研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

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Trends in Reoperation for Surgical Site Infection After Spinal Surgery With Instrumentation in a Multicenter Study 査読有り

Kobayashi, K; Imagama, S; Ando, K; Nakashima, H; Kato, F; Sato, K; Kanemura, T; Matsubara, Y; Yoshihara, H; Hirasawa, A; Deguchi, M; Shinjo, R; Sakai, Y; Inoue, H; Ishiguro, N

SPINE 45 巻 ( 20 ) 頁： 1459 - 1466 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Spine

Study Design.A multicenter retrospective analysis of a prospectively maintained database.Objective.To examine the characteristics of reoperation for surgical site infection (SSI) after spinal instrumentation surgery, including the efficacy of treatment for SSI and instrumentation retention.Summary of Background Data.Aging of the population and advances in surgical techniques have increased the demand for spinal surgery in elderly patients. Treatment of SSI after this surgery has the main goals of eliminating infection and retaining instrumentation.Methods.The subjects were 16,707 patients who underwent spine surgery with instrumentation in 11 hospitals affiliated with the Nagoya Spine Group from 2004 to 2015. Details of those requiring reoperations for SSI were obtained from surgical records at each hospital.Results.There were significant increases in the mean age at the time of surgery (54.6-63.7 years) and the number of instrumentation surgeries (726-1977) from 2004 to 2015. The incidence of reoperation for SSI varied from 0.9% to 1.8%, with a decreasing trend over time. Reoperation for SSI was performed in 206 cases (115 men, 91 women; mean age 63.2 years). The average number of reoperations (1.4 vs. 2.3, P < 0.05), time from SSI to first reoperation (4.3 vs. 9.5 days, P < 0.05), and the methicillin-resistant Staphylococcus identification rate (20% vs. 37%, P < 0.01) were all significantly lower in cases with instrumentation retention (n = 145) compared to those with instrumentation removal (n = 61).Conclusion.There were marked trends of aging of patients and an increase in operations over the study period; however, the incidences of reoperation and instrumentation removal due to SSI significantly decreased over the same period. Rapid debridement after SSI diagnosis may have contributed to instrumentation retention. These results can serve as a guide for developing strategies for SSI treatment and for improved planning of spine surgery in an aging society.Level of Evidence: 3.

DOI： 10.1097/BRS.0000000000003545

Preoperative 6-Minute Walk Performance in Children With Congenital Scoliosis

Nakashima, H; Kawakami, N; Matsumoto, H; Redding, GJ

JOURNAL OF PEDIATRIC ORTHOPAEDICS 40 巻 ( 9 ) 頁： E818 - E821 2020年10月

記述言語：英語出版者・発行元：Journal of Pediatric Orthopaedics

Background:The 6-minute walk test (6MWT) is used to assess the function of cardiopulmonary and neuromuscular conditions in adults and children. The primary research question was to determine the relationship between 6MWT distance and forced vital capacity (FVC) and the major curve among children with congenital scoliosis with rib anomalies.Methods:The authors recorded 6MWT distance in meters, FVC as a percentage of predicted normal value using arm span for height (FVC%), and Cobb angle in 20 children (13 girls; average age, 6.7±1.3 y) with congenital scoliosis before outpatient surgical treatment. The 6MWT uses a standardized protocol and measures distance traveled in 6 minutes on a flat surface. The authors then determined the correlation between these measures using linear regression analysis.Results:The Cobb angle of the major curvature was 55.4±20.5 degrees. The type of vertebral anomaly was mixed in 17 cases, formation failure in 2 cases, and segmentation failure in 1 case. The range of rib anomalies was 3.4±3.9 levels; 15 and 5 patients, respectively, had unilateral and bilateral rib anomalies. FVC and FVC% were 0.7±0.2 L and 60%±19%, respectively. The ratio of forced expiratory volume at 1 second to FVC (FEV1/FVC), which indicates obstructive lung disease, was normal at 93%±7%. The 6MWT distance was 386.3±59.4 m, which was ≤10% of the predicted distance for normal children. No child was able to walk the normal distance on the basis of published norms. 6MWT distance was significantly correlated with arm span (ρ=0.46, P=0.04) and major curve (ρ=-0.61, P=0.004), but not with FVC% (ρ=0.17, P=0.49).Conclusions:The 6MWT distance is a feasible measure of function and is substantially reduced before surgery in children with thoracic congenital scoliosis with rib anomalies. The 6MWT distance was significantly correlated with a major curve but not with FVC%. 6MWT distance is not affected by moderate lung function impairment.Level of Evidence:Level IV - retrospective cohort study.

DOI： 10.1097/BPO.0000000000001641

特集脊椎硬膜病変-最近の話題脊髄ヘルニアの病態と治療

中島宏彰, 今釜史郎, 安藤圭, 小林和克, 八木秀樹

脊椎脊髄ジャーナル 33 巻 ( 9 ) 頁： 865 - 869 2020年9月

Influence of Global Spine Sagittal Balance and Spinal Degenerative Changes on Locomotive Syndrome Risk in a Middle-Age and Elderly Community-Living Population 査読有り Open Access

Machino, M; Ando, K; Kobayashi, K; Nakashima, H; Kanbara, S; Ito, S; Inoue, T; Yamaguchi, H; Koshimizu, H; Seki, T; Ishizuka, S; Takegami, Y; Ishiguro, N; Hasegawa, Y; Imagama, S

BIOMED RESEARCH INTERNATIONAL 2020 巻頁： 3274864 2020年9月

記述言語：英語出版者・発行元：BioMed Research International

Purpose. The aim of this study was to describe the characteristics of each locomotive syndrome (LS) risk stage, including global spine sagittal alignment, spinal degenerative changes evident on plain radiographs, low back pain (LBP), muscle strength, and physical ability in middle-aged and elderly people in a health checkup. Methods. This study included 211 healthy Japanese volunteers (89 men and 122 women; mean age, 64.0 years) who underwent assessment with both radiographs and Spinal Mouse. Spinal sagittal parameters included thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sagittal vertical axis, and spinal inclination angle (SIA). Lumbar disc height (LDH) and lumbar osteophyte formation (LOF) at each level were evaluated as the spinal degenerative changes. The LS assessment comprised three tests: Stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25). The subjects were divided into three groups (no risk, stage 1 LS, or stage 2 LS) according to LS risk test criteria. The prevalence of LBP was investigated with a visual analogue scale (VAS), and physical performances were also compared among the groups. Results. Of the participants, 122 had no risk of LS, 56 had stage 1 LS risk, and 29 had stage 2 LS risk. With increasing LS risk stage, the prevalence of and VAS score for LBP increased significantly, and back muscle strength and physical abilities decreased significantly. The TKA did not differ among the three groups. The LLA decreased gradually with LS risk stage (P=0.0001). At each level except L1-L2 and L5-S1, LDH decreased gradually with LS risk stage. The prevalence of LOF increased significantly with increasing LS risk stage. The SIA increased significantly with LS risk stage (P=0.0167). Conclusions. Participants with LS had higher prevalence of spinal degeneration, small LLA, and global spinal imbalance by anterior spinal inclination.

DOI： 10.1155/2020/3274864

Patient-reported Quality of Life Following Posterior Lumbar Interbody Fusion or Indirect Decompression Using Lateral Lumbar Interbody Fusion

Nakashima, H; Kanemura, T; Satake, K; Ito, K; Tanaka, S; Ouchida, J; Segi, N; Kobayashi, K; Ando, K; Ishiguro, N; Imagama, S

SPINE 45 巻 ( 18 ) 頁： E1172 - E1178 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Spine

Study Design. A retrospective review of prospectively collected data. Objective. The aim of this study was to compare quality of life (QOL) outcomes of posterior lumbar interbody fusion (PLIF) with lateral lumbar interbody fusion (LLIF) using reports from patients obtained at the 2-year postoperative follow-up. Summary of Background Data. Indirect decompression with LLIF is used to treat degenerative lumbar diseases that require neural decompression. However, the difference in improvement in QOL following indirect decompression compared with direct neural decompression using PLIF is unclear. Methods. We enrolled 284 consecutive patients with degenerative lumbar spondylolisthesis in the present study, 203 who underwent PLIF and 81 who underwent LLIF. All patients completed a minimum of 2 years of follow-up. We evaluated the effectiveness of surgery in each category of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Results. The results of preoperative JOABPEQ and the severity of thecal sac stenosis were not significantly different between PLIF and LLIF, neither was the rate of perioperative complications (14.8% and 15.4% for the PLIF and LLIF groups, respectively; P ¼ 0.91). The effectiveness at 2 years postoperatively was almost the same for all five domains of the JOABPEQ: 62.6% and 68.9% for pain-related disorders (P ¼ 0.34), 38.3% and 42.7% for lumbar spine dysfunction (P ¼ 0.51), 65.8% and 67.5% for gait disturbance (P ¼ 0.79), 53.5% and 48.8% for social life dysfunction (P ¼ 0.47), and 29.1% and 33.3% for psychological disorders (P ¼ 0.48) following PLIF and LLIF, respectively. Visual analogue scale results for back and lower-limb pain and numbness of the lower limbs were almost the same for both groups. No significant differences were observed in terms of perioperative complications and radiographical outcomes. Conclusion. Indirect decompression using LLIF improves QOL and radiographical outcomes to a comparable degree as direct decompression via PLIF.

DOI： 10.1097/BRS.0000000000003535

Differences of locomotive syndrome and frailty in community-dwelling middle-aged and elderly people: Pain, osteoarthritis, spinal alignment, body balance, and quality of life 査読有り

Imagama, S; Ando, K; Kobayashi, K; Machino, M; Tanaka, S; Morozumi, M; Kanbara, S; Ito, S; Seki, T; Ishizuka, S; Nakashima, H; Ishiguro, N; Hasegawa, Y

MODERN RHEUMATOLOGY 30 巻 ( 5 ) 頁： 921 - 929 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Modern Rheumatology

Purpose: To identify differences between locomotive syndrome (LS) and frailty. Methods: A total of 1016 subjects (males 427, females 589, mean age 64 years) were prospectively examined in the Yakumo study. LS was defined as ≥16 on the GLFS-25 questionnaire. Frailty was diagnosed as ≥3 of unintentional weight loss, grip strength weakness, low walking speed, exhaustion, and low physical activity. Results: LS (14.4%) and frailty (10.8%) were more significant in older, female subjects with weaker muscle strength, lower gait speed, severer pain, poorer spinal alignment, and poor quality of life (QOL). LS strongly reflected musculoskeletal and neuropathic pain, knee and lumbar degeneration with poor spinal alignment, and poorer body balance, whereas frailty reflected muscle weakness. In multivariate analysis adjusted for age and gender, the significant independent risk factors were LS (odds ratio (OR) 10.6), frailty (OR 3.6), pain (OR 1.02) for poor physical QOL, and LS (OR 4.4) and lower gait speed (OR 1.6) for poor mental QOL. Conclusion: LS is more strongly related to musculoskeletal factors and may be more important than frailty for poor physical and mental QOL. LS should be checked early especially in independent elderly people to maintain activities of daily living and QOL.

DOI： 10.1080/14397595.2019.1665616

Impact of pelvic incidence on lumbar osteophyte formation and disc degeneration in middle-aged and elderly people in a prospective cross-sectional cohort 査読有り

Imagama, S; Ando, K; Kobayashi, K; Machino, M; Tanaka, S; Morozumi, M; Kanbara, S; Ito, S; Inoue, T; Seki, T; Ishizuka, S; Nakashima, H; Ishiguro, N; Hasegawa, Y

EUROPEAN SPINE JOURNAL 29 巻 ( 9 ) 頁： 2262 - 2271 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：European Spine Journal

Purpose: Pelvic incidence (PI) is unique to each individual and does not change throughout life. High PI is related to lumbar spondylolisthesis, but associations of PI with lumbar osteophyte formation and disc degeneration are unclear. The objective was to evaluate relationships of PI with lumbar osteophyte formation and disc degeneration, as well as spinal sagittal alignment and geriatric diseases, in middle-aged and elderly people. Methods: A total of 1002 volunteers (male: 434, female: 568, average age: 63.5) were prospectively examined for lumbar osteophyte formation (Nathan class ≥ 2) and disc degeneration (disc score ≥ 3). High (PI ' 51, n = 501) and low (PI ≤ 51, n = 501) PI groups were defined. Clinical factors, frailty, sarcopenia, and physical quality of life (QOL) were compared between these groups, and risk factors for lumbar osteophyte formation and disc degeneration were identified in multivariate logistic regression analysis. Results: Physical QOL was poorer in people with lumbar osteophyte formation (54.8%) and disc degeneration (33.6%). Age, male gender, spinal parameters including PI, bone mineral density, back muscle strength, and gait ability differed significantly between the groups, whereas frailty and sarcopenia were not significantly different. Low PI, low lumbar lordosis, elder age, male gender, high BMI, and weak back muscle strength were significant risk factors for lumbar osteophyte formation and disc degeneration. Conclusions: Low PI was identified as a risk factor for lumbar osteophyte formation and disc degeneration, both of which reduce physical QOL in middle-aged and elderly people. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

DOI： 10.1007/s00586-019-06204-w

Age-related changes in upper and lower cervical alignment and range of motion: normative data of 600 asymptomatic individuals 査読有り

Inoue, T; Ito, K; Ando, K; Kobayashi, K; Nakashima, H; Katayama, Y; Machino, M; Kanbara, S; Ito, S; Yamaguchi, H; Koshimizu, H; Kato, F; Imagama, S

EUROPEAN SPINE JOURNAL 29 巻 ( 9 ) 頁： 2378 - 2383 2020年9月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: To identify age-related changes and the relationship between upper and lower cervical sagittal alignment and the range of motion (ROM). Methods: A total of 600 asymptomatic volunteers were enrolled. There were 50 males and 50 females in each decade of life between the third and the eighth. The O–C2 angle and the C2–7 angle were measured using the neutral radiographs of the cervical spine. ROM was assessed by measuring the difference in alignment in the neutral, flexion, and extension positions. Results: The mean O–C2 angle in the neutral position was 14.0° lordotic. The mean ROM of the O–C2 angle was 23.1°. The mean C2–7 angle in the neutral position was 14.3° lordotic. The mean ROM of the C2–7 angle was 56.0°. The O–C2 angle was 16.1° in the third decade and gradually decreased to 11.4° in the eighth decade. There were no significant age-related changes in the ROM of the O–C2 angle. The C2–7 angle was 7.2° in the third decade and gradually increased to 20.8° in the eighth decade, and the ROM gradually decreased with increasing age. Significant negative correlation was observed between O–C2 angle and C2–7 angle. Conclusion: The O–C2 angle gradually decreased and the C2–7 angle increased with age. The ROM of the O–C2 angle did not change, but the ROM of the C2–7 angle decreased with age. The upper and lower cervical spine showed different age-related changes.

DOI： 10.1007/s00586-020-06547-9

True accuracy of percutaneous pedicle screw placement in thoracic and lumbar spinal fixation with a CT-based navigation system: Intraoperative and postoperative assessment of 763 percutaneous pedicle screws 査読有り

Ouchida, J; Kanemura, T; Satake, K; Nakashima, H; Segi, N; Suzuki, K; Imagama, S

JOURNAL OF CLINICAL NEUROSCIENCE 79 巻頁： 1 - 6 2020年9月

記述言語：英語出版者・発行元：Journal of Clinical Neuroscience

Purpose: To investigate intraoperative reinsertion of percutaneous pedicle screw (PPS) with intraoperative CT-based navigation and to evaluate the rate of deviation of PPS at postoperative radiographic examination. Methods: Seven hundred sixty-three screws were inserted in 138 patients. We investigated the rate of occurrence of intraoperative PPS reinsertion after the diagnosis of screw deviation by fluoroscopy and the causes of each screw deviation. The subsequent distribution of PPS deviation was evaluated by postoperative CT. We also assess the difference in variance between the group judged to be PPS misplaced intra-/postoperatively (IOD group/POD group) and appropriate PPS placement (ND group). Results: Among all the screws inserted, 10 (1.3%) were diagnosed as being deviated by fluoroscopy during surgery, and 74 (9.7%) screws were found to be deviated at postoperative CT evaluation. We found more pedicle screw mismatch in the POD group than in the ND group (52.7 vs 11.0%, P < 0.001). The distance between the screw and the reference was greater in the IOD group than that in the ND group (1.4 ± 1.2 vs 2.4 ± 1.1 vertebral levels, P = 0.016). In one patient in the IOD group, a motor function deficit was observed postoperatively. Conclusion: PPS fixation under intraoperative CT-based navigation did not prevent screw deviation completely. It is necessary to consider errors that occur during surgery and to confirm placement with real-time assistance such as fluoroscopy even in a surgery performed under CT navigation assistance.

DOI： 10.1016/j.jocn.2020.07.012

Poor spinal alignment in females with obesity: The Yakumo study Open Access

Ando, K; Kobayashi, K; Nakashima, H; Machino, M; Ito, S; Kanbara, S; Inoue, T; Hasegawa, Y; Imagama, S

JOURNAL OF ORTHOPAEDICS 21 巻頁： 512 - 516 2020年9月

記述言語：英語出版者・発行元：Journal of Orthopaedics

Objective: The goal of this prospective study was prospectively to investigate the relationship between obesity and spinal sagittal alignment. Methods: 286 were referred for orthopedic evaluation. Differences in spinal parameters among these groups and between males and females were evaluated. Results: Obese subjects had significantly higher C2S, CPA, CTPA, PI-LL, and lower cervical lordosis, L4S1, lumbar lordosis, and sacral slope. In multivariate logistic regression analysis adjusted for age in females, CTPA was identified as the only independent and significant factor associated with obesity. Conclusions: Obesity in females has significant relationships with spinal sagittal alignment and results in poorer physical QOL.

DOI： 10.1016/j.jor.2020.09.006

Zonisamide ameliorates progression of cervical spondylotic myelopathy in a rat model 査読有り Open Access

Kanbara, S; Ohkawara, B; Nakashima, H; Ohta, K; Koshimizu, H; Inoue, T; Tomita, H; Ito, M; Masuda, A; Ishiguro, N; Imagama, S; Ohno, K

SCIENTIFIC REPORTS 10 巻 ( 1 ) 頁： 13138 2020年8月

記述言語：英語出版者・発行元：Scientific Reports

Cervical spondylotic myelopathy (CSM) is caused by chronic compression of the spinal cord and is the most common cause of myelopathy in adults. No drug is currently available to mitigate CSM. Herein, we made a rat model of CSM by epidurally implanting an expanding water-absorbent polymer underneath the laminae compress the spinal cord. The CSM rats exhibited progressive motor impairments recapitulating human CSM. CSM rats had loss of spinal motor neurons, and increased lipid peroxidation in the spinal cord. Zonisamide (ZNS) is clinically used for epilepsy and Parkinson's disease. We previously reported that ZNS protected primary spinal motor neurons against oxidative stress. We thus examined the effects of ZNS on our rat CSM model. CSM rats with daily intragastric administration of 0.5% methylcellulose (n = 11) and ZNS (30 mg/kg/day) in 0.5% methylcellulose (n = 11). Oral administration of ZNS ameliorated the progression of motor impairments, spared the number of spinal motor neurons, and preserved myelination of the pyramidal tracts. In addition, ZNS increased gene expressions of cystine/glutamate exchange transporter (xCT) and metallothionein 2A in the spinal cord in CSM rats, and also in the primary astrocytes. ZNS increased the glutathione (GSH) level in the spinal motor neurons of CSM rats. ZNS potentially ameliorates loss of the spinal motor neurons and demyelination of the pyramidal tracts in patients with CSM.

DOI： 10.1038/s41598-020-70068-0

Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy <i>Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament</i> 査読有り

Nakashima, H; Kanemura, T; Satake, K; Ito, K; Ouchida, J; Morita, D; Ando, K; Kobayashi, K; Ishiguro, N; Imagama, S

SPINE 45 巻 ( 15 ) 頁： E909 - E916 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Spine

Study Design.Retrospective cohort study.Objective.The objective of this study was to elucidate the rate and causes of reoperation for late neurological deterioration after cervical laminoplasty by comparing cases of cervical spondylotic myelopathy (CSM) with those of ossification of the posterior longitudinal ligament (OPLL).Summary of Background Data.Although the long-term surgical outcomes of cervical laminoplasty in patients with CSM or OPLL are satisfactory, reoperation is sometimes required for late neurological deterioration after laminoplasty. However, limited information is available about long-term follow-up in such cases.Methods.This retrospective cohort study included 623 patients who underwent cervical laminoplasty for cervical myelopathy (average follow-up duration, 6.1 [range, 2-15] years). The rate of reoperations for late neurological deterioration (>6 mo after the initial surgery) was investigated.Results.Primary diagnoses were CSM and OPLL in 522 (83.8%) and 101 (16.2%) patients, respectively. During the follow-up period, 10 (1.6%) patients required reoperation: 7 (1.3%) in the CSM group and 3 (3.0%) in the OPLL group. No significant difference was found between the CSM and OPLL groups regarding patients requiring reoperation (P=0.26). The mean elapsed time between primary surgery and reoperation was 4.7±3.2 and 10.0±5.7 years in the CSM and OPLL groups, respectively. The predicted risk percentages of reoperation at 10 years after primary surgery were 2.9% and 1.0% in the CSM and OPLL group, respectively. The causes of reoperation for CSM were C5 palsy in five, severe radiculopathy in one, and restenosis due to instability after laminoplasty in one case; the cause of reoperation for OPLL was enlargement of ossification in all three cases.Conclusion.Although the clinical outcomes of laminoplasty were favorable in most patients, reoperation for late neurological deterioration was required in approximately 1.0% to 3.0% of CSM and OPLL cases within 10 years after laminoplasty.Level of Evidence: 4.

DOI： 10.1097/BRS.0000000000003408

Lateral approach corpectomy and reconstruction after anterior longitudinal ligament release in cases with fixed kyphosis: A technical note and a preliminary case series 査読有り

Nakashima, H; Kanemura, T; Satake, K; Ito, K; Tanaka, S; Segi, N; Ouchida, J; Ando, K; Kobayashi, K; Ishiguro, N; Imagama, S

JOURNAL OF CLINICAL NEUROSCIENCE 78 巻頁： 164 - 169 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Clinical Neuroscience

Lateral approach corpectomy is a useful surgical technique for adult spinal deformity with vertebral deformity. However, in cases with anterior ankylosing over adjacent vertebrae, it is hard to achieve ideal correction without posterior column resection. To minimize surgical invasiveness, we have developed a method for lateral approach corpectomy and reconstruction after anterior longitudinal ligament release (LCRA) in such cases. The aim of the current study is to describe LCRA, and investigate surgical invasiveness, sagittal correction and perioperative complications in this surgery. The subjects were three patients (all female, average age 69.0 years old) with adult spinal deformity with severe fixed kyphosis who underwent LCRA and posterior fixation with pedicle screws. The primary disease was osteoporotic vertebral fracture in all patients. The operative levels were T12 in 2 cases and L2 in 1 case. The operative time and estimated blood loss were 442.3 ± 51.9 min and 875.7 ± 397.5 mL, respectively. Local kyphotic deformity was well corrected from 54.2 ± 4.3° preoperatively to 10.1 ± 3.7° in these surgeries (p < 0.001). There were surgical complications of dural tear and postoperative hemothorax in one case each. These outcomes suggest that LCRA gives good sagittal correction in cases with fixed kyphosis after osteoporotic vertebral fracture, and that this method is a viable surgical option for correction of fixed kyphosis.

DOI： 10.1016/j.jocn.2020.04.084

Risk Factors for Neuropathic Pain in Middle-Aged and Elderly People: A Five-Year Longitudinal Cohort in the Yakumo Study 査読有り

Imagama, S; Ando, K; Kobayashi, K; Nakashima, H; Seki, T; Hamada, T; Machino, M; Ota, K; Tanaka, S; Morozumi, M; Kanbara, S; Ito, S; Ishiguro, N; Hasegawa, Y

PAIN MEDICINE 21 巻 ( 8 ) 頁： 1604 - 1610 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Pain Medicine (United States)

Objective. To determine the risk factors for new neuropathic pain (NeP) after five years in healthy middle-aged and elderly volunteers. Design. Prospective longitudinal cohort study (Yakumo study). Setting. Clinical evaluation in a health checkup. Subjects. A total of 366 people (male N = 146, female N = 220, average age = 63.5 years) who did not have NeP in 2013 were examined. Methods. NeP was diagnosed based on a painDETECT questionnaire score 13. Body mass index (BMI), comorbidity, low back pain (LBP), sciatica, physical ability, grip and back muscle strength, osteoporosis, sarcopenia, frailty, spinal alignment, and quality of life (QOL) with the SF36 in 2013 were compared between NeP(\+) and NeP(-) subjects in 2018 using multivariate logistic regression analysis. Results. The NeP(\+) rate in 2018 was 5.2%, with no significant differences in age and gender. NeP(\+) subjects had significantly lower BMI, severe sciatica, poor gait ability, higher rates of osteoporosis and sarcopenia, greater lumbar kyphosis and spinal inclination, and poorer mental health in 2013. Poor gait ability (odds ratio [OR] = 8.05), low BMI (OR = 2.31), lumbar kyphosis (OR = 1.38), low percentage of the young adult mean (OR = 1.15), and low mental QOL (OR = 1.06) were identified as significant and independent risk factors for new NeP after five years. Conclusions. This longitudinal cohort study identified five independent risk factors for development of new NeP after five years, with related factors of spinal inclination, sarcopenia, and sciatica. New NeP may be prevented by intervention or treatment of these factors at an early stage in relatively healthy middle-aged and elderly people.

DOI： 10.1093/pm/pnaa036

Dynapenia and physical performance in community-dwelling elderly people in Japan 査読有り Open Access

Kobayashi, K; Imagama, S; Ando, K; Nakashima, H; Machino, M; Morozumi, M; Kanbara, S; Ito, S; Inoue, T; Yamaguchi, H; Ishiguro, N; Hasegawa, Y

NAGOYA JOURNAL OF MEDICAL SCIENCE 82 巻 ( 3 ) 頁： 415 - 424 2020年8月

記述言語：英語出版者・発行元：Nagoya Journal of Medical Science

Aging of society has increased the incidence of physical disability. The goal of this study was to examine the physical ability of elderly people classified as having sarcopenia, presarcopenia, or dynapenia (a low muscle function without low muscle mass) in a community in Japan. The subjects were volunteers aged >60 years who were participants in a health checkup in Yakumo, Hokkaido and were in good general health. Demographic data were collected and physical performance tests were performed to measure grip strength, walking speed, back muscle strength, maximum stride length, and 3-m timed-up-and-go (3m TUG) time. A measurement of skeletal muscle mass was used as a basis for calculating the appendicular skeletal muscle index (aSMI). The rates of sarcopenia, presarcopenia, and dynapenia were 10%, 22%, and 8% in males (n=101, age 69.7±5.4 years), and 19%, 23%, and 13% in females (n=112, 68.5±5.9 years). Body mass index in subjects with dynapenia was significantly higher compared to that in subjects with sarcopenia and presarcopenia (p<0.01). Back muscle strength, maximum stride length and 3m TUG were similar in dynapenia and sarcopenia, but differed significantly with those in presarcopenia in both males and females without the influence of age (p<0.05). Further studies are needed to evaluate the benefits of dynapenia intervention programs and to explore the underlying pathophysiology of dynapenia.

DOI： 10.18999/nagjms.82.3.415

Associations of Serum MicroRNA with Bone Mineral Density in Community-Dwelling Subjects: The Yakumo Study 査読有り Open Access

Nakashima, H; Ando, K; Kobayashi, K; Seki, T; Ishizuka, S; Fujii, R; Takegami, Y; Yamada, H; Ando, Y; Suzuki, K; Hasegawa, Y; Imagama, S

BIOMED RESEARCH INTERNATIONAL 2020 巻頁： 5047243 2020年7月

記述言語：英語出版者・発行元：BioMed Research International

Osteoporosis is a disease characterized by deterioration of bone tissue and mass, with an increasing global prevalence. Therefore, the discovery of biomarkers for osteoporosis would help to guide appropriate treatment. Circulating microRNAs (miRNAs) have become increasingly recognized as biomarkers for detecting diseases. However, few studies have investigated the association of circulating miRNA with osteoporosis in the general population. The aim of this study was to identify miRNA associated with osteoporosis in a general resident health check-up for potential use as an osteoporosis biomarker. We conducted a cross-sectional study as part of a health check-up program and recruited 352 volunteers (139 men, 213 women, mean age 64.1±9.6 years). Osteoporosis was diagnosed according to the WHO classification. Twenty-two candidate microRNAs were screened through real-time quantitative PCR, and miRNAs associated with osteoporosis were analyzed using logistic regression analysis including other risk factors. In total, 95 females and 30 males were diagnosed with osteoporosis with bone mineral density tests (BMD: T-score<-2.5). We found that miR195 was significantly lower in females, while miR150 and miR222 were significantly higher in males. The results of the logistic regression analysis indicated that in females, higher age and lower miR195 (odds ratio: 0.45, 95% confidential interval: 0.03-0.98) were significant risk factors for lower BMD, while the presence of a smoking habit and lower miR150 (odds ratio: 1.35, 95% confidential interval: 1.02-1.79) were significant risk factors for osteoporosis. Serum levels of miR195 and miR150 are independently associated with low bone mineral density in females and males, respectively.

DOI： 10.1155/2020/5047243

特集脊椎手術-前方か後方か? 胸腰椎移行部破裂骨折に対する前方除圧椎体置換術

中島宏彰, 今釜史郎, 安藤圭, 小林和克, 町野正明, 金村徳相

臨床整形外科 55 巻 ( 7 ) 頁： 811 - 817 2020年7月

Prognostic Factors in the New Katagiri Scoring System After Palliative Surgery for Spinal Metastasis 査読有り

Kobayashi Kazuyoshi, Ando Kei, Nakashima Hiroaki, Sato Koji, Kanemura Tokumi, Yoshihara Hisatake, Hirasawa Atsuhiko, Kato Fumihiko, Ishiguro Naoki, Imagama Shiro

SPINE 45 巻 ( 13 ) 頁： E813 - E819 2020年7月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Spine

Study Design.Retrospective study.Objective.The purpose of the study was to examine survival after surgery for a metastatic spinal tumor using prognostic factors in the new Katagiri score.Summary of Background Data.Surgery for spinal metastasis can improve quality of life and facilitate treatment of the primary cancer. However, choice of therapy requires identification of prognostic factors for survival, and these may change over time due to treatment advances. The new Katagiri score for the prognosis of skeletal metastasis includes classification of the primary tumor site and the effects of chemotherapy and hormonal therapy.Methods.The subjects were 201 patients (127 males, 74 females) who underwent surgery for spinal metastases at six facilities in the Nagoya Spine Group. Age at surgery, gender, follow-up, metastatic spine level, primary cancer, new Katagiri score (including primary site, visceral metastasis, laboratory data, performance status (PS), and chemotherapy) and survival were obtained from a prospectively maintained database.Results.Posterior decompression (n=29) and posterior decompression and fixation with instrumentation (n=182) were performed at a mean age of 65.9 (range, 16-85) years. Metastasis was present in the cervical (n=19, 10%), thoracic (n=155, 77%), and lumbar (n=26, 13%) spine, and sacrum (n=1, 1%). In multivariate analysis, moderate growth (HR 2.95, 95% CI, 1.27-7.89, P<0.01) and rapid growth (HR 4.71, 95% CI, 2.78-12.31, P<0.01) at the primary site; nodular metastasis (HR 1.53, 95% CI, 1.07-3.85, P<0.01) and disseminated metastasis (HR 2.94, 95% CI, 1.33-5.42, P<0.01); and critical laboratory data (HR 3.15, 95% CI, 2.06-8.36, P<0.01), and poor PS (HR 2.83, 95% CI, 1.67-4.77, P<0.01) were significantly associated with poor survival.Conclusion.Accurate prognostic factors are important in deciding the treatment strategy in patients with spinal metastasis, and our identification of these factors may be useful for these patients.Level of Evidence: 3.

DOI： 10.1097/BRS.0000000000003415

Locomotive syndrome and the power spectral characteristics of body sway 査読有り

Tanaka, S; Ando, K; Kobayashi, K; Nakashima, H; Seki, T; Ishizuka, S; Machino, M; Kanbara, S; Ito, S; Kanemura, T; Ishiguro, N; Hasegawa, Y; Imagama, S

GERIATRICS & GERONTOLOGY INTERNATIONAL 20 巻 ( 7 ) 頁： 691 - 696 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Geriatrics and Gerontology International

Aim: In Japan, nursing care is advised for patients with locomotive syndrome (LS) because of musculoskeletal disorders. Balance tests have indicated an association between LS risk and sway size related to center of pressure (COP) movement. Here, the power spectrum represents the energy contained in each frequency of COP sway. Although balance tests are often performed during health checkups, no studies have investigated the relationship between the power spectrum and LS. This study investigated this relationship. Methods: In total, 605 recipients of health checkups were evaluated for LS using the 25-item Geriatric Locomotive Function Scale. Power spectrums were calculated by applying fast Fourier transform to COP sway time-series data. These were classified into three sections (0.02–0.2 Hz [low-frequency band; LFB], 0.2–2 Hz [mid-frequency band], and 2–10 Hz [high-frequency band; HFB]). Power spectrums were evaluated in left–right and front–back directions. Results: LS was associated with significantly lower ratios for both the HFB (P = 0.001) in the left–right direction and LFB (P = 0.007) in the front–back direction. In addition, men had significantly lower HFB ratios in the left–right direction (P = 0.032) and LFB ratios in the front–back (P = 0.013), whereas women had significantly lower HFB ratios in the left–right direction (P = 0.007). Conclusions: LS was associated with significantly lower ratios for both the HFB in the left–right direction and LFB in the front–back direction. This understanding of the power spectral characteristics of LS may be useful in the context of pathology and therapeutic intervention. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2020; ••: ••–••.

DOI： 10.1111/ggi.13937

Superficial Siderosis With Verrucous Vegetation Around a Dural Defect Confirmed by Intraoperative Ultrasonography. 査読有り Open Access

Machino M, Imagama S, Ando K, Kobayashi K, Nakashima H, Kanbara S, Ito S, Ishiguro N

Journal of medical cases 11 巻 ( 7 ) 頁： 192 - 195 2020年7月

記述言語：英語出版者・発行元：Journal of Medical Cases

Superficial siderosis (SS) of the central nervous system (CNS) is a rare disease caused by repeated hemorrhages in the subarachnoid space. We describe surgical treatment of an SS case in which a dural defect with verrucous vegetation in the spinal canal was detected by intraoperative ultrasonography (US). After laminectomy, intraoperative US imaging confirmed verrucous vegetation and epidural fluid collection around the ventral dural defect before incision of the posterior dura mater. As intraoperative US also showed a dural defect at the ventral and right sides of the spinal cord, the posterior dural incision was made in a manner that was slightly more right lateral than standard midline. The ventral dural defect was repaired by direct sutures. After repair, intraoperative US imaging confirmed dural hole closure, removal of vegetation and resolution of the collected fluid. Dural closure was successful and symptoms partially improved despite the patient’s long history of SS. Intraoperative US can help surgeons make decisions about precise dural incision before repair. Intraoperative US is useful for detecting the level of dural defect and verrucous vegetation before repair and confirming closure of the dural defect, successful removal of vegetation and resolution of fluid collection after repair.

DOI： 10.14740/jmc3495

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