Toward a new era in medical practice - A Team of researchers in spine biomechanics led by Ecole Polytechnique Professor Carl-Eric Aubin is Revolutionizing orthopedic surgery



    MONTREAL, March 15 /CNW Telbec/ - Marie-Claude Pastorel is one of the 2
to 4% of young Quebecers afflicted with idiopathic scoliosis, a condition that
results in an abnormal three dimensions curvature of the spine. In
Marie-Claude's case, the deformation had passed the 60-degree mark, making
surgical intervention necessary. In 2000, the young woman, then 18, underwent
surgery led by Dr. Hubert Labelle, orthopedic surgeon and Chief of Orthopedics
at Centre hospitalier universitaire (CHU) Sainte-Justine. The operation, which
lasted nearly five hours, involved affixing metal implants to Marie-Claude's
spine to force it to straighten, then fusing the vertebrae with a bone graft
to stabilize the spine.

    This technique is about to totally change, thanks to research carried out
by an Ecole Polytechnique team under the direction of Carl-Eric Aubin, full
professor with the school's Department of Mechanical Engineering and
researcher at CHU Sainte-Justine. Soon, surgeons treating patients like
Marie-Claude will be able to "operate" on a three-dimensional model of the
patient's spine and analyze the outcome before any actual surgery is
performed.
    "Without a doubt, orthopedics is one of the medical fields that stands to
directly benefit from engineering methodologies," says Professor Aubin. "For
an engineering researcher, the convergence of these two disciplines -
orthopedics and engineering, where technological solutions are applied to
health problems - is one of the most stimulating areas to work in."
    For his part, Dr. Labelle stresses: "Corrective scoliosis surgery is
complex. Even though the surgical technique is well understood, the surgeon
faces numerous difficulties: judging exactly where on the spine to intervene
and what type of implant to use, as well as trying to anticipate the progress
of post-operative spinal straightening. The projects developed with Ecole
Polytechnique will soon make the surgeon's task much easier."

    Projects that are revolutionizing medical practice

    In cooperation with the CHU Sainte-Justine Research Centre, Ecole
Polytechnique's new NSERC/Medtronic Industrial Research Chair in Spine
Biomechanics, directed by Professor Aubin, aims to develop a series of 3-D
simulation and analytical software applications, along with new biomedical
tools and support systems.
    Endowed with a budget of nearly $3 million, the Chair stands to
considerably advance surgery of the locomotive system.
    Currently, Professor Aubin's team has no less than 15 projects on the go,
including:

    Virtual scoliosis surgical software

    Created for surgeons, this pre-operative surgical simulation tool allows
surgeons to test the effects of the operation and plan which implants to use
to obtain optimal correction.

    Virtual operating room

    Adapted from the preceding tool, the virtual operating room functions in
an immersive virtual environment. The project was developed in conjunction
with Dr. Labelle and Professor Benoît Ozell of the Department of Computer
Engineering at Ecole Polytechnique. Mainly destined as a surgical training
tool, the platform - which re-creates the conditions of an actual operation -
allows surgeons to operate on various clinical cases that have been modelled
in 3-D. It also allows medical personnel to conduct distance analysis of
actual patients whose cases have been reconstituted in 3-D, and determine the
best surgical approach.

    A new operating table

    Since the patient's position on the operating table can significantly
affect the surgical outcome, the Chair's team has developed a new
multifunctional operating table for all forms of spinal surgery.

    "Smart" micro-implants

    Micro-staples aimed at replacing the current correctional apparatus
(screws, rods and hooks) will exploit the potential of body growth while
making the surgery less invasive and improving postoperative patient mobility.
Other surgical devices are also under development.
    "Our projects are the fruit of an exceptional collaborative effort
between engineers and medical personnel," says Professor Aubin. "I truly
believe that we are entering a new era of medical practice."

    High hopes for patient quality of life

    Of the 10% of teens with scoliosis who must wear orthopedic corsets,
approximately one-tenth will undergo surgery. Both forms of treatment take
their toll physically and psychologically, as Marie-Claude Pastorel affirms:
"Wearing a rigid corset for over 20 hours a day for years can be hard,
especially for a teen! As for the surgery, I was lucky: my scars weren't too
big. But some people have scars all down their backs."

    The projects developed by the Chair, on the other hand, allow for earlier
intervention and optimal results:

    
    - Better-designed corsets allow spinal curvature to be corrected more
      quickly and to a greater degree.
    - Surgery, when necessary, is less invasive since - as opposed to the
      current operation - micro-staples can be positioned endoscopically. As
      a result, scarring is considerably reduced.
    - Carrying out surgery before young patients have finished growing allows
      the bone-growth process to be exploited. What's more, vertebrae will no
      longer need to be fused, resulting in greater mobility for the patient.
    
    Perhaps unsurprisingly, patients are very enthusiastic about these new
practices and the promise they hold. The Chair team has had no difficulty
recruiting volunteers: already more than 8,000 patients have participated in
research protocols over the last decade. Marie-Claude Pastorel is proud to
have been among them.

    A partnership that positions Québec as a world leader in the treatment of
    spinal conditions

    Bringing together an extremely effective multidisciplinary team, the
Chair's research falls under Musculoskeletal Diseases and Movement Sciences,
one of CHU Ste-Justine's six priority research focuses supported by the Fonds
de recherche en santé du Québec (FRSQ).
    "The creation of this Chair is cause for celebration on more than one
level," says Dr. Guy Rouleau, head of the CHU Ste-Justine Research Centre.
"Not only does it represent hope for the patients, it also demonstrates the
solid partnership between CHU Ste-Justine and Ecole Polytechnique. These
projects enable the development and maintenance of a unique, Québec-based
expertise in orthopedic surgery. Through this rewarding association, CHU
Ste-Justine has become a world leader in the treatment of idiopathic
scoliosis."
    Terry A. Finley, Medtronic of Canada's Director of Sales and Marketing
(Spinal and ERT Products), adds: "Because medical technology is the core of
Medtronic's activities, we are proud to be associated with the Chair's work in
spine biomechanics, an irrefutable force for innovation. The projects that
emerge from this partnership will open up new horizons in medical
instrumentation."
    For Ecole Polytechnique, the benefits of the partnership are extremely
positive in more ways than one. "Working with the CHU Sainte-Justine Research
Centre helps Polytechnique maintain its lead in biomedical engineering
training and research," says Robert L. Papineau, Director-General of
Polytechnique. "We would like to mention the vital role played by our
partners: the NSERC, which regularly supports Polytechnique's scientific
initiatives; and our industrial partner, Medtronic of Canada. Thanks to their
support, the Chair is in a position to strengthen its research activities for
the years to come and to expand its team." Mr. Papineau added: "We would also
like to reaffirm our pride at having among our ranks world-class
professor/researchers who are working to develop their knowledge for the
benefit of society."
    Polytechnique has developed an enviable expertise in the field of
biomedical engineering. In fall 2008, the school will offer the first and only
undergraduate degree in Québec specializing in biomedical engineering.

    Founded in 1873, Ecole Polytechnique de Montréal is one of Canada's
leading engineering institutions in terms of both teaching and research. It is
the largest engineering school in Québec as regards its student population and
the scope of its research activities. Ecole Polytechnique provides instruction
in 11 engineering specialties and is responsible for more than one-quarter of
university research in engineering in Québec. The school has 230 professors
and nearly 6,000 students. Its operating budget is $85 million, in addition to
a $68-million research and infrastructure fund that includes $38 million in
grants and contracts. Polytechnique is affiliated with Université de Montréal.




For further information:

For further information: Andrée Peltier, Relations publiques Andrée
Peltier Inc., Tel.: (514) 846-0003, Cell: (514) 944-8689,
apeltier@ca.inter.net; Source: Chantal Cantin, Communications and Recruitment
Office, Ecole Polytechnique de Montréal, chantal.cantin@polymtl.ca; Photos and
video available: Photos and video of Chair members and some of their
accomplishments are available at the following FTP site:
http://www.polymtl.ca/sc_journal/Biomecanique/


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