelvic orientation and morphology.
    Journal of spinal disorders & techniques 11/2013; DOI:10.1097/BSD.0b013e3182956d62 · 1.89 Impact Factor
  • Revue de Chirurgie Orthopédique et Traumatologique 11/2013; 99(7):S369. DOI:10.1016/j.rcot.2013.09.251

Publication Stats

4k Citations
419.30 Total Impact Points


  • 2015
    • Centre Hospitalier Sainte Anne
      Lutetia Parisorum, Île-de-France, France
  • 1995–2014
    • Université de Montréal
      • • Department of Surgery
      • • Division of Orthopaedic Surgery
      • • Faculty of Medicine
      Montréal, Quebec, Canada
  • 2013
    • Hôpital du Sacré-Coeur de Montréal
      Montréal, Quebec, Canada
  • 1993–2013
    • CHU Sainte-Justine
      Montréal, Quebec, Canada
  • 1994–2012
    • Montreal Polytechnic
      • Département de génie mécanique
      Montréal, Quebec, Canada
  • 2009
    • Philips
      Eindhoven, North Brabant, Netherlands
  • 2004–2008
    • Centre de recherche informatique de Montréal
      Montréal, Quebec, Canada
  • 2007
    • McGill University
      Montréal, Quebec, Canada
  • 2006
    • École Polytechnique
      Paliseau, Île-de-France, France
  • 2003
    • McGill University Health Centre
      Montréal, Quebec, Canada
  • 2002
    • Université du Québec à Montréal
      Montréal, Quebec, Canada
  • 2000–2002
    • The University of Calgary
      • Department of Surgery
      Calgary, Alberta, Canada
  • 1996
    • University of Vermont
      • Department of Orthopaedics and Rehabilitation
      Burlington, Vermont, United States