研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

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Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study) 査読有り Open Access

Tachi H., Takegami Y., Okura T., Tokutake K., Nakashima H., Mishima K., Kasai T., Imagama S.

Arthroplasty Today 33 巻 2025年6月

出版者・発行元：Arthroplasty Today

Background: Periprosthetic femoral fractures are challenging complications after total hip arthroplasty (THA) or bipolar hemiarthroplasty (BHA). This multicenter study compared clinical outcomes of surgical periprosthetic femoral fracture (PFF) treatment following initial implantation of cemented vs cementless femoral stems. Methods: This retrospective multicenter study included 201 patients from multiple hospitals who had PFFs treated surgically between 2010 and 2022. They were divided into THA (n = 71) and BHA (n = 130) cohorts based on initial arthroplasty. Clinical outcomes of mortality, radiographic bone union, operative metrics, and complications were compared after the patients were matched for age. Results: In the matched THA cohorts (n = 15 each), there were no significant differences in mortality, bone union, operative time, blood loss, or complications between cemented and cementless stems. In the matched BHA cohorts (n = 27 each), mortality and bone union were similar, but cementless stems showed higher intraoperative blood loss. Furthermore, Type B fractures were more common with cementless stems, whereas Type C fractures were predominated with cemented stems. Conclusions: Among patients who underwent THA or BHA, mortality and bone union following treatment of PFFs did not differ between cemented and cementless stems. However, patients who underwent BHA with cementless stems required longer operations and lost more blood. Type B fractures requiring revision occurred more frequently with cementless stems, whereas Type C fractures treated with open reduction and internal fixation were more frequent with cemented stems, which thus influenced perioperative factors. Cement use for initial arthroplasty was associated with certain favorable characteristics and positive treatment outcomes of PFFs.

DOI： 10.1016/j.artd.2025.101699

Open Access

Scopus

特集　整形外科領域におけるAIの応用 Ⅵ章. AIによる手術・治療成績予測 1.AIを用いた頚椎・頚髄損傷予後予測因子の探索査読有り

伊藤定之, 中島宏彰, 世木直喜, 大内田隼, 小田昌宏, 今釜史郎

整形外科 76 巻 ( 6 ) 頁： 627 - 632 2025年5月

Influence of Diabetes Mellitus on Neurological Recovery in Older Patients With Cervical Spinal Cord Injury Without Bone Injury: A Retrospective Multicenter Study 査読有り Open Access

Takeda, K; Watanabe, K; Nori, S; Yamane, J; Kono, H; Yokogawa, N; Sasagawa, T; Nakashima, H; Segi, N; Funayama, T; Eto, F; Furuya, T; Yunde, A; Nakajima, H; Yamada, T; Hasegawa, T; Terashima, Y; Hirota, R; Suzuki, H; Imajo, Y; Ikegami, S; Tonomura, H; Sakata, M; Hashimoto, K; Kawaguchi, K; Suzuki, N; Uei, H; Nakanishi, K; Terai, H; Inoue, G; Kiyasu, K; Iizuka, Y; Akeda, K; Funao, H; Oshima, Y; Kaito, T; Yoshii, T; Ishihara, M; Okada, S; Imagama, S; Kato, S

GLOBAL SPINE JOURNAL 15 巻 ( 4 ) 頁： 2274 - 2285 2025年5月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Retrospective study. Objectives: To investigate the impact of diabetes mellitus on neurological recovery and determine the relationship between moderate-severe diabetes and neurological recovery in patients with cervical spinal cord injury (CSCI) without bone injury. Methods: A retrospective study was conducted on 389 consecutive patients aged ≥65 years with CSCI without bone injury across 33 medical institutes. The patients were divided into a nondiabetic group (n = 270) and a diabetic group (n = 119). Neurological outcomes were compared between the two groups through propensity score matching. The impact of moderate-severe diabetes (defined as hemoglobin A1c ≥ 7.0% or requiring insulin treatment) on neurological recovery was evaluated through multiple linear regression analysis. Results: Propensity score matching revealed no significant differences between the diabetic and nondiabetic groups in terms of American Spinal Injury Association (ASIA) impairment scale grade and mean total ASIA motor scores (AMS) at 6 months post-injury. Multiple linear regression analysis indicated that age on admission (B = −0.34; 95% confidence interval [CI], −0.59 to −0.08; P = 0.01), dementia (B = −16.50; 95% CI, −24.99 to −8.01; P < 0.01), and baseline total AMS (B = −0.62; 95% CI, −0.72 to −0.51; P < 0.01) were negative predictors of neurological recovery at 6 months post-injury. The presence of moderate-severe diabetes did not influence neurological recovery at 6 months post-injury. Conclusions: Diabetic patients with CSCI without bone injury achieved improvements in neurological function comparable to those of nondiabetic patients. Moderate-severe diabetes did not affect neurological recovery in patients with CSCI without bone injury.

DOI： 10.1177/21925682241297587

Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient's Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study 査読有り Open Access

Segi, N; Nakashima, H; Ito, S; Ouchida, J; Shiratani, Y; Shimizu, T; Suzuki, A; Terai, H; Kakutani, K; Kanda, Y; Tominaga, H; Kawamura, I; Ishihara, M; Paku, M; Takahashi, Y; Funaba, M; Funayama, T; Nakajima, H; Akeda, K; Hirai, T; Inoue, H; Nakanishi, K; Funao, H; Oshigiri, T; Otsuki, B; Kobayakawa, K; Tanishima, S; Hashimoto, K; Iimura, T; Sawada, H; Uotani, K; Manabe, H; Iwai, C; Yamabe, D; Hiyama, A; Seki, S; Goto, Y; Miyazaki, M; Watanabe, K; Nakamae, T; Kaito, T; Nagoshi, N; Kato, S; Watanabe, K; Imagama, S; Inoue, G; Furuya, T

GLOBAL SPINE JOURNAL 15 巻 ( 4 ) 頁： 2286 - 2299 2025年5月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Prospective multicenter study. Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments. Methods: We prospectively compared the data of 203 patients with spinal metastases at 2-3 consecutive segments who were divided into the following three groups: cervical, patients with cervical spine lesions; thoracic, patients with upper–middle thoracic spine lesions; and TL/L/S, patients with lesions at the thoracolumbar junction and lumbar and sacral regions. Preoperative and postoperative EuroQol 5-dimension (EQ5D) 5-level were compared. Results: All groups exhibited improvement in the Frankel grade, performance status, pain, Barthel index, EQ5D health state utility value (HSUV), and EQ5D visual analog scale (VAS) postoperatively. Although preoperative EQ5D HSUVs did not significantly differ between the groups (cervical, 0.461 ± 0.291; thoracic, 0.321 ± 0.292; and TL/L/S, 0.376 ± 0.272), the thoracic group exhibited significantly lower postoperative EQ5D HSUVs than the other two groups (cervical, 0.653 ± 0.233; thoracic, 0.513 ± 0.252; and TL/L/S, 0.624 ± 0.232). However, postoperative EQ5D VAS was not significantly different between the groups (cervical, 63.4 ± 25.8; thoracic, 54.7 ± 24.5; and TL/L/S, 61.7 ± 21.9). Conclusions: Palliative surgery for metastatic spinal tumors provided comparable QOL improvement, irrespective of the spinal segment involved. Patients with upper and middle thoracic spinal metastases had poorer QOL outcomes than those with metastases in other segments; however, sufficient QOL improvement was achieved.

DOI： 10.1177/21925682241297948

Impact of surgical treatment on patient reported outcome in patients with spinal metastases from prostate cancer 査読有り

Hirota, R; Oshigiri, T; Iesato, N; Emori, M; Teramoto, A; Shiratani, Y; Suzuki, A; Terai, H; Shimizu, T; Kakutani, K; Kanda, Y; Tominaga, H; Kawamura, I; Ishihara, M; Paku, M; Takahashi, Y; Funayama, T; Miura, K; Shirasawa, E; Inoue, H; Kimura, A; Iimura, T; Moridaira, H; Nakajima, H; Watanabe, S; Akeda, K; Takegami, N; Nakanishi, K; Sawada, H; Matsumoto, K; Funaba, M; Suzuki, H; Funao, H; Hirai, T; Otsuki, B; Kobayakawa, K; Uotani, K; Manabe, H; Tanishima, S; Hashimoto, K; Iwai, C; Yamabe, D; Hiyama, A; Seki, S; Goto, Y; Miyazaki, M; Watanabe, K; Nakamae, T; Kaito, T; Nakashima, H; Nagoshi, N; Kato, S; Imagama, S; Watanabe, K; Inoue, G; Furuya, T

JOURNAL OF ORTHOPAEDIC SCIENCE 30 巻 ( 3 ) 頁： 423 - 432 2025年5月

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

Objective: This study aimed to elucidate postoperative outcomes in patients with spinal metastases of prostate cancer, with a focus on patient-oriented assessments. Methods: This was a prospective multicenter registry study involving 35 centers. A total of 413 patients enrolled in the Japanese Association for Spine Surgery and Oncology Multicenter Prospective Study of Surgery for Metastatic Spinal Tumors were evaluated for inclusion. The eligible patients were followed for at least 1 year after surgery. The Frankel Classification, Eastern Cooperative Oncology Group Performance Status, visual analog scale for pain, face scale, Barthel Index, vitality index, indications for oral pain medication, and the EQ-5D-5L questionnaire were used for evaluating functional status, activities of daily living, and patient motivation. Results: Of the 413 eligible patients, 41 with primary prostate cancer were included in the study. The patient-oriented assessments indicated that the patients experienced postoperative improvements in quality of life and motivation in most items, with the improvements extending for up to 6 months. More than half of the patients with Frankel classifications B or C showed improved neurological function at 1 month after surgery, and most patients presented maintained or improved their classification at 6 months. Conclusion: Surgical intervention for spinal metastases of prostate cancer significantly improved neurological function, quality of life, and motivation of the patients. Consequently, our results support the validity of surgical intervention for improving the neurological function and overall well-being of patients with spinal metastases of prostate cancer.

DOI： 10.1016/j.jos.2024.07.012

Web of Science

Scopus

PubMed

Longitudinal transitions in frailty and health-related quality of life investigated by a 5-year community study 査読有り Open Access

Oishi, R; Segi, N; Okazaki, M; Ito, S; Ouchida, J; Yamauchi, I; Seki, T; Takegami, Y; Ishizuka, S; Hashizume, A; Hasegawa, Y; Imagama, S; Nakashima, H

SCIENTIFIC REPORTS 15 巻 ( 1 ) 頁： 15162 2025年4月

記述言語：英語出版者・発行元：Scientific Reports

The purpose of this study was to determine the association between frailty and quality of life (QOL) in a five-year longitudinal cohort of community-dwelling middle-aged and older adults and determine how to identify health-related QOL changes. This study included 124 volunteers (67 women; mean 65 years at baseline) who underwent health checkups in 2014 and 2019. The association between frailty status (robust, prefrail, frail), according to the Japanese Cardiovascular Health Study criteria, and health-related QOL, measured with the SF-36 questionnaire, were investigated. Five-year changes in frailty status were categorized into improved, maintained, and worsened groups. The baseline prevalence of prefrailty and frailty were 44.4% and 7.2%, respectively. Five years later, the frailty of 20 participants improved, 66 maintained frailty status, and frailty worsened in 38 participants. Significant trends toward higher scores on the physical component summary (PCS), role/social component summary (RCS), and subscales of physical functioning, role-physical, vitality, social functioning, and role-emotional were detected across groups with improvements in their frailty status from 2014 to 2019. The fully adjusted multivariable regression model revealed significantly higher PCS scores (β, 12.9; 95% confidence interval (CI), 6.0 to 19.9) and RCS scores (β, 13.6; 95% CI, 6.6 to 20.6) compared with the worsened group. In conclusion, this longitudinal cohort study demonstrates that frailty status is not static and improvements or maintenance of frailty are associated with better physical and social QOL outcomes. Addressing frailty early may reverse or mitigate its impact and improve the overall well-being of older adults.

DOI： 10.1038/s41598-025-99843-7

脊柱変形up-to-date Ⅲ.成人脊柱変形 2.診断成人脊柱変形における手術での矢状面アライメントの目標値査読有り

大内田隼, 中島宏彰, 伊藤定之, 世木直喜, 山内一平, 今釜史郎

別冊整形外科 1 巻 ( 87 ) 頁： 95 - 99 2025年4月

遅発性放射線障害が疑われる首下がり症候群の一例査読有り Open Access

大島和馬, 都島幹人, 富田浩之, 森下和明, 大山博己, 中島宏彰, 大内田隼, 長谷康弘, 今釜史郎, 金村徳相

Journal of Spine Research 16 巻 ( 4 ) 頁： 726 - 731 2025年4月

記述言語：日本語出版者・発行元：一般社団法人日本脊椎脊髄病学会

はじめに：首下がり症候群は頚椎の後弯により頭部が下垂する疾患である．首下がり症候群をきたしうる疾患は多彩であり，神経筋原性疾患やパーキンソン病などがある．近年，悪性腫瘍に対する治療の進歩はめざましく，長期生存する患者が増加しているが，その一方で放射線治療の晩期合併症として，首下がり症候群の報告が散見されるようになっている．我々は下咽頭癌に対して放射線治療された後，晩期合併症として首下がり症候群が生じた症例を経験した．症例：65歳．男性．53歳時に下咽頭癌に対して抗がん剤加療，左頚部郭清術と，強化療法として放射線照射の既往歴があった．61歳時に頚部痛，63歳時に首下がりが出現した．神経学的に無症候であったため原疾患の精査を先行するも診断に至らず，徐々に首下がりの増悪，両上肢の筋力低下や歩行時のふらつきなどの脊髄障害が出現したため，65歳時に後方除圧固定術を行った．術後も依然として原因が不明なため，放射線障害が原因と判断した．結語：今後も医療の発展により，がんサバイバーが増加することが見込まれ，放射線障害による首下がり患者が増加する可能性があり，首下がり症候群の原因の一つとして留意する必要がある．

DOI： 10.34371/jspineres.2025-0405

Open Access

CiNii Research

Response to Letter to the Editor Regarding: Multimodal Deep Learning-Based Radiomics Approach for Predicting Surgical Outcomes in Patients With Cervical Ossification of the Posterior Longitudinal Ligament 査読有り

Maki, S; Furuya, T; Katsumi, K; Nakajima, H; Honjoh, K; Watanabe, S; Kaito, T; Takenaka, S; Kanie, Y; Iwasaki, M; Furuya, M; Inoue, G; Miyagi, M; Ikeda, S; Imagama, S; Nakashima, H; Ito, S; Takahashi, H; Kawaguchi, Y; Futakawa, H; Murata, K; Yoshii, T; Hirai, T; Koda, M; Ohtori, S; Yamazaki, M

SPINE 50 巻 ( 8 ) 頁： E159 - E160 2025年4月

Risk Factors for Early 3-Month Postoperative Mortality in Metastatic Spinal Tumor Surgery: A JASA Multicenter Prospective Study. 査読有り

Uto T, Kato S, Yokogawa N, Shimizu T, Demura S, Shiratani Y, Suzuki A, Tamai K, Kakutani K, Kanda Y, Tominaga H, Kawamura I, Ishihara M, Paku M, Funayama T, Miura K, Shirasawa E, Inoue H, Kimura A, Iimura T, Moridaira H, Akeda K, Takegami N, Nakanishi K, Sawada H, Matsumoto K, Funaba M, Suzuki H, Nakajima H, Oshigiri T, Hirai T, Otsuki B, Kobayakawa K, Funao H, Uotani K, Tanishima S, Sairyo K, Hashimoto K, Iwai C, Seki S, Miyazaki M, Watanabe K, Nakamae T, Kaito T, Nakashima H, Nagoshi N, Imagama S, Watanabe K, Inoue G, Furuya T

Spine 2025年4月

Impact of Signal Intensity Change in MRI on the Clinical Outcomes of Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study. 査読有り

Nagoshi N, Egawa S, Yoshii T, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nishida N, Nagamoto Y, Oshima Y, Ando K, Nakashima H, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Moridaira H, Fujibayashi S, Katoh H, Kanno H, Watanabe K, Taneichi H, Imagama S, Kawaguchi Y, Takeshita K, Nakamura M, Matsumoto M, Yamazaki M

Spine 2025年4月

記述言語：英語出版者・発行元：Spine

Study Design. A multicenter prospective cohort study. Objective. To evaluate the clinical significance of intramedullary signal intensity (SI) changes on T2-weighted magnetic resonance imaging (MRI) in patients with cervical ossification of the posterior longitudinal ligament (OPLL) and assess their impact on surgical outcomes. Summary of Background Data. In OPLL, SI changes on MRI are frequently observed, but their prognostic significance remains unclear. While some studies associate SI changes with poor neurological function and recovery, others report a weak correlation. Methods. A total of 402 patients with cervical OPLL were analyzed. Patients were classified into SI (+) and SI (-) groups based on preoperative T2-weighted MRI. Clinical outcomes, including the Japanese Orthopaedic Association (JOA) score, the visual analog scale, and the JOA Cervical Myelopathy Evaluation Questionnaire, were evaluated preoperatively and at two years postoperatively. Multiple regression and logistic regression were performed to adjust for confounders. Results. A total of 348 cases (86.6%) were in the SI (+) group. Patients in the SI (+) group were older and had greater cervical range of motion (ROM). They exhibited lower preoperative JOA scores and more severe extremity pain. However, at two-year follow-up, neurological improvement, pain reduction, and patient-reported outcomes did not differ significantly between groups. Conclusion. SI changes on MRI are associated with worse preoperative neurological function and greater pain but do not predict inferior surgical outcomes. Surgical decompression remains effective regardless of SI changes, which can be valuable information for explaining the prognosis to patients in clinical practice.

DOI： 10.1097/BRS.0000000000005355

Scopus

PubMed

Is routine implant removal necessary after open reduction internal fixation of Lisfranc injuries? Comparing functional outcomes of routine and on-demand removal: A multicenter study 査読有り

Muto, S; Takegami, Y; Nakashima, H; Mishima, K; Kumagai, H; Imagama, S

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 56 巻 ( 4 ) 頁： 112240 2025年4月

記述言語：英語出版者・発行元：Injury

Introduction: Lisfranc joint injuries are a severe cause of disruption of foot stability and function, often requiring surgical intervention such as open reduction and internal fixation (ORIF). The necessity of routine implant removal after healing remains controversial. This study aimed to compare functional recovery and postoperative complications among patients undergoing routine, on-demand, or no implant removal following ORIF for Lisfranc fracture-dislocations. Materials and Methods: This multicenter retrospective study analyzed 188 patients treated with ORIF for Lisfranc fracture-dislocations. Patients were divided into three groups: routine removal (RR), on-demand removal (ODR), and no removal (NR). Functional outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at the final follow-up. Complications were categorized as implant-related or post-removal. AOFAS midfoot scores and complication rates were compared between the three groups. Results: The median AOFAS midfoot scores at the final follow-up were 92 (IQR 83.00–95.00) in the RR group, 95 (IQR 85.00–95.00) in the ODR group, and 95 (IQR 82.00–95.00) in the NR group, with no significant differences among the three groups (p > 0.05). Implant-related complications were comparable across the groups, although irritation was significantly more frequent in the ODR group (42.9 %) than in the RR (24.4 %) and NR (11.9 %) groups (p = 0.013). Post-removal complications occurred in two cases in the RR group, including one case of loss of correction requiring reoperation. Conclusion: Routine implant removal did not show superior outcomes in functional recovery or complication rates compared to selective removal or retention. Implant retention or selective removal based on individual needs minimizes complications and optimizes patient outcomes.

DOI： 10.1016/j.injury.2025.112240

Web of Science

Scopus

PubMed

Development of a YOLOv3-Based Model for Automated Detection of Thoracic Ossification of the Posterior Longitudinal Ligament and the Ligamentum Flavum on Plain Radiographs 査読有り Open Access

Ito, S; Nakashima, H; Segi, N; Ouchida, J; Yamauchi, I; Hirai, T; Oda, M; Mori, K; Yamazaki, M; Yoshii, T; Imagama, S

JOURNAL OF CLINICAL MEDICINE 14 巻 ( 7 ) 2025年3月

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

Background/Objectives: This study aims to develop and validate a YOLOv3-based deep learning model for detecting ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) on lateral thoracic radiographs, improving early diagnosis and screening accessibility. Methods: A retrospective dataset of 356 lateral thoracic radiographs, including 176 with OPLL or OLF and 180 controls, was annotated by spine surgeons. The YOLOv3 model was trained using data augmentation and evaluated via five-fold cross-validation, with accuracy, precision, recall, and F1-score compared to two spine surgeons. Results: The model achieved 80.6% accuracy, 70.3% precision, 92.6% recall, and 79.9% F1-score, surpassing spine surgeons in accuracy and recall, especially for combined OPLL and OLF cases. Detection accuracy was 81.1% for OPLL, 53.3% for OLF, and 86.3% for combined cases. Conclusions: The YOLOv3-based model provides high accuracy and robust detection of OPLL and OLF on plain radiographs, offering an efficient and accessible screening tool.

DOI： 10.3390/jcm14072389

Trabecular Bone Remodeling After Posterior Lumbar Interbody Fusion: Comparison of the Osseointegration in Three-Dimensional Porous Titanium Cages and Polyether-Ether-Ketone Cages Open Access

Segi, N; Nakashima, H; Ito, S; Ouchida, J; Yamauchi, I; Matsumoto, T; Kanbara, S; Ito, K; Imagama, S

GLOBAL SPINE JOURNAL 2025年3月

特集人工知能(AI)革命-脊椎脊髄診療の将来像は? AIによる後縦靭帯骨化症の画像診断と手術合併症リスク予測査読有り

伊藤定之, 中島宏彰, 世木直喜, 大内田隼, 今釜史郎

脊椎脊髄ジャーナル 38 巻 ( 4 ) 頁： 229 - 233 2025年3月

Clinical Outcomes Associated with Screw Loosening in S2 Alar-Iliac Fixation in Adult Spinal Deformity 査読有り Open Access

Nagatani, Y; Nakashima, H; Kanemura, T; Tsushima, M; Tomita, H; Morishita, K; Oyama, H; Ito, S; Segi, N; Ouchida, J; Yamauchi, I; Ode, Y; Okada, Y; Imagama, S

JOURNAL OF CLINICAL MEDICINE 14 巻 ( 6 ) 2025年3月

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

Purpose: To explore the clinical outcomes associated with screw loosening after S2 alar-iliac (SAI) screw fixation for adult spinal deformity (ASD). Overview of the literature: SAI fixation is widely used in ASD corrective surgery; despite the biomechanical advantages of this screw, complications such as screw loosening remain a significant concern. Methods: We retrospectively reviewed 27 patients undergoing corrective surgery for ASD using SAI as the distal fixation point at a single institution between February 2013 and February 2018. Patients were divided into non-loosening (N) and loosening (L) groups based on radiological evidence of screw loosening (radiolucent area of 1 mm around the screw) and compared for demographic characteristics, bone mineral density (T-score), spinal alignment parameters, and patient-reported outcome using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores. Results: Screw loosening was observed in 78% of patients (n = 21/27); however, there were no statistically significant differences between the N and L groups in terms of the preoperative and 5-year postoperative JOABPEQ scores (p > 0.05 across all domains) and spinal sagittal alignment (p > 0.05). The improvements achieved through corrective surgery were largely maintained regardless of the presence of screw loosening. Conclusions: SAI screw loosening is a common sequela in ASD surgery; however, its loosening might not affect long-term clinical outcomes. Therefore, the choice of fixation should be individualized based on patient factors such as age and bone quality.

DOI： 10.3390/jcm14061881

Pelvic ring ratio: a novel indicator of comprehensive pelvic alignment assessment Open Access

Nakashima, H; Kawakami, N; Ito, S; Segi, N; Ouchida, J; Yamauchi, I; Kanemura, T; Imagama, S

ASIAN SPINE JOURNAL 2025年3月

Predicting Postoperative Neurological Outcomes in Metastatic Spinal Tumor Surgery Using Machine Learning. 査読有り

Maki S, Shiratani Y, Orita S, Suzuki A, Tamai K, Shimizu T, Kakutani K, Kanda Y, Tominaga H, Kawamura I, Ishihara M, Paku M, Takahashi Y, Funayama T, Miura K, Shirasawa E, Inoue H, Kimura A, Iimura T, Moridaira H, Nakajima H, Watanabe S, Akeda K, Takegami N, Nakanishi K, Sawada H, Matsumoto K, Funaba M, Suzuki H, Funao H, Oshigiri T, Hirai T, Otsuki B, Kobayakawa K, Uotani K, Manabe H, Tanishima S, Hashimoto K, Iwai C, Yamabe D, Hiyama A, Seki S, Kato K, Miyazaki M, Watanabe K, Nakamae T, Kaito T, Nakashima H, Nagoshi N, Inoue G, Imagama S, Watanabe K, Kato S, Ohtori S, Furuya T, JASA Study Group

Spine 2025年3月

記述言語：英語出版者・発行元：Spine

Study Design. Retrospective analysis of data collected across multiple centers. Objective. To develop machine learning models for predicting neurological outcomes one month postoperatively in patients with metastatic spinal tumors undergoing surgery, and to identify key factors influencing neurological recovery. Summary of Background Data. The increasing prevalence of spinal metastases has led to a growing need for surgical intervention to address mechanical instability and neurological deficits. Predicting postoperative neurological status, as assessed by the Frankel classification, can provide valuable insights for surgical planning and patient counseling. Traditional prognostic models have shown limitations in capturing the complexity of neurological recovery patterns. Methods. We analyzed data from 244 patients who underwent spinal surgery for metastatic disease across 38 institutions. The primary outcome was functional ambulation, defined as Frankel grades D or E at one month postoperatively. Four machine learning algorithms (Random Forest, XGBoost, LightGBM, and CatBoost) were used to build predictive models. Feature selection employed the Boruta algorithm and Variance Inflation Factor analysis to reduce multicollinearity. Results. Among the 244 patients, the proportion of ambulatory patients (Frankel grades D or E) increased from 36.8% preoperatively to 63.1% at one month postoperatively. The Random Forest model achieved the highest area under the receiver operating characteristic curve (AUC-ROC) of 0.8516, followed by XGBoost (0.8351), CatBoost (0.8331), and LightGBM (0.8098). SHapley Additive exPlanations analysis identified preoperative Frankel classification, transfer ability, inflammatory markers (C-reactive protein, white blood cell-lymphocyte), and surgical timing as the most important predictors of postoperative outcomes. Conclusions. Machine learning models showed strong predictive performance in assessing postoperative neurological status for patients with metastatic spinal tumors. Key factors including preoperative neurological function, functional ability, and inflammation markers significantly influenced outcomes. These findings could inform surgical decision-making and help set realistic postoperative expectations while potentially improving patient care through more accurate outcome prediction.

DOI： 10.1097/BRS.0000000000005322

Scopus

PubMed

Early Versus Delayed Surgery for Elderly Traumatic Cervical Spinal Injury: A Nationwide Multicenter Study in Japan 査読有り Open Access

Segi, N; Nakashima, H; Ito, S; Yokogawa, N; Sasagawa, T; Watanabe, K; Nori, S; Funayama, T; Eto, F; Nakajima, H; Terashima, Y; Hirota, R; Hashimoto, K; Onoda, Y; Furuya, T; Yunde, A; Ikegami, S; Uehara, M; Suzuki, H; Imajo, Y; Uei, H; Sawada, H; Kawaguchi, K; Nakanishi, K; Suzuki, N; Oshima, Y; Hasegawa, T; Iizuka, Y; Tonomura, H; Terai, H; Akeda, K; Seki, S; Ishihara, M; Inoue, G; Funao, H; Yoshii, T; Kaito, T; Kiyasu, K; Tominaga, H; Kakutani, K; Sakai, D; Ohba, T; Otsuki, B; Miyazaki, M; Murotani, K; Okada, S; Imagama, S; Kato, S

GLOBAL SPINE JOURNAL 15 巻 ( 2 ) 頁： 1143 - 1154 2025年3月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Retrospective multicenter study. Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes. Methods: This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared. Results: Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory. Conclusions: Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.

DOI： 10.1177/21925682241227430

Fracture of the patella involving inferior pole is associated with postoperative patella baja - A retrospective multicenter study 査読有り

Murase, F; Takegami, Y; Tokutake, K; Oyama, H; Arakawa, O; Takatsu, T; Nakashima, H; Mishima, K; Imagama, S

JOURNAL OF ORTHOPAEDIC SCIENCE 30 巻 ( 2 ) 頁： 379 - 384 2025年3月

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

Background: The patella fracture involving of inferior pole fractures (IPF) may be associated with patella baja, However, the clinical impact of this condition remains unclear. This study aims to clarify 1) the incidence of patella baja following patellar fracture surgery, 2) the associated clinical outcomes with and without the presence of patella baja, and 3) the potential correlation between the detection of IPF on CT and the occurrence of patella baja. Methods: We conducted a retrospective multicenter study involving 251 patients who underwent surgical treatment for patellar fractures. Patients were divided into the patella baja (PB; n = 49) group and patella norma (PN; n = 202) group. Data collected included demographics, radiographic findings, surgical details, and postoperative complications. We compared these items between PB group and PN group. Logistic regression analyses were used to identify risk factors for patella baja. Results: Immediately following surgery, 36 (14.3%) patients presented with patella baja which increased to 49 cases (19.5%) at six months postoperatively. There is no statistically significant difference in the demographics, surgical details, clinical outcomes and complication between PB group and PN group. While, in the radiographical assessment, the prevalence of IPF on CT scan in the patella baja group was significantly higher than that in the patella norma group. By logistic regression analysis, IPFP on CT was identified as an independent risk factor for patella baja. (odds ratio 2.11, 95% confidence interval: 1.03–4.33, p = 0.042). Conclusion: In patients with patellar fractures, the incidence of patella baja increased from 14.3% immediately post-surgery to 19.5% at the six-month check-up. No significant differences were observed in clinical outcomes between the patella baja group and the norma group. The patella fracture involving IPF on CT emerged as a predictive factor for patella baja.

DOI： 10.1016/j.jos.2024.03.008

Web of Science

Scopus

PubMed

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