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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVII | Pages 26 - 26
1 Jun 2012
PROPRIO-OCULO-VESTIBULAR ABNORMALITIES IN SCOLIOSIS
Deroubaix J Rousie D Salvetti P Baudrillard J
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Introduction

The Proprio-oculo-vestibular system is involved in scoliosis. In Congress ZORAB, Oxford 2006, we showed correlations between morphological semicircular canals (SCC) anomalies and vestibular dysfunctions associated with oculomotor anomalies. We will describe a set of specific anomalies in adolescent idiopathic scoliosis (AIS) in favour of an altered perception of space.

Methods

The study included 95 patients with AIS: 57 had thoracolumbar scoliosis, 24 thoracic scoliosis, and 14 lumbar deformation. Patients were submitted to a set of tests: (1) three-dimensional vestibular evaluation with semicircular canal-specific horizontal and vertical stimulations; (2) measurement of the static ocular torsion; (3) ocular smooth pursuits analyses with a new automatised programme; and (4) posturographic recording (static and dynamic tests). The tests were done before and after treatment (vestibular training and oculomotor training).

Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 433 - 433
1 Aug 2008
ADOLESCENT IDIOPATHIC SCOLIOSIS (AIS) AND BASICRANIUM ASYMMETRY
Rousié D Joly O Vasseur J Salvetti P Deroubaix J Berthoz A
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Introduction: Several authors observed links between AIS and asymmetries as in function and anatomy, especially in the brain. Others described high frequency of AIS in patients suffering from craniofacial asymmetry (CFA). CFA involves asymmetry of Basicranium separating the face from the brain. Because of neurodevelopmental factors, CFA reflects brain growth. So, Posterior Basicranium (PB) asymmetry involves cerebellum asymmetry and spatial asymmetry of vestibular organs. In a previous study we highlighted that CFA was associated with functional anomalies: difficulty of fixation caused by ocular torsion, off balance caused by vestibular dysfunction, postural disorders.

Purpose: To explore AIS on different levels: PB, Eyes and Vestibular System.

Patients:

Control group (CG):32 subjects, 26W. & 6M., fr. 8 to 51.

AIS group (AISG):93 subjects, 77W. & 16M., fr. 6 to 63. AIS were classified according to

– Amplitude of spine deformation (d°) G1: 8 to10°, G2: 10 to 15°, G3:15 to 40°

– Location of deformation (Ponsetti class.): TL=thoracolumbar, T=thoracic, L=lumbar.

Methods: We used MRI (EXCITE G.E.) 1.5T, head coil, Volumic T2-weighted sequence.

Step1: 3D Basicranium measurements in both groups with Brainvisa processing: (http://brainvisa.info/)

Step2: 3D anatomical study of semicircular canals in both groups with original modelling software.

Discussion: Normal subjects revealed weak asymmetry and dorsoventral rotation of P.B & cerebellum

AIS showed a pathognomic increase of these Human traits. Inside AIS subgroups, TL & G3 revealed highest levels of asymmetry and rotation.

We will discuss, thanks to AIS homozygosis twins in mirror, genetic origins for these specific P.B. & Cerebellum asymmetries.

Modelling of semi-circular canals revealed significative malformations in AIS compared to normal group. Again, T.L. and G3 revealed highest scores of canals anomalies. We highlighted a specific malformation in AIS: abnormal connexion between lateral & posterior canal.

We will demonstrate, thanks to same AIS twins, genetic origins of this malformation and propose a genetic hypothesis to link the different results.

Conclusion: These specific anomalies could be considered as preventive factors of AIS. Work supported by Cotrel Fondation.