研究者詳細 - 中島　宏彰

Multivariate analysis of factors related to the absence of musculoskeletal degenerative disease in middle-aged and older people 査読有り国際誌 Open Access

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

GERIATRICS & GERONTOLOGY INTERNATIONAL 19 巻 ( 11 ) 頁： 1141 - 1146 2019年11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: Musculoskeletal degenerative disease (MSD; osteoporosis, knee arthritis and lumbar spondylosis) decreases the quality of life (QOL) of older people. The objective of the present study was to identify the factors related to the absence of MSD in multivariate logistic regression analysis. Methods: The participants were 1034 volunteers (444 men, 590 women, mean age 63.5 years) in the Yakumo study. Osteoporosis (percentage of young adult mean ≤70%), knee arthritis (Kellgren–Lawrence grade ≥2), and lumbar spondylosis (Nathan class ≥3) were prospectively examined. Participants were divided into those with and without MSD. Age, sex, body mass index, muscle strength, gait ability, pain, body balance, spinal sagittal alignment, geriatric syndrome (locomotive syndrome, frailty and sarcopenia) and QOL (Short Form Health Survey) were compared between these groups to identify the factors associated with the absence of MSD. Results: Significantly lower age, body mass index and pain; higher gait speed, grip and back muscle strength; more stable body balance; better sagittal spinal alignment; and lower rates of locomotive syndrome, frailty and sarcopenia were observed in the group without MSD (n = 445, 43%), with significantly better QOL (P < 0.0001). In multivariate logistic regression analysis adjusted for age and sex, lower body mass index (odds ratio [OR] 1.10, P < 0.001), lower spinal inclination (OR 1.08, P < 0.01), higher back muscle strength (OR 1.01, P < 0.05), no locomotive syndrome (OR 1.80, P < 0.05) and good body balance (OR: 1.12, P < 0.05) were significant factors for the absence of MSD. Conclusions: Factors related to an absence of MSD are also related to good QOL, and should be a focus of health interventions in healthy middle-aged and older people. Geriatr Gerontol Int 2019; 19: 1141–1146.

DOI： 10.1111/ggi.13786

Increase in lumbar kyphosis and spinal inclination, declining back muscle strength, and sarcopenia are risk factors for onset of GERD: a 5-year prospective longitudinal cohort study 査読有り国際誌

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

EUROPEAN SPINE JOURNAL 28 巻 ( 11 ) 頁： 2619 - 2628 2019年11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: The objective was to identify risk factors for new development of gastroesophageal reflux disease (GERD) 5 years later in a prospective longitudinal cohort study. Methods: A total of 178 subjects (male 72, female 106, mean age 68 years) without GERD in 2013 were examined for GERD in 2018. A Frequency Scale for Symptoms of GERD score ≥ 8 was used for diagnosis of GERD. Body mass index, spinal alignment, muscle strength, physical ability, number of oral drugs per day, sarcopenia, and frailty determined in 2013 and 2018 were compared between the GERD(+) and GERD(−) groups in 2018. Aggravation of lumbar kyphosis and spinal inclination from 2013 to 2018 was defined as a change of ≥ 5° or ≥ 10°, and weakening of back muscle strength as a change of ≥ 10 kg. QOL (SF-36) was also examined. Results: Of the 178 subjects, 38 (21%) were diagnosed as GERD(+) in 2018. Sarcopenia in 2018 was significantly related to a GERD(+) status (p < 0.05). The GERD(+) group had significantly higher rates of changes of lumbar kyphosis ≥ 5° (p < 0.005) and ≥ 10° (p < 0.0001), of spinal inclination ≥ 5° (p < 0.0001), and of decreased back muscle strength ≥ 10 kg (p < 0.05). SF-36 were also significantly worse in the GERD(+) group (p < 0.05). Conclusions: This prospective longitudinal study firstly demonstrated that lumbar kyphotic change, aggravation of spinal inclination, decreased back muscle strength, and sarcopenia are significant risk factors for new development of GERD. Management and prevention of these factors may contribute to reduction of GERD symptoms and increased 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/s00586-019-06139-2

特集ついに始まった頸椎人工椎間板置換術頸椎人工椎間板の適応と短期成績-Mobi-C

金村徳相, 佐竹宏太郎, 伊藤研悠, 田中智史, 中島宏彰, 今釜史郎

脊椎脊髄ジャーナル 32 巻 ( 10 ) 頁： 919 - 928 2019年10月

Factors Affecting Postoperative Sagittal Alignment after Lateral Lumbar Interbody Fusion in Adult Spinal Deformity: Posterior Osteotomy, Anterior Longitudinal Ligament Rupture, and Endplate Injury. 査読有り国際誌 Open Access

Nakashima H, Kanemura T, Satake K, Ishikawa Y, Ouchida J, Segi N, Yamaguchi H, Imagama S

Asian spine journal 13 巻 ( 5 ) 頁： 738 - 745 2019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：Asian Spine Journal

Study Design: Prospective cohort study. Purpose: To identify factors that affect sagittal alignment correction in lateral lumbar interbody fusion (LIF) surgery for adult spinal deformity (ASD) and to investigate the degree of correction in each condition. Overview of Literature: LIF is a useful procedure for ASD, but the degree of correction can be affected by posterior osteotomy, intraoperative endplate injury, or anterior longitudinal ligament (ALL) rupture. Methods: Radiographical data for 30 patients who underwent LIF for ASD were examined prospectively. All underwent two-stage surgery (LIF followed by posterior fixation). Radiographical parameters were measured preoperatively, after LIF, and after posterior fixation; these included the segmental lordotic angle, lumbar lordosis (LL), and other sagittal alignment factors. Results: LL was corrected from 16.5°±16.7° preoperatively to 33.4°±13.8° after LIF (p<0.001) and then to 52.1°±7.9° following posterior fixation (p<0.001). At levels where Schwab grade 2 osteotomy was performed, the acquired segmental lordotic angles from the preoperative value to after posterior fixation and from after LIF to after posterior fixation were 19.5°±9.2° and 9.9°±3.9°, respectively. On average, 12.4° more was added than in cases without osteotomy. Endplate injury was identified at 21 levels (19.4%) after LIF, with a mean loss of 3.4° in the acquired segmental lordotic angle (5.3°±8.4° and 1.9°±5.9° without and with endplate injury, respectively). ALL rupture was identified at seven levels (6.5%), and on average 19.3° more was added in these cases between the preoperative and postoperative values than in cases without ALL rupture. Conclusions: LIF provides adequate sagittal alignment restoration for ASD, but the degree of correction is affected by grade 2 osteotomy, intraoperative endplate injury, and ALL rupture.

DOI： 10.31616/asj.2018.0275

Unplanned Second-Stage Decompression for Neurological Deterioration Caused by Central Canal Stenosis after Indirect Lumbar Decompression Surgery. 査読有り国際誌

Nakashima H, Kanemura T, Satake K, Ishikawa Y, Ouchida J, Segi N, Yamaguchi H, Imagama S

Asian spine journal 13 巻 ( 4 ) 頁： 584 - 591 2019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：Asian Spine Journal

Study Design: Prospective cohort study. Purpose: This study aimed to identify risk factors for unplanned second-stage decompression for postoperative neurological deficit after indirect decompression using lateral lumbar interbody fusion (LLIF) with posterior fixation. Overview of Literature: Indirect lumbar decompression with LLIF has been used as a minimally invasive alternative to direct decompression to treat degenerative lumbar diseases requiring neural decompression. However, evidence on the prevalence of neurological deficits caused by spinal canal stenosis after indirect decompression is limited. Methods: This study included 158 patients (mean age, 71.13±7.98 years; male/female ratio, 67/91) who underwent indirect decompression with LLIF and posterior fixation. Indirect decompression was performed at 271 levels (mean level, 1.71±0.97). Logistic regression analysis was used to identify the risk factors for postoperative neurological deficits. The variables included were age, sex, body mass index, presence of primary diseases, diabetes mellitus, preoperative motor deficit, levels operated on, preoperative severity of lumbar stenosis, and preoperative Japanese Orthopedic Association (JOA) score. Results: Postoperative neurological deficit due to spinal canal stenosis occurred in three patients (1.9%). Spinal stenosis due to hemodialysis (p < 0.001), ligament ossification (p < 0.001), presence of preoperative motor paralysis (p < 0.001), low JOA score (p=0.004), and severe canal stenosis (p=0.02) were significantly more frequent in the paralysis group. Conclusions: Severe preoperative canal stenosis and neurological deficit were identified as risk factors for postoperative neurological deterioration caused by spinal canal stenosis. Additionally, uncommon diseases, such as spinal stenosis due to hemodialysis and ligament ossification, increased the risk of postoperative neurological deficit; therefore, in such cases, indirect decompression is contraindicated.

DOI： 10.31616/asj.2018.0232

Both common and rare genetic variants of ABCG2 are risks for gout 査読有り

Higashino T., Takada T., Nakaoka H., Toyoda Y., Stiburkova B., Miyata H., Ikebuchi Y., Nakashima H., Shimizu S., Kawaguchi M., Sakiyama M., Nakayama A., Akashi A., Tanahashi Y., Kawamura Y., Nakamura T., Wakai K., Okada R., Yamamoto K., Hosomichi K., Hosoya T., Ichida K., Ooyama H., Suzuki H., Inoue I., Merriman T. R., Shinomiya N., Matsuo H.

EUROPEAN JOURNAL OF HUMAN GENETICS 27 巻頁： 645 - 646 2019年7月

Comparative Radiographic Outcomes of Lateral and Posterior Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Kyphosis. 査読有り国際誌 Open Access

Nakashima H, Kanemura T, Satake K, Ishikawa Y, Ouchida J, Segi N, Yamaguchi H, Imagama S

Asian spine journal 13 巻 ( 3 ) 頁： 395 - 402 2019年6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：Asian Spine Journal

Study Design: Retrospective case-control study. Purpose: To compare surgical invasiveness and radiological outcomes between posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF) for degenerative lumbar kyphosis. Overview of Literature: LLIF is a minimally invasive interbody fusion technique; however, few reports compared the clinical outcomes of conventional PLIF and LLIF for degenerative lumbar kyphosis. Methods: Radiographic data for patients who have undergone lumbar interbody fusion (≥3 levels) using PLIF or LLIF for degenerative lumbar kyphosis (lumbar lordosis [LL] < 20°) were retrospectively examined. The following radiographic parameters were retrospectively evaluated preoperatively and 2 years postoperatively: segmental lordotic angle, LL, pelvic tilt (PT), pelvic incidence (PI), C7 sagittal vertical axis, and T1 pelvic angle. Results: Nineteen consecutive cases with PLIF and 27 cases with LLIF were included. There were no significant differences in patients' backgrounds or preoperative radiographic parameters between the PLIF and the LLIF groups. The mean fusion level was 5.5±2.5 levels and 5.8±2.5 levels in the PLIF and LLIF groups, respectively (p=0.69). Although there was no significant difference in surgical times (p=0.58), the estimated blood loss was significantly greater in the PLIF group (p < 0.001). Two years postoperatively, comparing the PLIF and LLIF groups, the segmental lordotic angle achieved (7.4°±7.6° and 10.6°±9.4°, respectively; p=0.03), LL (27.8°±13.9° and 39.2°±12.7°, respectively; p=0.006), PI-LL (19.8°±14.8° and 3.1°±17.5°, respectively; p=0.002), and PT (22.6°±7.1° and 14.2°±13.9°, respectively; p=0.02) were significantly better in the LLIF group. Conclusions: LLIF provided significantly better sagittal alignment restoration in the context of degenerative lumbar kyphosis, with less blood loss.

DOI： 10.31616/asj.2018.0204

What Are the Important Predictors of Postoperative Functional Recovery in Patients With Cervical OPLL? Results of a Multivariate Analysis 査読有り国際誌

Nakashima, H; Kanemura, T; Kanbara, S; Satake, K; Ito, K; Ishiguro, N; Kato, F; Imagama, S

GLOBAL SPINE JOURNAL 9 巻 ( 3 ) 頁： 315 - 320 2019年5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：Global Spine Journal

Study Design: A retrospective cohort study. Objective: The objective of this study was to identify important predictors of poor functional recovery in patients undergoing surgery for cervical ossification of the posterior longitudinal ligament (OPLL). Methods: This was a retrospective cohort study of 142 OPLL patients with laminoplasty; 135 had complete radiographical data and were followed up for ≥2 years. The following OPLL characteristics were compared between patients with “good” and “poor” outcomes (Japanese Orthopedic Association [JOA] recovery rate ≥50% and <50%, respectively): number of ossified levels, OPLL classification, ossification shape, K-line, canal-occupying ratio, and increased magnetic resonance imaging (MRI) signal intensity. Predictors of functional recovery were identified. Results: Pre- and postoperative (2 years following surgery) JOA scores were 10.6 ± 2.9 and 14.1 ± 2.2, respectively, indicating significant improvement following laminoplasty (P <.001). The average JOA recovery rate was 53.4% ± 34.7%, with 81 (60.0%) and 54 (40.0%) patients in the better and poorer neurological outcome groups, respectively. The canal occupation ratio of OPLL ≤60%/>60% were 117 (86.7%) and 18 (13.3%) patients, respectively. In the stepwise logistic regression analysis, an occupation ratio greater than 60% was identified as a significant factor for poor postoperative neurological outcome (relative risk, 4.82; 95% confidential interval, 1.61-14.46, P =.005). Conclusions: This multivariate analysis demonstrated a large size OPLL (occupying ratio >60%) was associated with a risk of poor neurological recovery roughly 5 times greater, and therefore other types of surgery are recommended in cases with such a ratio.

DOI： 10.1177/2192568218794665

整形外科/知ってるつもり脊髄ヘルニアの画像診断と治療

Anatomic evaluation of retroperitoneal organs for lateral approach surgery: a prospective imaging study using computed tomography in the lateral decubitus position. 査読有り

Ouchida J, Kanemura T, Satake K, Nakashima H, Segi N

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 28 巻 ( 4 ) 頁： 835 - 841 2019年4月

特別寄稿脳神経外科コントロバーシー2019 (10)増え続ける高齢者の成人脊柱変形に整形外科医としてどのように対峙するか査読有り

金村徳相, 佐竹宏太郎, 中島宏彰, 石川喜資, 大内田隼, 山口英敏, 世木直喜, 今釜史郎

Neurological Surgery 脳神経外科 47 巻 ( 3 ) 頁： 271 - 285 2019年3月

A Systematic Review of Classification Systems for Cervical Ossification of the Posterior Longitudinal Ligament 査読有り国際誌 Open Access

Tetreault, L; Nakashima, H; Kato, S; Kryshtalskyj, M; Nagoshi, N; Nouri, A; Singh, A; Fehlings, MG

GLOBAL SPINE JOURNAL 9 巻 ( 1 ) 頁： 85 - 103 2019年2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：Global Spine Journal

Design: Systematic review. Objective: To conduct a systematic review to (1) summarize various classification systems used to describe cervical ossification of the posterior longitudinal ligament (OPLL) and (2) evaluate the diagnostic accuracy of various imaging modalities and the reliability of these classification systems. Methods: A search was performed to identify studies that used a classification system to categorize patients with OPLL. Furthermore, studies were included if they reported the diagnostic accuracy of various imaging modalities or the reliability of a classification system. Results: A total of 167 studies were deemed relevant. Five classification systems were developed based on X-ray: the 9-classification system (0.60%); continuous, segmental, mixed, localized or focal, circumscribed and others (92.81%); hook, staple, bridge, and total types (2.40%); distribution of OPLL (2.40%); and K-line classification (4.19%). Six methods were based on computed tomography scans: free-type, contiguous-type, and broken sign (0.60%); hill-, plateau-, square-, mushroom-, irregular-, or round-shaped (5.99%); rectangular, oval, triangular, or pedunculate (1.20%); centralized or laterally deviated (1.80%); plank-, spindle-, or rod-shaped (0.60%); and rule of nine (0.60%). Classification systems based on 3-dimensional computed tomography were bridging and nonbridging (1.20%) and flat, irregular, and localized (0.60%). A single classification system was based on magnetic resonance imaging: triangular, teardrop, or boomerang. Finally, a variation of methods was used to classify OPLL associated with the dura mater (4.19%). Conclusions: The most common method of classification was that proposed by the Japanese Ministry of Health, Labour and Welfare. Other important methods include K-line (+/−), signs of dural ossification, and patterns of distribution.

DOI： 10.1177/2192568217720421

Is Pregabalin Effective Against Acute Lumbar Radicular Pain ? 査読有り Open Access

Nakashima H, Kanemura T, Ando K, Kobayashi K, Yoneda M, Ishiguro N, Imagama S

Spine surgery and related research 3 巻 ( 1 ) 頁： 61 - 66 2019年1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 Surgery and Related Research

Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for acute lumbar radicular pain accompanying lumbar disc herniation (LDH), but their effects are minimal. The purpose of this study was to evaluate the efficacy and safety of pregabalin (PGB) as an alternative therapy for this condition. Methods: Patients with acute lumbar radicular pain accompanying LDH were randomly administered either NSAIDs plus PGB (30 patients) or NSAIDs alone (30 patients) for up to 4 weeks. The primary outcome was leg pain at 2 and 4 weeks. Secondary outcomes were reduction in sleep disturbances and patient global impressions of change (PGIC) at 2 and 4 weeks. Results: Four patients in the NSAIDs plus PGB group were deemed ineligible and excluded from the study. Fewer sleep disturbances were reported by patients administered NSAIDs plus PGB compared with the NSAID monotherapy group at both 2 and 4 weeks. Additionally, the NSAIDs plus PGB group showed greater improvement in pain than the NSAID monotherapy group at 4 weeks, although this difference was not significant. PGIC was also significantly better in the NSAIDs plus PGB group than in the NSAID monotherapy group at 4 weeks. The incidence of adverse events was significantly greater in the NSAIDs plus PGB group than in the NSAID monotherapy group. Conclusions: The combination of NSAIDs plus PGB is more effective against sleep disturbance than NSAIDs alone in patients with acute LDH, although the control of sciatic pain is minimal. Patients reported satisfactory recoveries could also be obtained, and thus, this combination therapy could be a good option for the conservative treatment of acute lumbar radicular pain, including LDH.

DOI： 10.22603/ssrr.2018-0003

今釜史郎, 中島宏彰, 八木秀樹, 安藤圭, 小林和克, 石黒直樹

臨床整形外科 53 巻 ( 12 ) 頁： 1110 - 1114 2018年12月

特集ハイテク機器を利用した最新の脊椎脊髄手術「O－arm」の最新の応用法

金村徳相, 佐竹宏太郎, 中島宏彰, 石川喜資, 大内田隼, 山口英敏, 世木直喜, 今釜史郎

脊椎脊髄ジャーナル 31 巻 ( 11 ) 頁： 938 - 951 2018年11月

Factors Affecting the Severity of Neurological Disorders in Thoracic Idiopathic Spinal Cord Herniation 査読有り国際誌

Nakashima, H; Kanemura, T; Yagi, H; Kato, F; Sato, K; Kamiya, M; Yoshihara, H; Ito, K; Matsuyama, Y; Ishiguro, N; Imagama, S

SPINE 43 巻 ( 22 ) 頁： 1552 - 1558 2018年11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 multicenter case-controlled study. Objective. The objective of this study was to quantitatively examine imaging findings of idiopathic spinal cord herniation (ISCH) and determine the relationship between the image findings and the severity of pre- and postoperative neurological symptoms. Summary of Background Data. Many radiographic types of ISCH have been identified with regard to the location of the hernial opening or amount of herniated spinal cord. However, few previous studies have investigated the relationship between radiographic findings and the severity of neurological symptoms. Methods. Of 30,469 patients who underwent spinal surgery at 7 hospitals, 18 patients who underwent surgery for ISCH were identified. Their preoperative neurological severity, disease duration, magnetic resonance imaging findings, computed tomography myelography findings, surgical findings, and postoperative improvements were retrospectively examined. The spinal cord kink angle and minimum cord occupancy rate within the dural tube were measured. In addition, herniation was classified according to the location of the hiatus as either central (type C) or lateral (type L) type. Results. A negative correlation was found between the spinal cord kink angle and the minimum cord occupancy rate. Patient age was significantly higher in the severe paralysis group than in the mild paralysis group. In addition, the number of patients with type C herniation and the kink angle were significantly higher in the severe paralysis group. The number of patients with type L herniation was higher in the significant recovery group than in the mild recovery group; however, the difference was not significant. Conclusion. Patients with a large spinal cord kink angle had a smaller spinal cord occupancy rate within the dural tube, and this resulted in severe preoperative conditions. Type C ISCH cases had a severe preoperative neurological deficit and poor postoperative neurological recovery, and the spinal cord in such cases might be damaged irreversibly.

DOI： 10.1097/BRS.0000000000002574