Multiple-Rod Constructs Do Not Reduce Pseudarthrosis and Rod Fracture After Pedicle Subtraction Osteotomy for Adult Spinal Deformity Correction but Improve Quality of Life

Anouar Bourghli,Louis Boissiere,David Kieser,Daniel Larrieu,Javier Pizones,Ahmet Alanay,Ferran PelIise,Franck Kleinstück,Ibrahim Obeid 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

Objective: To compare the radiological and functional outcomes and complications of adult spinal deformity patients who underwent a pedicle subtraction osteotomy (PSO) below L2 but categorized according to their construct where either 2-rod or multiple-rod construct is applied. Methods: Sixty-seven patients met the inclusion criteria, and were categorized into 3 groups: 2 rods (2R), multiple rods around the PSO (MRP), multiple rods around the PSO and lumbosacral junction (MRL). Demographic data, operative parameters, spinopelvic parameters, functional outcomes, and complications were collected. Results: Health-related quality of life scores showed a better outcome at 6 months and last follow-up visits in the MRP and MRL groups which were noted on different domains of Scoliosis Research Society-22 questionnaire, 36-item Short Form Health Surve, and Oswestry Disability Index scores (p<0.05). The 3 groups showed similar rates of rod-related complications with no significant difference (p=0.95). And inside each group, distribution of complications between pseudarthrosis with revision and rod fracture without revision was also similar (p=0.99). Conclusion: The use of multiple rods across the PSO did not show a better outcome when compared to single rods in terms of incidence and types of mechanical complications. However, better postoperative coronal alignment and health-related quality of life scores in the multiple rods group could be seen demonstrating an improved functional outcome.

Cervical Deformity Arising From Upper Thoracic Malalignment

Ibrahim Obeid,Louis Boissiere,Anouar Bourghli 대한척추신경외과학회 2020 Neurospine Vol.17 No.3

This study aims to describe the surgical management of cervical deformity arising from outside the cervical spine because of upper thoracic malalignment, using pedicle subtraction osteotomy (PSO). Cervical spine deformity is a complex topic and it can be generally divided into 2 categories, the first category is when the primary deformity is inside the cervical spine and the treatment will focus on the cervical spine itself, whereas the second category is when the primary deformity is outside the cervical spine usually in the adjacent upper thoracic area, the cervical deformity is a compensation for the adjacent malalignment, and thus in this situation, the management will occur in the upper thoracic area. Description of a single surgeon’s technique for performing PSO to treat rigid upper thoracic deformity. PSO in the upper thoracic spine is a safe and effective procedure and can result in satisfying clinical and radiological outcome with indirect correction of the compensatory cervical deformity. Cervical deformity arising from upper thoracic malalignment should be dealt with by treating the problem at its origin outside the cervical spine by performing a PSO in the upper thoracic spine.

Obeid-Coronal Malalignment Classification Is Age Related and Independently Associated to Personal Reported Outcome Measurement Scores in the Nonfused Spine

David Christopher Kieser,Louis Boissiere,Anouar Bourghli,Kazunori Hayashi,Derek Cawley,Caglar Yilgor,Ahmet Alanay,Emre Acaroglu,Frank Kleinstueck,Javier Pizones,Ferran Pellise,Francisco Javier Sanchez 대한척추신경외과학회 2021 Neurospine Vol.18 No.3

Objective: To evaluate Obeid-coronal malalignment (O-CM) modifiers according to age, sagittal alignment, and patient-reported outcome measures (PROMs), in the mobile spine. Methods: Retrospective review of a prospective multicenter adult spinal deformity (ASD) database with 1,243 (402 nonoperative, 841 operative) patients with no prior fusion surgery. Patients were included if they were aged over 18 years and were affected by spinal deformity defined by one of: Cobb angle ≥20°, pelvic tilt ≥25°, sagittal vertical axis ≥5 cm, thoracic kyphosis ≥60°. Patients were classified according to the O-CM classification and compared to coronally aligned patients. Multivariate analysis was performed on the relationship between PROMs and age, global tilt (GT) and coronal malalignment (CM). Results: Four hundred forty-three patients had CM of more than 2 cm compared to 800 who did not. The distribution of these modifiers was correlated to age. After multivariate analysis, using age and GT as confounding factors, we found that before the age of 50 years, 2A1 patients had worse sex life and greater satisfaction than patients without CM. After 50 years of age, patients with CM (1A1, 1A2) had worse self-image and those with 2A2, 2B had worse self-image, satisfaction, and 36-item Short Form Health Survey physical function. Self-image was the consistent determinant of patients opting for surgery for all ages. Conclusion: CM distribution according to O-CM modifiers is age dependent. A clear correlation between the coronal malalignment and PROMs exists when using the O-CM classification and in the mobile spine, this typically affects self-image and satisfaction. Thus, CM classified according to O-CM modifiers is correlated to PROMs and should be considered in ASD.

International comparison CCQM-K66: Impurity analysis of methane

Kato, Kenji,Watanabe, Takuro,Heine, Hans-Joachim,Boissiere, C,Schulz, G,Woo, Jin-Chun,Kim, Jin Seog,Oh, Sang Hyup,Bae, Hyun Kil,Kim, Yong Du,Qiao, Han,Guenther, Frank R,Rhoderick, George C,Miller, Wal Springer-Verlag 2012 METROLOGIA -BERLIN- Vol.49 No.-

<P>This key comparison was performed to demonstrate the capability of NMIs to analyse the purity of methane for use as a source gas in the preparation of standard gas mixtures. This capability is an essential requirement for the preparation of accurate standards of natural gas and some other fuels.</P><P>Since it is difficult to carry out a comparison with individual samples of pure gas, the sample for this comparison was a synthetic mixture of high purity methane with selected added impurities of nitrogen, argon, carbon dioxide and ethane. These mixtures were prepared by a gas company as a batch of 10 cylinders and their homogeneity and stability were evaluated by NMIJ.</P><P>The KCRVs for the four different analytes in this key comparison are based on a consensus of values reported by participants. The uncertainties in the degrees of equivalence were calculated by combining the reported uncertainties with the homogeneity of the samples and the uncertainty of the KCRV. The results submitted are generally consistent with the KCRV within the estimated uncertainties.</P><P>Finally, this comparison demonstrates that the analysis of nitrogen, argon, carbon dioxide and ethane in methane at amount fractions of 1 µmol/mol to 5 µmol/mol is generally possible with an uncertainty of 5% to 10%.</P><P>Main text.To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.</P><P>The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).</P>

Anterior Bone Loss in Cervical Disc Arthroplasty

David Christopher Kieser,Derek Thomas Cawley,Takashi Fujishiro,Celeste Tavolaro,Simon Mazas,Louis Boissiere,Ibrahim Obeid,Vincent Pointillart,Jean Marc Vital,Olivier Gille 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.1

Study Design: Retrospective, longitudinal observational study. Purpose: To describe the natural history of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and introduce a classification system for its assessment. Overview of Literature: ABL has recently been recognized as a complication of CDA, but its cause and clinical effects remain unknown. Methods: Patients with non-keeled CDA (146) were retrospectively reviewed. X-rays were examined at 6 weeks, 3, 6, 9, 12, 18, and 24 months, and annually thereafter for a minimum of 5 years. These were compared with the initial postoperative X-rays to determine the ABL. Visual Analog Scale pain scores were recorded at 3 months and 5 years. Neck Disability Index was recorded at postoperative 5 years. The natural history was determined and a classification system was introduced. Results: Complete radiological assessment was available for 114 patients with 156 cervical disc replacements (CDRs) and 309 endplates (average age, 45.3 years; minimum, 28 years; maximum, 65 years; 57% females). ABL occurred in 57.1% of CDRs (45.5% mild, 8.3% moderate, and 3.2% severe) and commenced within 3 months of the operation and followed a benign course, with improvement in the bone stock after initial bone resorption. There was no relationship between ABL degree and pain or functional outcome, and no implants were revised. Conclusions: ABL is common (57.1%). It occurs at an early stage (within 3 months) and typically follows a non-progressive natural history with stable radiographic features after the first year. Most ABL cases are mild, but severe ABL occurs in approximately 3% of CDAs. ABL does not affect the patients’ clinical outcome or the requirement for revision surgery. Surgeons should thus treat patients undergoing CDA considering ABL.

<i>EPOXI</i> : COMET 103P/HARTLEY 2 OBSERVATIONS FROM A WORLDWIDE CAMPAIGN

Meech, K. J.,A’Hearn, M. F.,Adams, J. A.,Bacci, P.,Bai, J.,Barrera, L.,Battelino, M.,Bauer, J. M.,Becklin, E.,Bhatt, B.,Biver, N.,Bockelé,e-Morvan, D.,Bodewits, D.,Bö,hnhardt, H.,Boissier, J IOP Publishing 2011 ASTROPHYSICAL JOURNAL LETTERS - Vol.734 No.1

<P>Earth- and space-based observations provide synergistic information for space mission encounters by providing data over longer timescales, at different wavelengths and using techniques that are impossible with an in situ flyby. We report here such observations in support of the EPOXI spacecraft flyby of comet 103P/Hartley 2. The nucleus is small and dark, and exhibited a very rapidly changing rotation period. Prior to the onset of activity, the period was similar to 16.4 hr. Starting in 2010 August the period changed from 16.6 hr to near 19 hr in December. With respect to dust composition, most volatiles and carbon and nitrogen isotope ratios, the comet is similar to other Jupiter-family comets. What is unusual is the dominance of CO2-driven activity near perihelion, which likely persists out to aphelion. Near perihelion the comet nucleus was surrounded by a large halo of water-ice grains that contributed significantly to the total water production.</P>