Lumbar annulus fibrosus biomechanical characterization in healthy children by ultrasound shear wave elastography
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Intervertebral disc (IVD) is key to spine biomechanics, and it is often involved in the cascade leading to spinal deformities such as idiopathic scoliosis, especially during the growth spurt. Recent progress in elastography techniques allows access to non-invasive measurement of cervical IVD in adults; the aim of this study was to determine the feasibility and reliability of shear wave elastography in healthy children lumbar IVD.
Elastography measurements were performed in 31 healthy children (6–17 years old), in the annulus fibrosus and in the transverse plane of L5–S1 or L4–L5 IVD. Reliability was determined by three experienced operators repeating measurements.
Average shear wave speed in IVD was 2.9 ± 0.5 m/s; no significant correlations were observed with sex, age or body morphology. Intra-operator repeatability was 5.0 % while inter-operator reproducibility was 6.2 %. Intraclass correlation coefficient was higher than 0.9 for each operator.
Feasibility and reliability of IVD shear wave elastography were demonstrated. The measurement protocol is compatible with clinical routine and the results show the method’s potential to give an insight into spine deformity progression and early detection.
• Intervertebral disc mechanical properties are key to spine biomechanics
• Feasibility of shear wave elastography in children lumbar disc was assessed
• Measurement was fast and reliable
• Elastography could represent a novel biomarker for spine pathologies
KeywordsSpine Spinal diseases Fibrocartilage Tissue elasticity imaging Pediatrics
The scientific guarantor of this publication is Prof. Wafa Skalli, (Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers ParisTech, 151 bd de l'Hopital 75013 Paris, France). The authors of this manuscript declare relationships with the following companies: Jean-Luc Gennisson is a scientific consultant for SuperSonic Imagine, and Mickael Tanter is cofounder and shareholder of SuperSonic Imagine (Aix-en-Provence, France). The other authors do not have any conflicting financial interests. This study has received funding by the ParisTech BiomecAM chair program on subject-specific musculoskeletal modelling for funding (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Proteor and Covea) and by the “Investissements d'Avenir” program. We would also like to thank Dr. Pauline Lallemant and Ms. Sonia Simoes for their technical help. One of the authors has significant statistical expertise. Institutional review board approval was obtained.
Written informed consent was obtained from both parents of all minor subjects (patients) in this study.
Some study subjects or cohorts have been previously reported in national congresses. Methodology: prospective, cross-sectional study, multicentre study.
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