研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

分割表示 308 件中 21 - 40 件目／全件表示 >>

Characteristics of Poor Recordability of Intraoperative Neurophysiological Monitoring during Metastatic Spinal Tumor Surgery: A Multicenter Study Open Access

Segi N., Nakashima H., Funaba M., Hashimoto J., Kawabata S., Takahashi M., Yoshida G., Ushirozako H., Kurosu K., Shigematsu H., Takatani T., Morito S., Yamada K., Iwasaki H., Fujiwara Y., Yasuda A., Ando M., Taniguchi S., Wada K., Tadokoro N., Kobayashi K., Yamamoto N., Nakanishi K., Kanchiku T., Takeshita K., Matsuyama Y., Imagama S.

Spine Surgery and Related Research 9 巻 ( 2 ) 頁： 164 - 172 2025年

記述言語：英語出版者・発行元：Spine Surgery and Related Research

Introduction: The objective of this study is to investigate the poor recordability characteristics of intraoperative neurophysiological monitoring (IONM) for metastatic spinal tumors, focusing on tumor status or preoperative muscle weakness. Methods: A total of 132 patients (age 65.3±11.8 years; 82 men) with or without preoperative lower extremity muscle weakness were included in this study. The patients’ background characteristics, the presence and degree of pre- and postoperative muscle weakness, and the IONM outcome, including the availability of transcranial motor evoked potential (Tc-MEP) recording and the occurrence of Tc-MEP alarms, were investigated. The data between the groups with and without preoperative muscle weakness were compared. Logistic regression analysis was performed to identify the risk factors for unrecordable Tc-MEP. Results: Sixty-seven patients with muscle weakness had significantly more unrecordable Tc-MEP (19% vs. 5%, p=0.009) than the 65 patients without muscle weakness. The highest percentage of recordable Tc-MEP in the group with muscle weakness was noted in the plantar muscle (72%). Multivariate analysis identified manual muscle test (MMT) score of !3 (odds ratio [OR] 4.529) and ventral spinal cord compression by metastatic tumor (OR 3.924) as independent significant factors for unrecordable Tc-MEP. Conclusions: IONM for metastatic spinal cord tumors with muscle weakness had a high rate of unrecordable Tc-MEP. Additionally, Tc-MEP may not be detectable in cases of ventral spinal cord compression by a tumor; therefore, preoperative imaging should be thoroughly evaluated.

DOI： 10.22603/ssrr.2024-0260

Deep-Depth Probability-Maintained Notch Enabling Nonlinear Distortion Measurement for Various Modulation Formats Open Access

Li J., Ye T., Su X., Fan Y., Zhang K., Shi S., Nakashima H., Hoshida T., Tao Z., Mori Y., Hasegawa H.

Journal of Lightwave Technology 2025年

出版者・発行元：Journal of Lightwave Technology

Nonlinear distortion is critical for optical communication systems with a high baud rate and a high-order modulation format. Thus, a simple and accurate method to measure the nonlinear distortion is highly desired. Although simple notch, which directly removes the certain frequency components of nonlinear system input and then measures the regrowth components of nonlinear system output, is straightforward to measure nonlinear distortion, it is only applicable to the Gaussian signal. However, pulse amplitude modulation (PAM) and quadrature amplitude modulation (QAM), which are widely used in communication systems, are not Gaussian signals. In this study, we propose a deep-depth probability-maintained notch generation method for the PAM to accurately characterize the nonlinear distortion based on the signal spectrum measurement. Employing the proposed time order perturbation, the notch depth for PAM2/4/8 achieves 20/24/28 dB, which allows for a large dynamic range nonlinear distortion measurement for various modulation formats. The experiment demonstrates that the nonlinear noise power ratios are measured within a root mean square error of 0.6 dB for the uniform PAM2/4/8 as well as the probabilistic shaped PAM4/8. The proposed method is also applicable to square QAM formats because a square QAM is composed of two independent PAMs.

DOI： 10.1109/JLT.2025.3540066

Does Somatosensory-Evoked Potential Simultaneously Decrease with Transcranial Motor-Evoked Potential Alarm? A Multicenter Study by the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research Open Access

Shigematsu H., Yoshida G., Ushirozako H., Kurosu K., Tadokoro N., Funaba M., Kawabata S., Hashimoto J., Ando M., Taniguchi S., Takahashi M., Segi N., Nakashima H., Imagama S., Morito S., Yamada K., Takatani T., Kanchiku T., Fujiwara Y., Iwasaki H., Wada K., Yamamoto N., Kobayashi K., Yasuda A., Nakanishi K., Tanaka Y., Matsuyama Y., Takeshita K.

Spine Surgery and Related Research 9 巻 ( 2 ) 頁： 173 - 178 2025年

記述言語：英語出版者・発行元：Spine Surgery and Related Research

Introduction: Multimodal intraoperative neurophysiological monitoring (IONM)―such as monitoring muscle-evoked potentials after transcranial electrical stimulation (Tc-MEP) with somatosensory-evoked potential (SEP) after electrical stimulation of the peripheral nerve―is recommended in spine surgeries to prevent iatrogenic neurological complications. However, the effect of using Tc-MEP with SEP to protect against neurological complications, particularly motor function, remains unknown. In clinical settings, changes due to Tc-MEP meeting the alarm points must be a potential neurological injury. This retrospective study, focusing on true-positive (TP) cases, aimed to clarify the change in the SEP waveform simultaneously with the Tc-MEP alarm. Methods: We included 68 patients with TP who had Tc-MEP changes and new postoperative motor weakness at more than one level of the manual muscle test after surgery. We compared the cases based on the category of spine surgery and paralysis type. We evaluated sex, age at spine surgery (high- or non high-risk), and paralysis type (segmental, long tract, or both). We defined the alarm points as follows: >70% decrease in Tc-MEP wave amplitudes, >50% decrease in wave amplitudes, or 10% extension of SEP latency. Next, we evaluated the SEP wave changes with a Tc-MEP alarm. Results: All patients showed progressive motor weakness after surgery, and 21 patients (31%) showed SEP changes at the same time as the Tc-MEP alarm. There were no statistically significant differences in the ratio of SEP change between the two groups according to the spine surgery category or among the three groups according to the paralysis type. Conclusions: Multimodal IONM is an important tool. However, the SEP changes do not necessarily appear immediately after the Tc-MEP alarm. Spine surgeons should appropriately treat Tc-MEP alarms to preserve motor function, regardless of SEP changes.

DOI： 10.22603/ssrr.2024-0229

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 49 巻 ( 22 ) 頁： 1561 - 1569 2024年11月

記述言語：英語出版者・発行元：Spine

Study Design. A retrospective analysis. Objective. This research sought to develop a predictive model for surgical outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) using deep learning and machine learning (ML) techniques. Summary of Background Data. Determining surgical outcomes assists surgeons in communicating prognosis to patients and setting their expectations. Deep learning and ML are computational models that identify patterns from large data sets and make predictions. Methods. Of the 482 patients, 288 patients were included in the analysis. A minimal clinically important difference (MCID) was defined as gain in Japanese Orthopaedic Association (JOA) score of 2.5 points or more. The predictive model for MCID achievement at 1 year postsurgery was constructed using patient background, clinical symptoms, and preoperative imaging features (x-ray, CT, MRI) analyzed through LightGBM and deep learning with RadImagenet. Results. The median preoperative JOA score was 11.0 (IQR: 9.0-12.0), which significantly improved to 14.0 (IQR: 12.0-15.0) at 1 year after surgery (P < 0.001, Wilcoxon signed-rank test). The average improvement rate of the JOA score was 44.7%, and 60.1% of patients achieved the MCID. Our model exhibited an area under the receiver operating characteristic curve of 0.81 and the accuracy of 71.9% in predicting MCID at 1 year. Preoperative JOA score and certain preoperative imaging features were identified as the most significant factors in the predictive models. Conclusion. A predictive ML and deep learning model for surgical outcomes in OPLL patients is feasible, suggesting promising applications in spinal surgery.

DOI： 10.1097/BRS.0000000000005088

Prospective Registration Study for Establishing Minimal Clinically Important Differences in Patients Undergoing Surgery for Spinal Metastases 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

SPINE 49 巻 ( 22 ) 頁： 1539 - 1547 2024年11月

記述言語：英語出版者・発行元：Spine

Study Design. Multicenter, prospective registry study. Objective. To clarify minimal clinically important differences (MCIDs) for surgical interventions for spinal metastases, thereby enhancing patient care by integrating quality of life assessments with clinical outcomes. Background. Despite its proven usefulness in degenerative spinal diseases and deformities, the MCID remains unexplored regarding surgery for spinal metastases. Patients and Methods. This study included 171 (out of 413) patients from the multicenter "Prospective Registration Study on Surgery for Metastatic Spinal Tumors"by the Japan Association of Spine Surgeons. These were evaluated preoperatively and at 6 months postoperatively using the Face Scale, EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), including the Visual Analog Scale, and performance status. The MCIDs were calculated using an anchor-based method, classifying participants into the improved, unchanged, and deteriorated groups based on the Face Scale scores. Focusing on the improved and unchanged groups, the change in the EQ-5D-5L values from before to after treatment was analyzed, and the cutoff value with the highest sensitivity and specificity was determined as the MCID through receiver operating characteristic curve analysis. The validity of the MCIDs was evaluated using a distribution-based calculation method for patient-reported outcomes. Results. The improved, unchanged, and deteriorated groups comprised 121, 28, and 22 participants, respectively. The anchor-based MCIDs for the EQ-5D-5L index, EQ-Visual Analog Scale, and domains of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were 0.21, 15.50, 1.50, 0.50, 0.50, 0.50, and 0.50, respectively; the corresponding distribution-based MCIDs were 0.17, 15,99, 0.77, 0.80, 0.78, 0.60, and 0.70, respectively. Conclusion. We identified MCIDs for surgical treatment of spinal metastases, providing benchmarks for future clinical research. By retrospectively examining whether the MCIDs are achieved, factors favoring their achievement and risks affecting them can be explored. This could aid in decisions on surgical candidacy and patient counseling.

DOI： 10.1097/BRS.0000000000005062

Incremental cost-effectiveness ratio between titanium plate and hydroxyapatite block spacers in cervical laminoplasty for degenerative cervical myelopathy. 査読有り

Kagami Y, Nakashima H, Segi N, Ito S, Ouchida J, Ogura K, Shinjo R, Imagama S

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2024年11月

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

Introduction: Laminoplasty is a widely used surgical procedure to decompress the cervical spinal cord. Recently, titanium plates (TPs) have been used instead of conventional hydroxyapatite block (HA) spacers to prevent laminar reclosure. However, no study has compared the cost-effectiveness of TP and HA. Therefore, this study aimed to compare the cost-effectiveness and postoperative outcomes of laminoplasty using TP or HA. Methods: A total of 167 patients who underwent cervical laminoplasty at our institution were included in this study. Patients with cervical spinal cord injury, epidural hematoma, or follow-up of <1 year were excluded. Of the 167 patients, 69 underwent laminoplasty using TP (the TP group), and 98 underwent laminoplasty using HA (the HA group). The surgical costs and incremental cost-effectiveness ratio (ICER) were compared between the two groups. Additionally, the operation time, complications, Japanese Orthopaedic Association score, Hirabayashi recovery rate, and pre and postoperative cervical alignment on X-ray images were investigated. Results: The surgical costs were significantly higher in the TP group than in the HA group (HA, 7255 ± 1504 USD vs. TP, 11,642 ± 2492 USD, p < 0.01). The ICER was 21,935 USD per quality-adjusted life year in the TP group. The operation time was shorter in the TP group than in the HA group (HA, 70.0 ± 22.5 min vs. TP, 63.6 ± 19.3 min, p = 0.06). The Hirabayashi recovery rate and radiographic parameters were similar between the two groups. Implant displacements were significantly more common in the HA group than in the TP group (HA, 11.2 % vs. TP, 0 %, p < 0.01). Conclusions: The surgical costs and ICER with TPs were higher than those with HA spacers. However, no difference in the Hirabayashi recovery rate and postoperative radiological parameters was observed between the two groups, although the HA group had more implant displacements.

DOI： 10.1016/j.jos.2024.10.003

Safety and feasibility of intravenous administration of a single dose of allogenic-Muse cells to treat human cervical traumatic spinal cord injury: a clinical trial (vol 15, 259, 2024) 査読有り

Koda, M; Imagama, S; Nakashima, H; Ito, S; Segi, N; Ouchida, J; Suda, K; Matsumoto, SH; Komatsu, M; Endo, T; Suzuki, S; Inami, S; Ueda, H; Miyagi, M; Inoue, G; Takaso, M; Nagata, K; Yamada, H; Kamei, N; Nakamae, T; Suzuki, H; Nishida, N; Funaba, M; Kumagai, G; Furuya, T; Yamato, Y; Funayama, T; Takahashi, H; Yamazaki, M

STEM CELL RESEARCH & THERAPY 15 巻 ( 1 ) 頁： 402 2024年11月

記述言語：英語出版者・発行元：Stem Cell Research and Therapy

The original article contains two errors which the authors wish to address: On line 3 of page 3, the sentence should simply read, ‘B1 and B2, which indicates complete […]’, and the word ‘(Ref)’ should be disregarded. In Fig. 2C, the Y-axis label should instead read as ‘Change in total motor score’, and the word ‘lower’ should be disregarded’.

DOI： 10.1186/s13287-024-04044-0

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 頁： 21925682241297587 2024年11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 頁： 21925682241297948 2024年11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

Circulating miRNA-122 is associated with knee osteoarthritis progression: A 6-year longitudinal cohort study in the Yakumo study 査読有り

Funahashi, H; Takegami, Y; Osawa, Y; Nakashima, H; Ishizuka, S; Fujii, R; Yamada, H; Suzuki, K; Hasegawa, Y; Imagama, S

JOURNAL OF ORTHOPAEDIC SCIENCE 29 巻 ( 6 ) 頁： 1411 - 1416 2024年11月

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

Objective: The association between knee osteoarthritis (OA) and miRNAs has been widely reported. However, the utility of miRNAs as predictors of knee osteoarthritis (KOA) progression in longitudinal studies has not been reported. We aimed to identify circulating miRNAs (c-miRNAs) associated with KOA progression in the general population and to examine their potential use as predictors of KOA progression. Methods: In 2012 and 2018, 66 participants (128 knees) took part in a resident health check-up in the Yakumo study. If the KL classification progressed two or more levels, the patient was classified as having progressive OA. Quantitative real-time polymerase chain reaction was used to screen 21 c-miRNAs. The expression levels of those c-miRNAs were compared between the progressive OA group and non-progressive OA group using student-t-test. Logistic analysis was performed in c-miRNAs less than p < 0.10 in univariate analysis. Results: The progressive OA group consisted of 78 knees. The results of the comparison between the progressive OA group and the non-progressive OA group showed that six c-miRNAs as follows; let7d (p = 0.030), c-miRNA-122 (p < 0.001), 150 (p = 0.070), 199 (p = 0.078), 21 (p = 0.016) and 320 (p = 0.093) were extracted as factors related to the progression of knee OA. In addition, logistic regression analysis identified c-miRNA-122 as an independent factor involved in the progression of knee osteoarthritis (odds ratio: 1.510, 95% confidence interval: 1.060–2.140, p = 0.023). The ROC curve showed by c-miRNA-122 for the progression of OA risk had an area under the curve of 0.702 (95% CI: 0.609–0.795). The threshold of c-miRNA-122 was −4.609. Conclusion: The expression level of c-miRNA-122 was associated with the risk of KOA progression in community dwelling Japanese people.

DOI： 10.1016/j.jos.2023.10.004

Prevalence and treatment rates of osteoporosis among individuals with rotator cuff tears 査読有り

Kawashima, I; Ishizuka, S; Oba, H; Sakaguchi, T; Nakashima, H; Takegami, Y; Imagama, S

JOURNAL OF SHOULDER AND ELBOW SURGERY 33 巻 ( 11 ) 頁： e606 - e609 2024年11月

記述言語：英語出版者・発行元：Journal of Shoulder and Elbow Surgery

Background: The relationship between osteoporosis and rotator cuff tears has been reported previously. However, the treatment rate of osteoporosis in individuals with rotator cuff tear is still unknown. The aim of this study was to investigate the prevalence and treatment rate of osteoporosis in individuals with rotator cuff tears. Methods: In this cross-sectional study, we enrolled 207 participants. Participants underwent comprehensive assessments, including shoulder ultrasonographic examinations and quantitative ultrasound measurements for bone status evaluation. Osteoporosis diagnosis was predicated on a calcaneus ultrasound bone densitometry, and the cutoff value was set as a T score of −1.455, with reference to a previous report. Results: One hundred fifty-six participants were classified as individuals without rotator cuff tears (group A), and 51 participants were classified as those with (group B). The mean age in group A was significantly lower than that in group B (63 ± 10 vs. 68 ± 9, respectively; P = .003). In terms of the T score examined by quantitative ultrasound, the mean T score in group A was significantly higher than that in group B (−1.4 ± 1.3 vs. −1.9 ± 1.6, respectively; P = .0412). The percentage of subjects with a T score of −1.455 or less in group B was 60.8% (31/51). The proportion of subjects with a T score of −1.455 or less undergoing osteoporosis treatment was 14.5% (12/83) in group A and 12.9% (4/27) in group B, showing no significant difference. Conclusions: Participants with a rotator cuff tear had relatively high prevalence of osteoporosis. Among those with both a rotator cuff tear and osteoporosis, the proportion receiving osteoporosis treatment was l2.9%, a very low rate.

DOI： 10.1016/j.jse.2024.02.026

The prevalence and characteristics of diffuse idiopathic skeletal hyperostosis in the community-living middle-aged and elderly population: The Yakumo study 査読有り

Ohshima, K; Nakashima, H; Segi, N; Ito, S; Ouchida, J; Takegami, Y; Ishizuka, S; Hasegawa, Y; Imagama, S

JOURNAL OF ORTHOPAEDIC SCIENCE 29 巻 ( 6 ) 頁： 1346 - 1352 2024年11月

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

Background: The incidence of diffuse idiopathic skeletal hyperostosis (DISH) is increasing with the aging of the population. Asymptomatic DISH can decrease the spinal range of motion (ROM) and cause fractures. However, the prevalence or physical function of patients with DISH before experiencing fractures and other serious conditions is unclear. This study aimed to investigate the prevalence of DISH in the community residents on the basis of age and sex and characterize their physical function, ROM, and bone fragility. Methods: The subjects were community volunteers who attended a health checkup in 2018 and 2019. Overall, 455 subjects (mean age, 64.2 ± 9.7 years; 177 men) were included for analysis. We performed whole-spine lateral radiography for detecting DISH according to the criteria reported by Resnick. We compared the age, sex, body mass index (BMI), results of muscle strength and walking tests, ROM measured by SpinalMouse®, and quantitative ultrasound (QUS) of calcaneus with and without DISH. Results: DISH was detected in 83 (18.2%) cases. The DISH group was older (69.8 y.o. vs. 63.0 y.o.; p < 0.05) and comprised more men (prevalence: men, 27.7%; women, 12.2%; p < 0.001). BMI was high in the DISH group (24.8 vs. 23.3 kg/m2, p < 0.05). SpinalMouse measurements showed the DISH group had a significantly decreased ROM in the lumbar spine (43.2°, 57.2°, p < 0.05). The DISH group had a significantly lower T-score on the QUS measurement in the calcaneus (−2.0, −1.5, p < 0.05). There were, however, no significant differences between groups in both muscle strength test and walking test. Conclusion: Subjects with DISH had decreased ROM in the lumbar spine and bone mineral density in calcaneal QUS. However, physical functions such as muscle strength and walking ability were similar among subjects with and without DISH without subjective symptoms.

DOI： 10.1016/j.jos.2023.10.005

A class of chemical compounds enhances clustering of muscle nicotinic acetylcholine receptor in cultured myogenic cells 査読有り Open Access

Miyairi, Y; Ohkawara, B; Sato, A; Sawada, R; Ishii, H; Tomita, H; Inoue, T; Nakashima, H; Ito, M; Masuda, A; Hosono, Y; Imagama, S; Ohno, K

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 731 巻頁： 150400 2024年10月

記述言語：英語出版者・発行元：Biochemical and Biophysical Research Communications

Neuromuscular signal transmission is affected in various diseases including myasthenia gravis, congenital myasthenic syndromes, and sarcopenia. We used an ATF2-luciferase system to monitor the phosphorylation of MuSK in HEK293 cells introduced with MUSK and LRP4 cDNAs to find novel chemical compounds that enhanced agrin-mediated acetylcholine receptor (AChR) clustering. Four compounds with similar chemical structures carrying benzene rings and heterocyclic rings increased the luciferase activities 8- to 30-folds, and two of them showed continuously graded dose dependence. The effects were higher than that of disulfiram, a clinically available aldehyde dehydrogenase inhibitor, which we identified to be the most competent preapproved drug to enhance ATF2-luciferase activity in the same assay system. In C2C12 myotubes, all the compounds increased the area, intensity, length, and number of AChR clusters. Three of the four compounds increased the phosphorylation of MuSK, but not of Dok7, JNK. ERK, or p38. Monitoring cell toxicity using the neurite elongation of NSC34 neuronal cells as a surrogate marker showed that all the compounds had no effects on the neurite elongation up to 1 μM. Extensive docking simulation and binding structure prediction of the four compounds with all available human proteins using AutoDock Vina and DiffDock showed that the four compounds were unlikely to directly bind to MuSK or Dok7, and the exact target remained unknown. The identified compounds are expected to serve as a seed to develop a novel therapeutic agent to treat defective NMJ signal transmission.

DOI： 10.1016/j.bbrc.2024.150400

Risk factors for nonunion in femoral neck fracture patients with internal fixation: A multicenter (TRON group) retrospective study. 査読有り

Kurahashi S, Takegami Y, Tokutake K, Nakashima H, Mishima K, Yamauchi K, Imagama S

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2024年10月

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

Introduction: Femoral neck fractures (FNFs) are common in elderly individuals. When minimally displaced, they are typically treated with internal fixation. Nonunion is a complication of internal fixation of FNF, that sometimes necessitates reoperation. Radiographic parameters, including the Pauwels angle and posterior tilt angle, are risk factors for nonunion. However, these parameters are assessed solely in a two-dimensional context. We developed a novel radiographic parameter named the “Kindex.” This multicenter investigation aimed to identify risk factors for nonunion following FNF fixation and evaluate the validity of this index. Methods: This retrospective multicenter study collected data from 939 FNF patients who underwent internal fixation between 2016 and 2020 at 11 facilities (TRON group). The following exclusion criteria were applied: age <65, insufficient data, and Garden Stage III or IV fracture. Patient data, including age, sex, BMI, ASA classification, alcohol and smoking history, and comorbidities, were recorded. Radiographic measurements of the Pauwels angle and posterior tilt angle at the time of injury were used to calculate the Kindex. Correlations between the Pauwels angle, posterior tilt angle, Kindex, and nonunion were evaluated. A multivariate logistic regression analysis was performed to investigate independent risk factors for nonunion. A receiver operating characteristic (ROC) analysis was performed to determine the cutoff value of the Kindex, and the area under the curve (AUC) was calculated. Results: The study included 594 patients (males, n = 151; females, n = 443; average age, 80.9 years). Nonunion was observed in 13 cases (2.2 %). While the Pauwels angle and posterior tilt angle did not show significant correlations, the Kindex exhibited strong correlations with both parameters. In the multivariate analysis, the Kindex and renal impairment were independent risk factors for nonunion (Kindex: OR 1.06, p = 0.015; renal impairment: OR 1.48, p = 0.021). In the ROC analysis, a Kindex of 50 was identified as the optimal cutoff value (AUC 0.72). Conclusion: The nonunion rate after internal fixation of FNF was 2.2 %. Renal impairment and the Kindex were identified as independent risk factors. The Kindex at the time of injury may serve as a novel radiographic parameter to consider when evaluating the need for internal fixation in FNF cases.

DOI： 10.1016/j.jos.2024.09.002

Does global spinal alignment affect the use of walking aids after multi-segment spinal fixation for patients with ASD? A multicenter retrospective study 査読有り Open Access

Ouchida, J; Nakashima, H; Ito, S; Segi, N; Yamauchi, I; Oishi, R; Miyairi, Y; Morita, Y; Ode, Y; Nagatani, Y; Okada, Y; Tsushima, M; Machino, M; Ota, K; Tachi, H; Kagami, Y; Shinjo, R; Ohara, T; Tsuji, T; Kanemura, T; Imagama, S

EUROPEAN SPINE JOURNAL 33 巻 ( 10 ) 頁： 3833 - 3841 2024年10月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: This study aimed to clarify the relation between global spinal alignment and the necessity of walking aid use in patients with adult spinal deformity (ASD) and to investigate the impact of spinal fixation on mobility status after surgery. Methods: In total, 456 older patients with ASD who had multi-segment spinal fixation surgery and were registered in a multi-center database were investigated. Patients under 60 years of age and those unable to walk preoperatively were excluded. Patients were classified by their mobility status into the independent, cane, and walker groups. Comparison analysis was conducted using radiographic spinopelvic parameters and the previously reported global spine balance (GSB) classification. In addition, preoperative and 2 years postoperative mobility statuses were investigated. Results: Of 261 patients analyzed, 66 used walking aids (canes, 46; walkers, 20). Analysis of preoperative radiographical parameters showed increased pelvic incidence and pelvic incidence-lumbar lordosis mismatch in the walker group and increased sagittal vertebral axis in the cane and walker groups versus the independent group. Analysis of GSB classification showed a higher percentage of walker use in those with severe imbalance (grade 3) in the sagittal classification but not in the coronal classification. While postoperative radiographical improvements were noted, there was no significant difference in the use of walking aids before and 2 years after surgery (P = 0.085). Conclusion: A significant correlation was found between “sagittal” spinal imbalance and increased reliance on walking aids, particularly walkers. However, the limitation of improvement in postoperative mobility status suggested that multiple factors influence the mobility ability of elderly patients with ASD.

DOI： 10.1007/s00586-024-08380-w

Longitudinal impact of multi-segment spinal fixation surgery on mobility status and clinical outcomes in adult spinal deformity: a multicenter retrospective study 査読有り Open Access

Ouchida, J; Nakashima, H; Ito, S; Segi, N; Yamauchi, I; Oishi, R; Miyairi, Y; Morita, Y; Ode, Y; Nagatani, Y; Okada, Y; Tsushima, M; Kanemura, T; Machino, M; Ohara, T; Ota, K; Tachi, H; Tsuji, T; Kagami, Y; Shinjo, R; Imagama, S

EUROPEAN SPINE JOURNAL 33 巻 ( 10 ) 頁： 3894 - 3903 2024年10月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: To investigate changes in postoperative mobility status in patients with ASD, and the determining factors that influence these changes and their impact on clinical outcomes, including the rate of home discharge and long-term mobility. Methods: A total of 299 patients with ASD who underwent multi-segment posterior spinal fusion were registered in a multi-center database were investigated. Patient mobility status was assessed using walking aids and classified into five levels (1: independent, 2: cane, 3: walker, 4: assisted, and 5: wheelchair) preoperatively, at discharge, and after 2 years. We determined improvements or declines in the patient's mobility based on changes in the classification levels. The analysis focused on the factors contributing to the deterioration of postoperative mobility. Results: Two years postoperatively, 87% of patients maintained or improved mobility. However, 27% showed decreased mobility status at discharge, associated with a lower rate of home discharge (49% vs. 80% in the maintained mobility group) and limited improvement in mobility status (35% vs. 5%) after 2 years. Notably, postoperative increases in thoracic kyphosis (7.0 ± 12.1 vs. 2.0 ± 12.4°, p = 0.002) and lower lumbar lordosis (4.2 ± 13.1 vs. 1.8 ± 12.6°, p = 0.050) were substantial factors in mobility decline. Conclusion: Postoperative mobility often temporarily decreases but generally improves after 2 years. However, an overcorrection in sagittal alignment, evidenced by increased TK, could detrimentally affect patients’ mobility status. Transient mobility decline associated with overcorrection may require further rehabilitation or hospitalization. Further studies are required to determine the biomechanical effects of surgical correction on mobility.

DOI： 10.1007/s00586-024-08397-1

Peri-implant fractures after Intramedullary fixation for femoral trochanteric fracture: a multicenter (TRON Group) study 査読有り

Kaneda, T; Takegami, Y; Tokutake, K; Nakashima, H; Mishima, K; Mabuchi, M; Imagama, S

EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY 50 巻 ( 5 ) 頁： 2587 - 2594 2024年10月

記述言語：英語出版者・発行元：European Journal of Trauma and Emergency Surgery

Background: With the rise in elderly populations, the incidence of femoral trochanteric fractures has also increased. Although intramedullary nail therapy is commonly used, the incidence of peri-implant fractures (PIFs) as a complication and its associated factors are not fully understood. The purpose of this study was to determine the incidence of PIFs and treatment strategies and outcomes. Methods: A retrospective study across 11 hospitals from 2016 to 2020 examined 1855 patients with femoral trochanter fracture. After excluding 69 patients treated without intramedullary nailing, 1786 patients were analyzed. Parameters studied included age, sex, body mass index, medical history, and treatment methods. PIFs were categorized using the Chan classification. Treatment outcomes and patient mobility were assessed using the Parker Mobility Score, and postoperative complications and one-year survival data were compiled. Results: The incidence of PIFs was 8 in 1786 cases. Chan classification showed 1 case of N1A, 6 of N2A, and 1 of N2B. Only the type N1 case was a transverse fracture, whereas all cases of type N2 were oblique fractures. Among these cases, five patients had fractures extending to the upper part of the femoral condyle. The patient with N1A and one bedridden patient with N2A fracture underwent conservative treatment, one patient with N2A in which the fracture did not extend to the condyle was treated with nail replacement, and 5 patients (N2A: 4, N2B: 1) with fractures extending to the condyle were treated with additional plate fixation. All patients had survived at one year after treatment for PIF, and no reoperations were required. Conclusions: The incidence of PIF was very low (0.45%). Of the 6 PIF cases, excluding the bedridden patients, the treatment of choice for PIF was an additional plate if the fracture line extended to the femoral condyle; otherwise, the nail was replaced. All patients achieved bony fusion. Level of evidence: Therapeutic Level IV.

DOI： 10.1007/s00068-024-02567-y

Ten-Year Follow-up of Posterior Decompression and Fusion Surgery for Thoracic Ossification of the Posterior Longitudinal Ligament 査読有り

Ito, S; Nakashima, H; Segi, N; Ouchida, J; Oishi, R; Yamauchi, I; Miyairi, Y; Morita, Y; Ode, Y; Imagama, S

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME 106 巻 ( 17 ) 頁： 1600 - 1609 2024年9月

記述言語：英語出版者・発行元：Journal of Bone and Joint Surgery

Background: We evaluated the clinical, functional, and quality of life (QoL) outcomes of surgical treatment of thoracic ossification of the posterior longitudinal ligament (T-OPLL). Methods: We retrospectively evaluated 51 patients followed for ‡10 years after posterior decompression and corrective fusion surgery for T-OPLL. The data collected included demographics, comorbidities, and pre- and postoperative symptoms. The Japanese Orthopaedic Association (JOA) score, numerical rating scale (NRS) for back and leg pain, and EuroQol-5 Dimension-5 Level (EQ-5D-5L) were used to assess neurological function, pain, and QoL. Imaging evaluations were conducted to assess changes in kyphotic angles and ossification progression. Results: A significant improvement was observed in the JOA score from preoperatively (3.7) to 2 years postoperatively (7.9) (p < 0.05); the score remained stable thereafter. The mean EQ-5D-5L score improved from 0.53 preoperatively to 0.68 at 10 years postoperatively (p < 0.001). NRS scores for back and leg pain decreased from 5.4 to 3.5 and 4.0 to 3.0, respectively, from preoperatively to 10 years (p < 0.001 for both). Radiographic outcomes showed changes in kyphotic angles and ossification areas, with no significant progression after 2 years. Fourteen (27.5%) of the patients experienced postoperative complications. Of these, 8 (15.7%) required reoperation, 6 (11.8%) in the perioperative period and 2 (3.9%) later. Four (7.8%) of the patients underwent additional surgeries for conditions including lumbar spinal canal stenosis and cervical OPLL. Nonetheless, physical function in all cases with postoperative complications or additional surgery remained stable over the decade. Conclusions: Surgical treatment of T-OPLL is effective in improving neurological function, QoL, and pain management over an extended period. The long-term outcomes of T-OPLL surgery revealed that, although cervical and lumbar spinal lesions led to reoperations, they did not affect QoL, and relative improvement was maintained even after 10 years. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

DOI： 10.2106/JBJS.23.01475

Trabecular Bone Remodeling After Posterior Lumbar Interbody Fusion: Comparison of Three-Dimensional Porous Tantalum and Titanium-Coated Polyetheretherketone Interbody Cages 査読有り

Segi, N; Nakashima, H; Shinjo, R; Kagami, Y; Machino, M; Ito, S; Ouchida, J; Morishita, K; Oishi, R; Yamauchi, I; Imagama, S

GLOBAL SPINE JOURNAL 14 巻 ( 7 ) 頁： 2106 - 2115 2024年9月

担当区分：責任著者記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Retrospective cohort study Objectives: The criteria for determining completion of intervertebral stability after posterior lumbar interbody fusion (PLIF) remain controversial. Several new radiological indicators of bone growth and osteointegration have been established. We compared computed tomography (CT) findings related to osteointegration after PLIF with interbody cages of two different materials and designs. Methods: We retrospectively analyzed data from 103 patients who underwent PLIF with three-dimensional porous tantalum (Tn) cages or titanium-coated polyetheretherketone (TiP) cages. CT images obtained 3 months and 1 year after surgery were examined for trabecular bone remodeling (TBR), cancellous condensation (CC), and vertebral endplate cyst (VEC) formation. The incidences of each finding were compared by cage type, and rates of instrument failure and pseudarthrosis were determined. Results: Three months postoperatively, 87% of the levels with Tn cages exhibited TBR, whereas 96% of those with TiP cages did not (P <.001). Most levels with Tn cages levels exhibited TBR and no CC 3 months (81%) and 1 year (94%) after surgery. Although 78% of levels with TiP cages exhibited CC and no TBR 3 months after surgery, 59% exhibited both CC and TBR 1 year after surgery. Significantly fewer VECs formed around the Tn cages than around the TiP cages both 3 months (P =.002) and 1 year (P <.001) after surgery. Implant-related problems occurred at levels that exhibited neither TBR nor CC. Conclusions: The porous tantalum cage may enable intervertebral stability that is comparable to bony fusion soon after surgery.

DOI： 10.1177/21925682231170613

Safety and feasibility of intravenous administration of a single dose of allogenic-Muse cells to treat human cervical traumatic spinal cord injury: a clinical trial 査読有り

Koda, M; Imagama, S; Nakashima, H; Ito, S; Segi, N; Ouchida, J; Suda, K; Matsumoto, SH; Komatsu, M; Endo, T; Suzuki, S; Inami, S; Ueda, H; Miyagi, M; Inoue, G; Takaso, M; Nagata, K; Yamada, H; Kamei, N; Nakamae, T; Suzuki, H; Nishida, N; Funaba, M; Kumagai, G; Furuya, T; Yamato, Y; Funayama, T; Takahashi, H; Yamazaki, M

STEM CELL RESEARCH & THERAPY 15 巻 ( 1 ) 頁： 259 2024年8月

記述言語：英語出版者・発行元：Stem Cell Research and Therapy

Introduction: Spinal cord injury (SCI) is a devastating injury and remains one of the largest medical and social burdens because of its intractable nature. According to the recent advances in stem cell biology, the possibility of spinal cord regeneration and functional restoration has been suggested by introducing appropriate stem cells. Multilineage-differentiating stress enduring (Muse) cells are a type of nontumorigenic endogenous reparative stem cell. The positive results of Muse cell transplantation for SCI was shown previously. As a first step for clinical application in human SCI, we conducted a clinical trial aiming to confirm the safety and feasibility of intravenously injected donor-Muse cells. Methods: The study design of the current trial was a prospective, multicenter, nonrandomized, nonblinded, single-arm study. The clinical trial registration number was JRCT1080224764. Patients with a cervical SCI with a neurological level of injury C4 to C7 with the severity of modified Frankel classification B1 and B2 were included. A primary endpoint was set for safety and feasibility. Our protocol was approved by the PMDA, and the trial was funded by the Life Science Institute, Tokyo, Japan. The present clinical trial recruited 10 participants (8 males and 2 females) with an average age of 49.3 ± 21.2 years old. All 10 participants received a single dose of allogenic CL2020 (a total of 15 × 106 cells, 2.1–2.7 × 105 cells/kg of body weight), which is a Muse cell-based product produced from human mesenchymal stem cells, by an intravenous drip. Results: There were two reported severe adverse events, both of which were determined to have no causal relationship with Muse cell treatment. The change in the ISNCSCI motor score, the activity of daily living and quality of life scores showed statistically significant improvements compared to those data at the time of CL2020 administration. Conclusion: In the present trial, no safety concerns were identified, and Muse cell product transplantation demonstrated good tolerability. Future clinical trials with appropriate study designs incorporating a control arm will clarify the definitive efficacy of single-dose allogenic Muse cell treatment with intravenous administration to treat SCI. Trial registration: jRCT, JRCT1080224764. Registered 03 July 2019, https://jrct.niph.go.jp/latest-detail/jRCT1080224764.

DOI： 10.1186/s13287-024-03842-w

　前のページ - 次のページ　

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16