Faculty Profiles - NAKASHIMA Hiroaki

Papers - NAKASHIMA Hiroaki

Division display 281 - 300 of about 333 ／ All the affair displays >>

Neurological function following early versus delayed decompression surgery for drop foot caused by lumbar degenerative diseases Reviewed

Nakashima Hiroaki, Ishikawa Yoshimoto, Kanemura Tokumi, Kato Fumihiko, Satake Kotaro, Ito Keigo, Ito Kenyu, Ando Kei, Kobayashi Kazuyoshi, Ishiguro Naoki, Imagama Shiro

JOURNAL OF CLINICAL NEUROSCIENCE Vol. 72 page： 39 - 42 2020.2

GDNF rescues the fate of neural progenitor grafts by attenuating Notch signals in the injured spinal cord in rodents.

Khazaei M, Ahuja CS, Nakashima H, Nagoshi N, Li L, Wang J, Chio J, Badner A, Seligman D, Ichise A, Shibata S, Fehlings MG

Science translational medicine Vol. 12 ( 525 ) 2020.1

Changes in Sagittal Alignment Following Short-Level Lumbar Interbody Fusion: Comparison between Posterior and Lateral Lumbar Interbody Fusions. Reviewed International journal Open Access

Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama

Asian spine journal Vol. 13 ( 6 ) page： 904 - 912 2019.12

Language：English Publishing type：Research paper (scientific journal)

Study Design: Retrospective case-control study. Purpose: We aimed to compare radiologic outcomes between posterior (PLIF) and lateral lumbar interbody fusion (LLIF) in short-level spinal fusion surgeries. Overview of Literature: Although LLIF enables surgeons to insert large lordotic cages, it is unknown whether LLIF more effectively corrects local and global sagittal alignments compared with PLIF in short-level spinal fusion surgeries. Methods: Radiographic data acquired from patients with lumbar interbody fusion (≤3 levels) using PLIF or LLIF for degenerative lumbar diseases were analyzed. The following radiographic parameters were evaluated preoperatively and at 2 years postoperatively: segmental lordotic angle, disk height, lumbar lordosis (LL), pelvic tilt (PT), C7 sagittal vertical axis, and thoracic kyphosis (TK). Results: In total, 144 patients with PLIF (193 fused levels) and 101 with LLIF (159 fused levels) were included. Patients' backgrounds and preoperative radiographic parameters for any level of fusion did not differ significantly between PLIF and LLIF procedures. The LLIF group exhibited significantly greater changes at 1-level fusion compared to the PLIF group in the parameters of segmental lordotic angle (5.1°±5.8° vs. 2.1°±5.0°, p<0.001), disk height (4.2±2.3 mm vs. 2.2±2.0 mm, p<0.001), LL (7.8°±7.6° vs. 3.9°±8.6°, p=0.004), and PI-LL (-6.9°±6.8° vs. -3.6°±10.1°, p=0.03). While, a similar trend was observed regarding 2-level fusion, significantly greater changes were only observed in LL (12.1°±11.1° vs. 4.2°±9.1°, p=0.047) and PI-LL (-11.2°±11.3° vs. -3.0°±9.3°, p=0.043), PT (-6.4°±4.9° vs. -2.5°±5.3°, p=0.049) and TK (7.8°±11.8° vs. -0.3°±9.7°, p=0.047) in the LLIF group at 3-level fusion. Conclusions: LLIF provides significantly better local sagittal alignment than PLIF in 1- or 2-level fusion cases and improves spinopelvic alignment and local alignment for 3-level fusion cases. Thus, LLIF was demonstrated to be a useful lumbar interbody fusion technique, constituting a powerful tool for achieving sagittal realignment with minimal surgical invasiveness.

DOI： 10.31616/asj.2019.0011

Indirect Decompression on MRI Chronologically Progresses After Immediate Postlateral Lumbar Interbody Fusion: The Results From a Minimum of 2 Years Follow-Up. Reviewed International journal

Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama

Spine Vol. 44 ( 24 ) page： E1411 - E1418 2019.12

Language：English Publishing type：Research paper (scientific journal)

MINI: On magnetic resonance imaging, indirect decompression using lateral lumbar interbody fusion and posterior fixation was confirmed immediately after surgery and also continuously progressed after surgery, particularly during the first 6 months. Thecal sac enlargement was also confirmed, and is suspected to be caused by the atrophy of the ligamentum flavum and the disc. STUDY DESIGN: A prospective cohort study. OBJECTIVE: The aim of this study was to investigate radiographical changes related to indirect decompression using lateral lumbar interbody fusion (LLIF) with posterior fixation. SUMMARY OF BACKGROUND DATA: Indirect lumbar decompression via LLIF is used to treat degenerative lumbar diseases requiring neural decompression. Although evidence suggests that thecal sac enlargement follows shortly after surgery, few studies have described the postoperative changes on MRIs. METHODS: This study involved 102 patients who underwent indirect decompression at 136 levels, with LLIF and posterior fixation. Magnetic resonance imaging (MRIs) were collected preoperatively and several times postoperatively (over a 2-year period starting immediately after surgery). We then quantified the cross-sectional areas of the thecal sac and ligamentum flavum, as well as the anteroposterior diameter of disc bulging, and qualitatively assessed lumbar spinal stenosis according to a modified version of Schizas' classification [Grades A (mild) to C (severe)]. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was used for the assessment of the clinical symptoms. RESULTS: All changes were observable immediately after surgery, progressed over time, and were significantly different statistically at 2 years after surgery. The thecal sac was significantly larger (189% of preoperative; P < 0.0001), while the ligamentum flavum and disc bulge were significantly smaller [58.9% and 67.3% of preoperative (P < 0.001), respectively]. The number of patients with grade C (severe) lumbar stenosis also dropped significantly (preoperative, 17.6%; 2 years postoperative, 0%). There were no significant differences in JOABPEQ results at 6 months, 1 year, and 2 years postsurgery. CONCLUSION: Indirect decompression produces immediate positive results that continue to improve over time. The cross-sectional area of the thecal sac doubled by 2 years after surgery, and the ligamentum flavum cross-sectional area and disc bulging both shrank significantly. At the same time, however, postoperative radiographical improvements do not appear to correlate with clinical symptoms. LEVEL OF EVIDENCE: 3.

DOI： 10.1097/BRS.0000000000003180

Web of Science

Scopus

PubMed

Musculoskeletal Factors and Geriatric Syndromes Related to the Absence of Musculoskeletal Degenerative Disease in Elderly People Aged over 70 Years Reviewed Open Access

Imagama Shiro, Ando Kei, Kobayashi Kazuyoshi, Seki Taisuke, Ishizuka Shinya, Machino Masaaki, Tanaka Satoshi, Morozumi Masayoshi, Kanbara Shunsuke, Ito Sadayuki, Inoue Taro, Nakashima Hiroaki, Ishiguro Naoki, Hasegawa Yukiharu

BIOMED RESEARCH INTERNATIONAL Vol. 2019 page： 7097652 2019.11

Clinical Features of Thoracic Myelopathy: A Single-Center Study Reviewed Open Access

Ando Kei, Imagama Shiro, Kobayashi Kazuyoshi, Ito Kenyu, Tsushima Mikito, Morozumi Masayoshi, Tanaka Satoshi, Machino Masaaki, Ota Kyotaro, Nakashima Hiroaki, Nishida Yoshihiro, Ishiguro Naoki

JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS Vol. 3 ( 11 ) 2019.11

Multivariate analysis of factors related to the absence of musculoskeletal degenerative disease in middle-aged and older people. Reviewed International journal 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 Vol. 19 ( 11 ) page： 1141 - 1146 2019.11

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. Reviewed International journal

Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Masaaki Machino, Satoshi Tanaka, Masayoshi Morozumi, Shunsuke Kanbara, Sadayuki Ito, Taisuke Seki, Takashi Hamada, Shinya Ishizuka, Hiroaki Nakashima, Naoki Ishiguro, Yukiharu Hasegawa

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 Vol. 28 ( 11 ) page： 2619 - 2628 2019.11

Language：English Publishing type：Research paper (scientific 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. These slides can be retrieved under Electronic Supplementary Material.

DOI： 10.1007/s00586-019-06139-2

Web of Science

Scopus

PubMed

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 Vol. 32 ( 10 ) page： 919 - 928 2019.10

Factors Affecting Postoperative Sagittal Alignment after Lateral Lumbar Interbody Fusion in Adult Spinal Deformity: Posterior Osteotomy, Anterior Longitudinal Ligament Rupture, and Endplate Injury. Reviewed International journal Open Access

Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama

Asian spine journal Vol. 13 ( 5 ) page： 738 - 745 2019.10

Language：English Publishing type：Research paper (scientific 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. Reviewed International journal Open Access

Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama

Asian spine journal Vol. 13 ( 4 ) page： 584 - 591 2019.8

Language：English Publishing type：Research paper (scientific 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 Reviewed

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 Vol. 27 page： 645 - 646 2019.7

Comparative Radiographic Outcomes of Lateral and Posterior Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Kyphosis. Reviewed International journal Open Access

Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama

Asian spine journal Vol. 13 ( 3 ) page： 395 - 402 2019.6

Language：English Publishing type：Research paper (scientific 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. Reviewed International journal Open Access

Hiroaki Nakashima, Tokumi Kanemura, Shunsuke Kanbara, Kotaro Satake, Keigo Ito, Naoki Ishiguro, Fumihiko Kato, Shiro Imagama

Global spine journal Vol. 9 ( 3 ) page： 315 - 320 2019.5

Language：English Publishing type：Research paper (scientific 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

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

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

[(10)Surgical Strategy for Adult Spinal Deformity in Elderly Patients]. Reviewed

Tokumi Kanemura, Kotaro Satake, Hiroaki Nakashima, Yoshimoto Ishikawa, Jun Ouchida, Hidetoshi Yamaguchi, Naoki Segi, Shiro Imagama

No shinkei geka. Neurological surgery Vol. 47 ( 3 ) page： 271 - 285 2019.3

A Systematic Review of Classification Systems for Cervical Ossification of the Posterior Longitudinal Ligament. Reviewed International journal Open Access

Lindsay Tetreault, Hiroaki Nakashima, So Kato, Michael Kryshtalskyj, Nagoshi Nagoshi, Aria Nouri, Anoushka Singh, Michael G Fehlings

Global spine journal Vol. 9 ( 1 ) page： 85 - 103 2019.2

Language：English Publishing type：Research paper (scientific 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 ? Reviewed Open Access

Hiroaki Nakashima, Tokumi Kanemura, Kei Ando, Kazuyoshi Kobayashi, Minoru Yoneda, Naoki Ishiguro, Shiro Imagama

Spine surgery and related research Vol. 3 ( 1 ) page： 61 - 66 2019.1

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for 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

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

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 Vol. 53 ( 12 ) page： 1110 - 1114 2018.12

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 Vol. 31 ( 11 ) page： 938 - 951 2018.11

　 PREV - NEXT 　

<NAKASHIMA Hiroaki>

Papers - NAKASHIMA Hiroaki