You are cordially invited to attend the thesis defense ofMs. Emmanuelle FERRERO, who isseeking aDoctorate from the Ecole Nationale SupérieureArts et Métiers, specializing in Biomechanics.
Summary
Adult scoliosis is a condition whose prevalence increases with the aging of the population. In addition, functional demands are increasingly important in these patients. Numerous studies have shown the benefits of surgical treatment of adult deformities compared to medical treatment. However, this surgery is associated with numerous complications (up to 50%), most of which are mechanical. Thus, although radiographic analysis of scoliosis has been well explored, certain questions remain, such as the phenomena responsible for a sudden worsening of the deformity in some patients or the causes of failure. The aim of this study was to analyze adult scoliosis in 3D using stereoradiography and to evaluate the muscular system of these patients in order to highlight the relationship between spinal deformities, particularly through analysis of the horizontal plane, and muscular degeneration.
The first part of this work was devoted to 3D analysis of scoliosis: first with the analysis of reproducibility in adults of 3D measurements taken by stereoradiography, then by analyzing the overall alignment of these patients with spinal deformity, using a new parameter that takes into account the position of the cervico-cephalic junction. After analyzing postural alignment, the pelvic-spinal muscular system was studied in the second part. In addition to skeletal alignment, it is the activation of the muscular system that is responsible for maintaining an upright posture. In lumbar scoliosis, certain muscle groups were more affected by atrophy and fatty infiltration, particularly the spinal erectors, in connection with sagittal misalignment and axial rotation. After comparison with subjects without deformity, patients with scoliosis had muscle degeneration related to both deformity and aging. In a third part, linking the posture data from stereoradiography with the muscle data from MRI, we used a personalized musculoskeletal model to better understand the stresses exerted on the vertebral segments and thus to try to explain the mechanical failures.
Thus, combining 3D radiographic measurements and muscle analysis could lead to a better understanding of degenerative phenomena, enabling better prediction of the worsening of deformity and the risks of mechanical complications, and therefore preventing them through targeted rehabilitation and an appropriate surgical strategy. In addition, identifying risk factors for worsening deformity would lead to earlier treatment for these patients. A longitudinal analysis would therefore be of interest.
Practical information
The defense will take place onThursday, November 15, at 4:00 p.m. in the Guy Gautherin room on the Arts et Métiers campus Arts et Métiers Paris.
The thesis is entitled: "Lumbar scoliosis in adults—Relationship between clinical presentation, spinal statics, disc degeneration, and musculo-ligamentous degeneration: three-dimensional analysis using stereoradiography, magnetic resonance imaging, and computed tomography."."
Thesis supervisors: Wafa SKALLI, Virginie LAFAGE, Pierre GUIGUI.
Jury
- Mr. Yann Philippe CHARLES, Strasbourg University Hospital, University of Strasbourg
- Mr. Philippe GORCE, Professor, La Garde Campus, University of Toulon
- Ms. Wafa SKALLI, Professor, Arts et Métiers , Paris
- Ms. Virginie LAFAGE, Doctor, Hospital for Special Surgery, New York
- Mr. Pierre GUIGUI, Professor, Georges Pompidou European Hospital, Paris V University
- Mr. Jean-Marc VITAL, Professor, Pellegrin Hospital, University of Bordeaux
- Mr. Jean DUBOUSSET, Professor, National Academy of Medicine, Paris
