Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis

Langlais, Tristan; Vergari, Claudio; Pietton, Raphaël; Dubousset, Jean; Skalli, Wafa; Vialle, Raphaël

doi:10.1007/s00330-018-5309-2

Cited by 30 publications

(28 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, 40% of the patients who presented abnormally high axial vertebral torque also had IAR at junctions within the normality corridor (Table 2). Disc ultrasonographic elastography of normal and scoliotic of intervertebral discs recently suggested that scoliotic discs may be stiffer than normal ones [16]; therefore, IAR could be a secondary factor.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

et al. 2019

Self Cite

View full text Add to dashboard Cite

Study Design: Retrospective observational study. Objectives: To determine the mass distribution along the scoliotic trunk using barycentremetry and its relationship with vertebral axial rotation and torque. Summary of the Background Data: Deformity progression in adolescent idiopathic scoliosis (AIS) is not yet fully understood, but gravity load on the spine could play a role. Barycentremetry allows to characterize body mass distribution in standing position, which could provide a better understanding the mechanisms of progression. Methods: 81 subjects (27 healthy adolescents and 53 AIS patients) underwent biplanar radiography and 3D reconstruction of the spine and body envelope. Position of the gravity line was estimated, as well as trunk segmental centers of mass COMs at each vertebral level and resulting axial torques to each vertebra. Results: The COM of all trunk segments was less than 1 cm from the gravity line in the frontal plane for healthy subjects, and less than 1.5 cm for AIS patients. Vertebral axial torque was 0.7 AE 0.5 Nm in healthy subjects, 2.9 AE 2.1 Nm at the junctional vertebrae of AIS patients and 0.5 AE 0.5 at the apex. A strong association was found between high torque and high intervertebral rotation at junctions, with low torque and low intervertebral axial rotation at the apex. Conclusion: Results suggest that AIS patients can maintain the COM of each body segment close to their gravity line, irrespective of the severity and asymmetry of their deformity. Moreover, torque analysis shed some light on the importance of junctional vertebrae in the spinal deformity and, potentially, in the vicious cycle determining scoliosis progression. Level of Evidence: Level III.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…For instance, increased intervertebral torsion is characteristic of the progressive scoliosis geometric phenotype (Skalli et al 2017), suggesting a role of altered disc torsional behaviour, which in turn can be affected by lamellar structure (Adam et al 2015). Moreover, it is known that scoliotic spines are stiffer than healthy ones (Deviren et al 2002), and recent in vivo measurements showed that this increased stiffness could be due to the AF (Langlais et al 2018). Mechanical and microstructural alterations of the disc have been already demonstrated in adolescent idiopathic scoliosis patients (Yu et al 2005; Langlais et al 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is known that scoliotic spines are stiffer than healthy ones (Deviren et al 2002), and recent in vivo measurements showed that this increased stiffness could be due to the AF (Langlais et al 2018). Mechanical and microstructural alterations of the disc have been already demonstrated in adolescent idiopathic scoliosis patients (Yu et al 2005; Langlais et al 2018). If these changes are accompanied by morphological ones, the technique tested in this work could be used to assess them.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonography was performed by an experienced user with an Aixplorer (SuperSonic Imagine, Aix-en-Provence, France) and a linear SL 10-2 probe. Imaging protocol was previously described for shearwave elastography of the disc (Langlais et al 2018): the subject was supine, arms along the body, in normal respiration. The probe was placed against the abdomen, oriented in the transversal plane.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Microstructural characterization of annulus fibrosus by ultrasonography: a feasibility study with an in vivo and in vitro approach

Langlais

Desprairies

Pietton

et al. 2019

Biomech Model Mechanobiol

Self Cite

View full text Add to dashboard Cite

The main function of the intervertebral disc is biomechanical function, since it must resist repetitive high loadings, while giving the spine its flexibility and protecting the spinal cord from over-straining. It partially owes its mechanical characteristics to the lamellar architecture of its outer layer, the annulus fibrosus. Today, no non-invasive means exist to characterize annulus lamellar structure in vivo. The aim of this work was to test the feasibility of imaging annulus fibrosus microstructure in vivo with ultrasonography. Twenty-nine healthy adolescents were included. Ultrasonographies of L3–L4 disc were acquired with a frontal approach. Annulus fibrosus was segmented in the images to measure the thickness of the lamellae. To validate lamellar appearance in ultrasonographies, multimodality images of two cow tail discs were compared: ultrasonography, magnetic resonance and optical microscopy. In vivo average lamellar thickness was 229.7 ± 91.5 μm, and it correlated with patient body mass index and age. Lamellar appearance in the three imaging modalities in vitro was consistent. Lamellar measurement uncertainty was 7%, with good agreement between two operators. Feasibility of ultrasonography for the analysis of lumbar annulus fibrosus structure was confirmed. Further work should aim at validating measurement reliability, and to assess the relevance of the method to characterize annulus alterations, for instance in disc degeneration or scoliosis.

show abstract

“…The external compression to the tissue studied by quasistatic elastography made this kind of investigation not suitable for spinal cord lesions. Nonetheless the introduction of related techniques, based on acoustic radiation force impulse imaging and shearwave elasticity imaging, allowed to overcome this limitation and to reconstruct 2-D and 3-D stiffness maps of a given tissue (53). Those new concepts have been recently extended also to the field of neurosurgery; for instance Uff et al demonstrated that elastograms can be successfully generated in the spinal cord using vascular pulsations to generate internal strains: their results revealed a correlation between strain data and the surgeon's assessment of the stiffness of the tissues; furthermore they found that areas of reduction in cross-correlation coefficient and very high axial strain at tumor boundaries predicted cleavage planes (54).…”

Section: Challenges and Future Opportunitiesmentioning

confidence: 99%

Intraoperative ultrasound in spine surgery: history, current applications, future developments

Ganau¹,

Syrmos²,

Martín³

et al. 2018

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis

Cited by 30 publications

References 37 publications

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

Microstructural characterization of annulus fibrosus by ultrasonography: a feasibility study with an in vivo and in vitro approach

Intraoperative ultrasound in spine surgery: history, current applications, future developments

Contact Info

Product

Resources

About