Périé D, Sales De Gauzy J, Sévely A, Hobatho M C
Research Center, Sainte-Justine Hospital, 3175 chemin Cote Sainte-Catherine, H3T 1C5, Montréal, Que., Canada.
Clin Biomech (Bristol). 2001 Feb;16(2):129-37. doi: 10.1016/s0268-0033(00)00083-8.
The aim was to quantify the immediate effect of the Cheneau-Toulouse-Munster brace (worn at night) on scoliotic curvatures in vivo.Design. A three-dimensional geometrical model of the spine was developed using magnetic resonance images.
Many corrective ortheses were proposed for the orthopaedic treatment of idiopathic scoliosis. Simple radiographs were not sufficient to analyse the three-dimensional spinal deformations. So, three-dimensional geometrical models were developed using stereoradiography and axial tomography. MRI has been only used clinically for investigation of intervertebral disc disorders.
MRI examination had been performed on 14 girls having an idiopathic scoliosis and wearing a first Cheneau-Toulouse-Munster brace. The protocol investigated was performed with and without brace. Using an in-house image processing software and the pre-post processing software Patran, two geometrical models of the spine (spine without brace and spine with brace correction) were obtained, respectively, for each patient, the models including the vertebral bodies.
Our method reproducibility was found to be 0.5 mm on the displacements and 2.5 degrees on the rotations. The Cheneau-Toulouse-Munster brace decreased the coronal shift forward, the coronal tilt, the axial rotation, and increased the sagittal shift forward and the sagittal vertebral tilt.
The results showed that the Cheneau-Toulouse-Munster brace had a three-dimensional and personalised action on vertebrae. This technique using MRI provides no irradiation and allows the soft tissue visualisation, but actually is not dedicated for clinical use and is limited to the lying position.
The qualitative and quantitative data obtained allowed a better description of the Cheneau-Toulouse-Munster brace effect on scoliotic spine, and will help the orthopaedist in the brace design and the clinician in the scoliosis comprehension.
本研究旨在量化夜间佩戴的谢诺 - 图卢兹 - 明斯特支具对体内脊柱侧弯曲线的即时影响。设计：利用磁共振成像建立脊柱的三维几何模型。
许多矫正支具被用于特发性脊柱侧弯的矫形治疗。单纯的X光片不足以分析脊柱的三维变形。因此，利用立体放射摄影和轴向断层扫描技术建立了三维几何模型。磁共振成像仅在临床上用于椎间盘疾病的检查。
对14名患有特发性脊柱侧弯且佩戴第一代谢诺 - 图卢兹 - 明斯特支具的女孩进行了磁共振成像检查。研究方案在佩戴支具和不佩戴支具的情况下进行。使用内部图像处理软件和前后处理软件Patran，分别为每位患者获得了两个脊柱几何模型（无支具脊柱和有支具矫正的脊柱），模型包括椎体。
我们发现该方法在位移上的可重复性为0.5毫米，在旋转上的可重复性为2.5度。谢诺 - 图卢兹 - 明斯特支具减少了冠状面的向前移位、冠状面倾斜、轴向旋转，并增加了矢状面的向前移位和矢状面椎体倾斜。
结果表明，谢诺 - 图卢兹 - 明斯特支具对椎体具有三维和个性化的作用。这种使用磁共振成像的技术不会产生辐射，并能实现软组织可视化，但实际上并不适用于临床，且仅限于仰卧位。
所获得的定性和定量数据有助于更好地描述谢诺 - 图卢兹 - 明斯特支具对脊柱侧弯脊柱的影响，并将有助于骨科医生进行支具设计以及临床医生理解脊柱侧弯。
