Analyse tridimensionnelle de la correction des scolioses idiopathiques de l'adolescent par translation postéromédiale

Abstract : Idiopathic scoliosis is a tridimensional trunk deformity, affecting both the spine and the rib cage. Low dose EOS stereoradiography is designed to assess the patient specific 3D geometry of the skeleton in standing position. The goal of this work is to improve the quantitative analysis of postoperative results in a routine clinical use, and to integrate the rib cage morphological analysis. Tools, methods and necessary proocols were first developed and validated to allow such an evaluation. In particular, the reliability of 3D measurements in severe scoliosis and instrumented spine were assessed. The modelization method was then applied to a series of adolescents operated for thoracic idiopathic scoliosis using posteromedial translation. The first part of the analysis focused on the instrumented spine, and included a new reference axis to estimate patients' global balance. The second part of the work aimed to describe the postoperative change of the sagittal cervical alignement. Significant improvement was found, correlated with thoracic kyphosis restoration. Finally, biplanar stereoradiography allowed a descriptive analysis of the endo and exothoracic morphology in a cohort of 80 adolescents with idiopathic scoliosis. Correlations between quantitative spinal and thoracic parameters and pulmonary function tests were investigated. The method was used in order to characterize the postoperative thoracic changes. This study confirms the interest of having in routine clinical use a 3D evaluation of the spine and the rib cage in the quantitative analysis of idiopathic scoliosis postoperative results.
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Contributor : Brice Ilharreborde <>
Submitted on : Saturday, September 29, 2012 - 12:39:11 PM
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Brice Ilharreborde. Analyse tridimensionnelle de la correction des scolioses idiopathiques de l'adolescent par translation postéromédiale. Biomécanique [physics.med-ph]. Arts et Métiers ParisTech, 2012. Français. ⟨NNT : 2012ENAM0020⟩. ⟨pastel-00736755⟩

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