Chronic pelvic pain is a condition which receives less attention in men than in women. It is often difficult to diagnose and more difficult to treat. The new classification of prostatitis and its variants has introduced the term ‘chronic pelvic pain syndrome’ which underlines the difficulties in dealing with this disorder which may represent a variety of chronically painful conditions with a large functional component. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Approximately 25% of all fractures in dogs involve the pelvis, of which 18-46% are iliac fractures. Conservative treatment can be performed in simple cases where minimum displacement occurs fractured fragments. However when there is severe displacement of the fragments, pelvic canal narrowing and involvement of weight bearing, surgical fixation is indicated. A variety of techniques have been described for the iliac fracture fixation. The highest percentage of successful cases can be attributed to the use of plates. Other methods used include pins, cerclage wire and compression screw. This study evaluated biomechanically the use of cortical allografts preserved in honey for the stabilization of transverse osteotomy of the ilium in dogs, as well as the use of hemicerclage wire isolated this cases, and compared the of two methods against the forces of bending. Were prepared cortical bone implants removed from humerus of dogs that eventually died for reasons not related to this research. The implants were preserved in honey for a period between 30 and 128 days. Were tested bilaterally thirteen canines pelves which held the body transverse osteotomy of the ilium. One hemipelvis of each dog was stabilized with a bone graft fixed by two hemicerclage wire and the contralateral hemipelvis with hemicerclage wire alone. To test the strength of flexion was used a manual compression machine where hemipelvis each was mounted on a wooden support. It was established that the time to stop the application of bending force would be when the fissure of the fracture suffer traction until half the width of the ilium (TMLI) or to failure. The strength of flexion needed to TMLI was significantly higher (P = 0.03) for hemipelves stabilized with bone implants (mean ± SD: 16.54 ± 5.29 kg) than for hemipelves stabilized with hemicerclage wire used alone (mean ± SD: 12.54 ± 4.01 kg). The force applied to fail was also statistically higher (P = 0.002) for hemipelves stabilized with bone implants (mean ± SD: 20.16 ± 7.3 kg) than in stabilized with hemicerclage wire used alone (mean ± SD: 12.54 ± 4.01 kg). The results showed that the use of cortical bone implants is a viable alternative for fixing the iliac osteotomy and is more resistant to strength of flexion in relation to the use of hemicerclage wire used in isolation. / Aproximadamente 25% de todas as fraturas em cães envolvem a pelve, sendo que 18-46% são fraturas ilíacas. O tratamento conservador pode ser realizado em casos simples onde ocorre deslocamento mínimo dos fragmentos fraturados. Entretanto, quando há deslocamento grave dos fragmentos, estreitamento do canal pélvico e comprometimento do suporte de peso, a fixação cirúrgica é indicada. Uma variedade de técnicas tem sido descrita para a fixação de fraturas ilíacas. A maior porcentagem de casos de sucesso pode ser atribuída ao uso de placas. Outros métodos usados incluem pinos, cerclagem de fio de aço e parafusos compressivos. Este trabalho avaliou biomecanicamente o uso de um implante ósseo cortical alógeno preservado em mel para a estabilização de osteotomia transversa de ílio em cães, bem como o uso de hemicerclagem de fio de aço isoladamente nestes casos, e comparou os dois métodos de estabilização de ílio frente às forças de flexão. Foram confeccionados implantes ósseos corticais alógenos retirados de úmeros de cães que vieram a óbito por motivos não relacionados com este trabalho. Os implantes foram preservados em mel por um período entre 30 e 128 dias. Foram testadas bilateralmente 13 pelves caninas nas quais se realizou osteotomia transversa do corpo do ílio. Uma hemipelve de cada cão foi estabilizada com o implante ósseo fixado por meio de duas hemicerclagens de fio de aço e a hemipelve contralateral com hemicerclagem de fio de aço isoladamente. Para testar a força de flexão, foi utilizada uma prensa de compressão manual onde cada hemipelve foi montada em um suporte de madeira. Foi estabelecido que o momento de interromper a aplicação da força de flexão seria quando a fenda da fratura sofresse tração até a metade da largura do ílio (TMLI) ou até a falha. A força de flexão necessária para TMLI foi significativamente maior (P=0,03) para hemipelves estabilizadas com implante ósseo (média ± SD: 16,54 ± 5,29 kgf) do que para as hemipelves estabilizadas com hemicerclagem de fio de aço usada isoladamente (média ± SD: 12,54 ± 4,01 kgf). A força aplicada para falhar também foi estatisticamente maior (P= 0,002) para as hemipelves estabilizadas com implante ósseo (média ± SD: 20,16 ± 7,3 kgf) do que nas estabilizadas com hemicerclagem de fio de aço usada isoladamente (média ± SD: 12,54 ± 4,01 kgf). Os resultados demonstraram que o uso de implante ósseo cortical alógeno é uma alternativa viável para a fixação da osteotomia ilíaca e apresenta maior resistência à força de flexão em relação ao uso de hemicerclagem de fio de aço usada isoladamente.

Introdução: As fraturas do anel pélvico são raras e graves, sua incidência é de aproximadamente 3% de todas as fraturas e a mortalidade varia de 6 a 50%. Objetivo: Avaliar os desfechos hospitalares de pacientes submetidos à cirurgia de reparo de fratura do anel pélvico, admitidos em hospitais com diferentes volumes de atendimentos. Método: Coletou-se nas bases de dados públicas DATASUS (1993-2010) e Nationwide Inpatient Sample (1993-2009), brasileira e norte-americana, respectivamente, informações que permitissem estudar a associação entre os desfechos hospitalares (mortalidade, tempo de internação, complicações e alta hospitalar) e o volume de atendimento hospitalar. Resultados: A população do estudo incluiu 26.581 e 4.580 pacientes, predomínio de homens (76,9% e 62,6%) com média de idade de 35,8 (dp = 15,9) e 38,5 (dp = 17,3) anos, no Brasil e Estados Unidos, respectivamente. A maioria dos pacientes foi operada em hospital universitário no Brasil (49,3%) e hospital escola-urbano nos Estados Unidos (77,9%). A mortalidade foi observada em 1,5% na população brasileira e 7,1% na norte-americana. Em ambos os países, a mortalidade foi superior em hospitais de baixo volume de atendimento (OR =1,89; IC 95%, 1,42-2,51 e OR =1,62; IC 95%, 1,21-2,18; p<0,001) e mais frequente na primeira semana de internação (p<0,001). O tempo médio de internação foi de 11 dias no Brasil e de 18,7 dias nos Estados Unidos. Foram frequentes as complicações hospitalares em 43,3% da população norte-americana. Hospitais norte-americanos com baixo volume de atendimento encaminharam mais pacientes para centros de reabilitação (p<0,001). Conclusão: Pacientes operados em hospitais de alto volume de atendimento apresentaram menor taxa de mortalidade e a frequência de encaminhamento a hospitais de reabilitação foi menor. A associação entre complicações e volume hospitalar não atingiu significância. / Introduction: Pelvic ring fractures are rare and severe, its occurrence is about 3% approximately from all fractures and mortality rate varies from 6 to 50%. Purpose: To assess hospitals outcomes among patients undergoing pelvic fracture surgery who were admitted on different providers volumes. Method: Data were extracted from DATASUS (1993-2010) and Nationwide Inpatient Sample (1993-2009) public brazilian and north-american databases, respectively, in order to study the associations between hospitals outcomes (mortality rate, hospital stay, complications and discharge disposition) and hospital volume. Results: The study population included 26.581 and 4.580 patients who were predominantly men (76,9% and 62,6%) with a mean age of 35,8 (dp = 15,9) and 38,5 (dp = 17,3) years, at Brazil and United States, respectively. Most patients were treated at teaching hospitals (49,3%) in Brazil and in the United States at urban teaching hospitals (77,9%). Mortality had been observed in 1,5% and 7,1% in brazilian and north-american population. In both countries, mortality was higher at low hospital volumes (OR =1,89; IC, 95% 1,42- 2,51 e OR =1,62; IC, 95% 1,21-2,18; p<0,001) and at first week of hospitalization (p<0,001). The average length of stay was 11 days in Brazil and 18,7 in the United States. Hospital complications affected 43,3% of the north-american patients. Nonroutine discharge disposition was more frequent in american hospitals with low volume. Conclusion: Brazilian and North-american patients\' demographic characteristics are similar once is considered gender and age. Patients treated by providers with lower caseloads volumes had higher rates of mortality and nonroutine disposition. The association between hospital volume and complications did not achieve significance.

Malgré l’augmentation des cas de cancers, l’amélioration des thérapies anti-cancéreuses a permis d’accroitre la survie des patients. Bien qu’efficace, la radiothérapie peut induire des complications sévères. La sphère abdomino-pelvienne concentre de nombreux cancers (prostate, vessie…), et des organes à risque lors de la radiothérapie. Le côlon-rectum développe des séquelles sévères chez 20% des patients 20 ans après traitement. La fibrose colorectale est la principale de ces complications. Les traitements actuels de ces lésions sont palliatifs. Les Cellules Souches Mésenchymateuses (CSM) favorisent la régénération tissulaire dans de nombreuses pathologies, y compris fibrosantes, et semblent donc adaptées au traitement des atteintes radio-induites. Néanmoins, les effets des CSM sur la tumeur et sur les complications des radiothérapies sont méconnus. Nos travaux évaluent la sureté et l’efficacité de la transplantation de CSM avant et après radiothérapie colorectale chez le rat. Sur un modèle de tumorigénèse colorectale suivie de radiothérapie, l’injection de CSM a inhibé la croissance tumorale en modifiant le profil des lymphocytes T et macrophages du microenvironnement tumoral. Dans un second modèle, les CSM ont induit une suppression durable de la fibrose colorectale radio-induite. Les protéines HGF et TSG-6 sécrétées par les CSM bloquent l’acquisition du phénotype pro-fibrosant par les cellules sécrétrices de matrice extracellulaire dans le côlon-rectum. Les CSM ont amélioré la survie des animaux dans ces deux modèles. Dans l’ensemble, nos résultats supportent l’utilisation des CSM dans le contexte des complications des radiothérapies abdomino-pelviennes. / Despite the growing number of cancer cases, current anti-cancer treatments greatly improve patients’ survival. Although it is efficient, radiotherapy can induce severe complications. The abdomino-pelvic area regroups cancers with high prevalence (prostate, bladder…) and organs at risk during radiotherapy. Colon and rectum display severe side effects in 20% of patients 20 years after treatment. Colorectal fibrosis is the most frequent of these complications. Existing treatments are only palliative. Mesenchymal Stem Cells (MSCs) promote tissue regeneration in a wide variety of pathologies, fibrosis included, and thus seem fitted for the treatment of radiation-induced disorders. However, the effects of MSCs on tumor growth and radiotherapy induced damages are still unclear. Our work evaluates the safety and efficacy of MSC transplantation before and after colorectal radiotherapy in rats. In a model of chemically-induced colorectal carcinogenesis, followed by radiotherapy, MSC injection suppressed tumor growth by modifying the phenotype of T lymphocytes and macrophages of the tumor microenvironment. In a second model, transplanted MSCs suppressed radiation-induced fibrosis. Two proteins secreted by MSCs, HGF and TSG-6, are responsible for inhibiting extracellular matrix-producing cells, which are the major contributors to fibrosis. MSC injection was associated with increased survival in both studies. Overall, our results support the use of MSCs to treat the side effects of abdomino-pelvic radiotherapy.

Exercícios de inclinação da pelve (\"pelvic drop\") são frequentemente utilizados para o fortalecimento do músculo glúteo médio com o objetivo de aumentar ou priorizar o seu recrutamento. No entanto, o efeito da rotação do quadril no desempenho da ação do glúteo médio é desconhecido. O objetivo do estudo foi avaliar o efeito da rotação do quadril no recrutamento do músculo glúteo médio, tensor da fascia lata e quadrado lombar. Dezessete sujeitos saudáveis executaram o exercício de inclinação pélvica com o rotação de quadril lateral (IPRL), medial (IPRM) e neutro (IPN). A atividade eletromiográfica dos músculos glúteo médio (GM), tensor da fáscia lata (TFL) e quadrado lombar (QL) foram avaliadas por meio da eletromiografia de superfície. Os resultados demonstraram aumento significativo na ativação do GM com rotação medial e posição neutra quando comparados com a rotação lateral. Em relação à rotação medial e neutra não houve diferença. A razão GM/TFL não foi diferente em nenhum dos posicionamentos analisados. Em relação à razão GM/QL houve um aumento significativo da ativação muscular em rotação medial e neutra. Exercícios de inclinação pélvica são mais eficientes para ativar o glúteo médio quando o quadril está em rotação medial e posição neutra / Pelvic drop exercises are often used to strengthen the gluteus medius muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the gluteus medius is unknown. The aim of the study was to evaluate the effect of hip rotation on the recruitment of the gluteus medius muscle, tensor fasciae latae and quadratus lumborum. Seventeen healthy subjects performed pelvic drop exercises with lateral (PDLR), medial (PDMR) and neutral (PDN) rotation of the hip. The electromyographic activity of the gluteus medius muscle (GM), tensor fasciae latae (TFL) and quadratus lumborum (QL) were evaluated using surface electromyography (sEMG). The results showed significant increases in activation of the GM with medial and neutral rotation compared with lateral rotation. There was no difference between medial and neutral rotation. The GM/TFL ratio was the same in all analyzed positions. Regarding the GM/QL ratio, there was a significant increase in muscle activation in the medial and neutral rotation. Pelvic drop exercises are more efficient for activating the gluteus medius when the hip is in medial rotation and neutral position

This thesis uses the metric evaluation of 3D models created from CT images. The study is based on an examination of 51 males and 55 females CT scans from recent European population and also based on a metric data (10 linear measurements) of the same geographical provenance of the mid-20th century (n=113). The purpose of our research project is to determine the degree of sexual dimorphism in current population and compare the degree of sexual dimorphism in this geographic area in the middle of the last century. Intraobserver variabilities of linear measurements were less than 2%. Both groups were statistically tested. An index of sexual dimorphism (ISD) was used to assess the level of sexual dimorphism within each sample (Paris ISD = 8,28, Marseille ISD = 6,50). The two-sided t-test indicates that the degree of sexual dimorphism is not significantly different between population from the mid-20th century and recent population (p = 0,680). The secular trend was expressed by the z-score. The results showed that changes in the pelvic bone between the two groups are not significant, since neither one of the measurements does not exceed ±2 SD. Finally, we verified the reliability of method DSP ("Diagnose Sexuelle Probabiliste") for measurements deducted from CT-derived models. The results showed the...

Title: The influence of running shoes on leg and pelvis kinematics during the stance phase of run Objectives: The main objective of this thesis is to detect whether there exists a connection between the type of shoes used and changes in pelvis and legs kinematics in sagittal plane while running. Methology: For a purpose of the thesis research 12 active sportsmen (6 men and 6 women) participated in lab tests. Each of them was running on a tread mill for three time sequences - each counting 20 seconds - with changes in conditions applied as follows: barefoot run, minimalistic shod run, classic shod run. The 3D analysis was analysed using the Qualisys system (200 Hz). Data analytics was executed using the Qualisys Track Manager programme, where a comparative method was applied. Further statistical procedures ANOVA a Tukey test were performed in a programme called OriginPro 8. Key findings: The executed lab tests proved influence of running shoes on legs and pelvis kinematics during a stance phase of run. The main changes in kinematics were found in an ancle during touchdown, where the angle significantly increased while running barefoot rather than classic shod running. An analysis of pelvis kinematics parameters has proven that there are no changes in pelvis movements while running in different types...

La scoliose idiopathique de l’adolescence (SIA) est une déformation tridimensionnelle de la colonne vertébrale et de la cage thoracique dont la cause est inconnue. Il semble que la ceinture pelvienne soit impliquée dans la pathogénie de la SIA, car des différences géométriques des os coxaux ont été observées. Notamment, une rotation du bassin ou une inclinaison latérale dans le sens de la courbe scoliotique ont été mises en évidence en plus des distorsions osseuses. Il est difficile de dissocier la rotation du bassin de son asymétrie, car la majorité des études porte sur des données radiologiques bidimensionnelles. Une analyse tridimensionnelle de la morphologie du bassin de patientes ayant une SIA, mais n’ayant pas reçu de traitement par corset ou chirurgie permettrait d’identifier le rôle du bassin dans la progression de la scoliose. Dix-sept jeunes filles atteintes de la SIA ont participé à cette étude pour lesquelles des radiographies bi-planaires en station debout étaient disponibles au moment du diagnostic par un chirurgien orthopédiste pédiatrique et à l’instant de la prescription d'un corset. Des radiographies postéro-antérieures et latérales avaient été prises au moyen du système EOS®. Douze repères anatomiques du bassin ont été identifiés sur les paires de radiographies, alors que quatre repères ont été identifiés sur la radiographie postéro-antérieure uniquement. Ces quatre derniers n’étaient pas identifiables sur la radiographie latérale à cause de la superposition des repères droits et gauches. La reconstruction tridimensionnelle du bassin a été réalisée à partir de deux clichés radiographiques des 12 premiers repères osseux. Au total, neuf paramètres tridimensionnels ont été calculés afin de quantifier l’asymétrie et la distorsion du bassin entre les deux temps donnés. Des paramètres bidimensionnels ont également été mesurés sur les quatre derniers repères osseux afin de documenter des déformations du bassin pertinentes à la pratique clinique, telle que la rotation axiale de celui-ci. Dans le but d'évaluer une possible asymétrie entre les os coxaux du bassin, les paramètres tridimensionnels du bassin gauche ont été comparés à ceux du côté droit à chaque temps, au moyen d'un test-t pour échantillon apparié. La morphologie pelvienne a été également évaluée par l'analyse multivariée (MANOVA) à mesures répétées à deux conditions (côté*temps). En conséquence, nous avons constaté une croissance osseuse statistiquement significative du bassin dans l’intervalle de temps entre le diagnostic de la scoliose et le port du corset (p=0,033). Une asymétrie significative entre les côtés gauche et droit du bassin (p=0,013) a également été constatée. En ce qui concerne les paramètres bidimensionnels, nous avons constaté une augmentation de la version pelvienne (p=0,024) au cours de la croissance des jeunes filles. Finalement, le bassin n'a pas présenté de distorsion, puisqu'une valeur de p de 0,763 a été observée. En conclusion, la croissance des jeunes filles atteintes de la scoliose idiopathique de l'adolescence est accompagnée d'une asymétrie morphologique entre les deux os coxaux du bassin. Cette asymétrie constatée au moment du diagnostic de la scoliose des filles a évolué jusqu'à l’instant où le port du corset a été prescrit. Quant aux paramètres bidimensionnels, nous pouvons conclure que la rotation du bassin vers l'arrière a augmenté au cours de la croissance des jeunes filles, produisant ainsi une rétroversion pelvienne dans le plan sagittal. La distorsion tridimensionnelle du bassin n'a toutefois pas été observée au cours de la croissance des jeunes filles. / Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformation of the spine and rib cage of unknown cause. It seems that the pelvis is involved in the pathogenesis of the AIS because geometric differences in the hip bones were observed. A pelvic rotation or a lateral tilt in the direction of the scoliotic curve was observed in addition to bone distortions. It is difficult to separate the pelvic rotation from its asymmetry since most studies are based on bi-dimensional radiologic data. A three-dimensional analysis of the pelvis morphology in patients with AIS, but no brace treatment nor surgery could better define the role of pelvis in the progression of the scoliosis. Seventeen young girls with AIS have participated in this study. Standing bi-planer radiographs were available at the time of diagnosis by a pediatric orthopedic surgeon and at the moment of the brace prescription. Postero-anterior and lateral X-rays were taken using the EOS® system. Twelve anatomical landmarks of the pelvis were identified on the radiograph pairs and four landmarks were identified on the postero-anterior radiography only. These were not identified on the lateral radiograph due to the superposition of the right and left landmarks. The three-dimensional reconstruction of the pelvis was performed using two radiographs of the first 12 bony landmarks. A total of nine three-dimensional parameters were calculated to quantify the asymmetry of the pelvis distortion between the two given times. Bi-dimensional parameters were also measured on the last four bony landmarks in order to document the pelvic deformations relevant to the clinical practice such as the rotation. With the objective of evaluating a possible asymmetry between the hip bones of the pelvis, the three-dimension parameters of the left pelvis were compared to those of the right side in each time using a paired sample t-test. The pelvic morphology was also evaluated using a multivariate analysis (MANOVA) with repeated measures on two conditions (side*time). A statistically significant bone growth of the pelvis in the time interval between the diagnosis of the scoliosis and the brace prescription (p=0.033) was observed in consequence. A significant asymmetry between the left and right sides of the pelvis (p=0.013) without distortion was also observed. Regarding the bi-dimensional parameters, we found an increase in pelvic release (p=0.024) during the growth of the girls. Finally, the pelvis did not show a distortion because a p value of 0.763 was observed. In conclusion, the growth of young girls with adolescent idiopathic scoliosis is related to a morphological asymmetry between the two hipbones of the pelvis. This asymmetry observed at the moment of the scolioisis diagnosis has evolved until de moment of the brace prescription. As for the bi-dimensional parameters, we can conclude that the rotation of the pelvis to the back increased during the growth of the girls, producing a pelvic retroversion in the sagittal plan. The three-dimensional distortion of the pelvis, however, has not been observed during the young girls growth.

La spondylolyse et le spondylolisthésis sont une déformité bien connue dans le domaine de l’orthopédie. Par contre, il persiste des confusions et des débats sur différents aspects de cette pathologie incluant l’étiologie, l’histoire naturelle et le traitement. Récemment, deux études ont démontré l’influence significative de la morphologie du sacrum dans le spondylolisthésis par Inoue et al. et Whitesides et al.4,5 Ces trouvailles ont renouvelé l’intérêt dans l’évaluation radiologique de la balance sagittale de cette condition. L’objectif principal de ce travail est d’évaluer l’influence de la forme et l’orientation du sacrum chez les patients atteints de spondylolisthésis. Pour ce faire, nous avons construit une base de données de patients présentant un spondylolisthésis et d’un groupe contrôle. Par la suite les radiographies de ces sujets ont été analysées par un programme d’ordinateur afin de calculer tous les paramètres pertinents. Ce travail nous a tout d’abord permis de déterminer à partir des radiographies de 120 volontaires pédiatriques et plus de 130 patients pédiatriques atteints de la spondylolisthésis, les valeurs moyennes et la variation des paramètres angulaires qui influencent l’équilibre sagittal du rachis. Cette base de données est la première existante dans la population pédiatrique. Ces données seront d’une grande utilité pour le futur lors d’études concernant diverses conditions spinales. Nous avons remarqué une différence significative de la morphologie sacrée chez les sujets présentant le spondylolisthésis. Par ailleurs, l’étude de corrélation nous a également permis d’établir une forte relation entre le sacrum, le bassin et la colonne dans le profil sagittal. Finalement, ce travail a permis une meilleure compréhension globale de la posture sagittale chez les sujets normaux et chez les sujets atteints du spondylolisthésis qui pourra servir pour mieux analyser cette condition et pour ajuster les traitements selon l’analyse. / Developmental spondylolysis and spondylolisthesis is a well known and described sagittal spinal deformity in the literature. However, there is still an ongoing debate on different aspects about this pathology including its etiology, pathophysiology, natural evolution and preferred treatment. Numerous parameters and radiologic measures have been described in order to precisely quantify the abnormal relationship between L5 and S1. So far none of these parameters have been proven reliable to predict the evolution in the spinal deformity. Recently, two interesting studies showed that sacral morphology has a significant influence on spondylolisthesis.4,5 These findings have a direct implication to the evaluation and treatment of spondylolisthesis. This also renews our scientific interest in the sagittal morphology in this condition. The principal objective of this work is to evaluate the influence of the sacral form and orientation in patients with spondylolisthesis. First of all, we constructed a large database of all patients with spondylolisthesis with a comparable control group. After the radiographs are analyzed by computer to calculate all possible sagittal parameters described in the current literature. This project has first of all allowed us to establish an ongoing database of all patients with spondylolysis and spondylolisthesis. So far this database is the largest in the literature and consists of more than 120 subjects. This database allows us to analyze retrospectively and prospectively on the influence of sacropelvic sagittal morphology in subjects with spondylolisthesis.

La scoliose idiopathique de l’adolescence (SIA) est une déformation tridimensionnelle de la colonne vertébrale et de la cage thoracique dont la cause est inconnue. Il semble que la ceinture pelvienne soit impliquée dans la pathogénie de la SIA, car des différences géométriques des os coxaux ont été observées. Notamment, une rotation du bassin ou une inclinaison latérale dans le sens de la courbe scoliotique ont été mises en évidence en plus des distorsions osseuses. Il est difficile de dissocier la rotation du bassin de son asymétrie, car la majorité des études porte sur des données radiologiques bidimensionnelles. Une analyse tridimensionnelle de la morphologie du bassin de patientes ayant une SIA, mais n’ayant pas reçu de traitement par corset ou chirurgie permettrait d’identifier le rôle du bassin dans la progression de la scoliose. Dix-sept jeunes filles atteintes de la SIA ont participé à cette étude pour lesquelles des radiographies bi-planaires en station debout étaient disponibles au moment du diagnostic par un chirurgien orthopédiste pédiatrique et à l’instant de la prescription d'un corset. Des radiographies postéro-antérieures et latérales avaient été prises au moyen du système EOS®. Douze repères anatomiques du bassin ont été identifiés sur les paires de radiographies, alors que quatre repères ont été identifiés sur la radiographie postéro-antérieure uniquement. Ces quatre derniers n’étaient pas identifiables sur la radiographie latérale à cause de la superposition des repères droits et gauches. La reconstruction tridimensionnelle du bassin a été réalisée à partir de deux clichés radiographiques des 12 premiers repères osseux. Au total, neuf paramètres tridimensionnels ont été calculés afin de quantifier l’asymétrie et la distorsion du bassin entre les deux temps donnés. Des paramètres bidimensionnels ont également été mesurés sur les quatre derniers repères osseux afin de documenter des déformations du bassin pertinentes à la pratique clinique, telle que la rotation axiale de celui-ci. Dans le but d'évaluer une possible asymétrie entre les os coxaux du bassin, les paramètres tridimensionnels du bassin gauche ont été comparés à ceux du côté droit à chaque temps, au moyen d'un test-t pour échantillon apparié. La morphologie pelvienne a été également évaluée par l'analyse multivariée (MANOVA) à mesures répétées à deux conditions (côté*temps). En conséquence, nous avons constaté une croissance osseuse statistiquement significative du bassin dans l’intervalle de temps entre le diagnostic de la scoliose et le port du corset (p=0,033). Une asymétrie significative entre les côtés gauche et droit du bassin (p=0,013) a également été constatée. En ce qui concerne les paramètres bidimensionnels, nous avons constaté une augmentation de la version pelvienne (p=0,024) au cours de la croissance des jeunes filles. Finalement, le bassin n'a pas présenté de distorsion, puisqu'une valeur de p de 0,763 a été observée. En conclusion, la croissance des jeunes filles atteintes de la scoliose idiopathique de l'adolescence est accompagnée d'une asymétrie morphologique entre les deux os coxaux du bassin. Cette asymétrie constatée au moment du diagnostic de la scoliose des filles a évolué jusqu'à l’instant où le port du corset a été prescrit. Quant aux paramètres bidimensionnels, nous pouvons conclure que la rotation du bassin vers l'arrière a augmenté au cours de la croissance des jeunes filles, produisant ainsi une rétroversion pelvienne dans le plan sagittal. La distorsion tridimensionnelle du bassin n'a toutefois pas été observée au cours de la croissance des jeunes filles. / Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformation of the spine and rib cage of unknown cause. It seems that the pelvis is involved in the pathogenesis of the AIS because geometric differences in the hip bones were observed. A pelvic rotation or a lateral tilt in the direction of the scoliotic curve was observed in addition to bone distortions. It is difficult to separate the pelvic rotation from its asymmetry since most studies are based on bi-dimensional radiologic data. A three-dimensional analysis of the pelvis morphology in patients with AIS, but no brace treatment nor surgery could better define the role of pelvis in the progression of the scoliosis. Seventeen young girls with AIS have participated in this study. Standing bi-planer radiographs were available at the time of diagnosis by a pediatric orthopedic surgeon and at the moment of the brace prescription. Postero-anterior and lateral X-rays were taken using the EOS® system. Twelve anatomical landmarks of the pelvis were identified on the radiograph pairs and four landmarks were identified on the postero-anterior radiography only. These were not identified on the lateral radiograph due to the superposition of the right and left landmarks. The three-dimensional reconstruction of the pelvis was performed using two radiographs of the first 12 bony landmarks. A total of nine three-dimensional parameters were calculated to quantify the asymmetry of the pelvis distortion between the two given times. Bi-dimensional parameters were also measured on the last four bony landmarks in order to document the pelvic deformations relevant to the clinical practice such as the rotation. With the objective of evaluating a possible asymmetry between the hip bones of the pelvis, the three-dimension parameters of the left pelvis were compared to those of the right side in each time using a paired sample t-test. The pelvic morphology was also evaluated using a multivariate analysis (MANOVA) with repeated measures on two conditions (side*time). A statistically significant bone growth of the pelvis in the time interval between the diagnosis of the scoliosis and the brace prescription (p=0.033) was observed in consequence. A significant asymmetry between the left and right sides of the pelvis (p=0.013) without distortion was also observed. Regarding the bi-dimensional parameters, we found an increase in pelvic release (p=0.024) during the growth of the girls. Finally, the pelvis did not show a distortion because a p value of 0.763 was observed. In conclusion, the growth of young girls with adolescent idiopathic scoliosis is related to a morphological asymmetry between the two hipbones of the pelvis. This asymmetry observed at the moment of the scolioisis diagnosis has evolved until de moment of the brace prescription. As for the bi-dimensional parameters, we can conclude that the rotation of the pelvis to the back increased during the growth of the girls, producing a pelvic retroversion in the sagittal plan. The three-dimensional distortion of the pelvis, however, has not been observed during the young girls growth.