Programme intégré d'évaluation des déformations du rachis; prédiction de la progression des scolioses et traitement précoce de la déformation

 

Stefan Parent

Centre de recherche du CHU Ste-Justine

 

Domaine : appareil locomoteur et arthrite

Programme chercheurs-boursiers cliniciens - Senior

Concours 2014-2015

Scoliosis is a three-dimensional deformity of the spine affecting the orientation, position and shape of the vertebra. The most common form is adolescent idiopathic scoliosis (AIS) with a prevalence of 1-3% affecting primarily young adolescent females. Idiopathic scoliosis can either be treated conservatively using a brace; in rare cases (1% of patients seen at our institution) surgical correction and fusion are required to prevent progressive deformity and respiratory insufficiency. This research program's aim is to identify which curves are at increased risk of progression and what new treatment strategies can be used to correct the spinal deformities seen in patients with AIS without fusion at skeletal maturity. The program can be subdivided into four main projects.

First, we will conduct a multicenter prospective validation of a prediction model for AIS. The second project will be the development of a new generation of personalized braces where we will compare braces fabricated by standard means vs. braces fabricated using the brace simulator. The third project is the development of new growth modulation strategies for the treatment of AIS to prevent a more extensive fusion of the spine. Finally, the fourth project is a prospective multicenter analysis on 3D factors involved in the decision to perform a selective vs. non-selective fusion in AIS.

Benefits of the prospective study will be important both for patients not at risk of significant progression or for patients at high risk of progression. Reassurance to families regarding the non-necessity of bracing in a patient with a low risk of progression is as significant as early identification of patients requiring growth modulation intervention."