研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

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Intramedullary cavernous hemangioma of the spinal cord with intra- and extramedullary hematomas 査読有り Open Access

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

JOURNAL OF ORTHOPAEDIC SCIENCE 28 巻 ( 4 ) 頁： 937 - 941 2023年7月

Cervical Spinal Cord Compression in Adult Scoliosis 査読有り Open Access

Nakashima, H; Kawakami, N; Ohara, T; Saito, T; Tauchi, R; Imagama, S

GLOBAL SPINE JOURNAL 13 巻 ( 6 ) 頁： 1576 - 1581 2023年7月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Retrospective cohort study. Objectives: The aim was to examine cervical spinal cord compression (SCC) in adult scoliosis and clarify the prevalence of and risk factors for cervical SCC. Methods: This study included 270 adult scoliosis patients and 1211 healthy volunteers. Cervical SCC was evaluated on cervical magnetic resonance imaging (MRI). The rates of SCC for those with adult scoliosis and the healthy volunteers were compared. Logistic regression analysis was conducted to examine the factors associated with cervical SCC on MRI. Results: In cases with adult scoliosis, preoperative major scoliosis curve was 56.0° ± 18.8°, and cervical SCC was detected in 25 patients (9.3%). Among the healthy volunteers, 64 cases with cervical SCC were detected. Only in cases with adult scoliosis, logistic regression analysis revealed higher age (OR 1.09, 95% CI 1.04–1.14, P <.001), narrow canal diameter (OR 2.27, 95% CI 1.35–3.85, P =.002), and inferior sagittal balance (OR 2.45, 95% CI 1.02–5.89, P =.04) as significant risk factors. In the logistic regression analysis in all subjects (including adult scoliosis and healthy volunteers), higher age (OR 1.08, 95% CI 1.06–1.10, P <.001) and narrow canal diameter (OR 1.62, 95% CI 1.37–1.92, P <.001) were also found to be significant risk factors, but the presence of scoliosis was not a significant factor. Conclusions: Adult scoliosis itself was not significantly associated with cervical SCC. Inferior sagittal balance in addition to scoliosis constituted a significant risk factor for cervical SCC.

DOI： 10.1177/21925682211041979

Differences in Involvement of Whole-Body Compensatory Alignment for Decompensated Spinopelvic Sagittal Balance 査読有り Open Access

Ouchida, J; Nakashima, H; Kanemura, T; Ito, K; Tsushima, M; Machino, M; Ito, S; Segi, N; Ode, Y; Imagama, S

JOURNAL OF CLINICAL MEDICINE 12 巻 ( 14 ) 2023年7月

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

Background: The aim of this study was to investigate the differences in the involvement of whole-body compensatory alignment in different conditions of spinopelvic sagittal balance (compensated/decompensated). Methods: We enrolled 330 individuals who underwent medical checkups and divided them according to sagittal vertical axis (SVA): for the compensated group, this was <4 cm, (group C) and for the decompensated group, it was ≥4 cm, (group D). The correlation between the lack of ideal lumbar lordosis (iLL), which was calculated by using the Schwab formula, and the compensatory radiographic parameters in each group was analyzed. The threshold value of knee flexion (KF) angle, which indicated spinopelvic sagittal imbalance (SVA ≥ 4), was determined by a ROC-curve analysis. Results: The correlation analysis of the lack of iLL and each compensatory parameter showed a strong correlation for pelvic tilt (PT) (r = −0.723), and a weak correlation for thoracic kyphosis (TK) (r = 275) in Group C. In Group D, the correlations were strong for PT (r = −0.796), and moderate for TK (r = 0.462) and KF (r = −0.415). The optimal cutoff value for the KF angle was determined to be 8.4 degrees (sensitivity 89%, specificity 46%). Conclusions: The present study shows differences between compensated/decompensated spinopelvic sagittal balance in the correlation strength between lack of iLL and whole-body compensatory parameters.

DOI： 10.3390/jcm12144690

Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament 査読有り

Miyagi, M; Inoue, G; Yoshii, T; Egawa, S; Sakai, K; Kusano, K; Nakagawa, Y; Hirai, T; Wada, K; Katsumi, K; Kimura, A; Furuya, T; Nagoshi, N; Kanchiku, T; Nagamoto, Y; Oshima, Y; Nakashima, H; Ando, K; Takahata, M; Mori, K; Nakajima, H; Murata, K; Matsunaga, S; Kaito, T; Yamada, K; Kobayashi, S; Kato, S; Ohba, T; Inami, S; Fujibayashi, S; Katoh, H; Kanno, H; Koda, M; Takahashi, H; Ikeda, S; Imagama, S; Kawaguchi, Y; Takeshita, K; Matsumoto, M; Takaso, M; Okawa, A; Yamazaki, M

CLINICAL SPINE SURGERY 36 巻 ( 6 ) 頁： E277 - E282 2023年7月

記述言語：英語出版者・発行元：Clinical Spine Surgery

Study Design: A prospective multi-institutional observational study. Objective: To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). Summary of Background Data: Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. Methods: Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. Results: The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. Conclusions: The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. Level of Evidence: IV.

DOI： 10.1097/BSD.0000000000001449

Spinopelvic Imbalance Is Associated With Increased Sway in the Center of Gravity: Validation of the "Cone of Economy" Concept in Healthy Subjects 査読有り Open Access

Segi, N; Nakashima, H; Ando, K; Kobayashi, K; Seki, T; Ishizuka, S; Takegami, Y; Machino, M; Ito, S; Koshimizu, H; Tomita, H; Hasegawa, Y; Imagama, S

GLOBAL SPINE JOURNAL 13 巻 ( 6 ) 頁： 1502 - 1508 2023年7月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Cross-sectional study. Objectives: To investigate the effects of pelvic compensation on standing balance in healthy volunteers. Methods: The 180 healthy volunteers were recruited at a basic health checkup. The inclusion criteria were: 1) age ≥ 65 years, 2) underwent a whole spine radiograph and stabilometry, 3) well-balanced standing posture with a sagittal vertical axis <50 mm, and 4) a visual analog scale of lower back pain of <20 mm. Based on the pelvic incidence (PI) and lumbar lordosis (LL) mismatch, subjects were divided into harmonious (PI–LL ≤ 10°) or unharmonious (PI–LL > 10°) groups. Results: Participants in the unharmonious group were significantly older compared with the harmonious group (70.2 ± 4.4 vs. 72.0 ± 4.6 years, P <.01). The PI minus LL values were −2.2° ± 7.5° and 16.6° ± 7.0° in the harmonious and unharmonious groups, respectively (P <.001). Anteroposterior LNG/TIME (average center of pressure sway speed) was significantly greater in the unharmonious group with both open and closed eyes (1.04 ± 0.38 cm/s vs. 1.25 ± 0.47 cm/s, P <.001 and 1.22 ± 0.54 cm/s vs. 1.58 ± 0.77 cm/s, P <.001, respectively). Lateral LNG/TIME was significantly greater in the unharmonious group only with closed eyes (1.24 ± 0.54 cm/s vs. 1.47 ± 0.79 cm/s, P =.03). Conclusions: Healthy elderly subjects with poor spinopelvic harmony had relatively unstable standing balance. The “cone of economy” was demonstrated, showing that unharmonious spinopelvic balance had a non-economic effect on standing.

DOI： 10.1177/21925682211038897

Blunt Cerebrovascular Injury in the Elderly With Traumatic Cervical Spine Injuries: Results of a Retrospective Multi-Center Study of 1512 Cases in Japan 査読有り Open Access

Suzuki, H; Funaba, M; Imajo, Y; Yokogawa, N; Sasagawa, T; Ando, K; Nakashima, H; Segi, N; Funayama, T; Eto, F; Watanabe, K; Yamane, J; Furuya, T; Nakajima, H; Hasegawa, T; Terashima, Y; Ikegami, S; Inoue, G; Kaito, T; Kato, S

JOURNAL OF NEUROTRAUMA 40 巻 ( 11-12 ) 頁： 1164 - 1172 2023年6月

記述言語：英語出版者・発行元：Journal of Neurotrauma

This study is nationwide retrospective multi-center study to investigate the incidence and characteristics of blunt cerebrovascular injury (BCVI) in elderly Japanese patients with traumatic cervical spine injuries (CSI) including spinal cord injury (SCI) without major bone injury. The study enrolled 1512 patients (average age: 75.8 ± 6.9 years; 1007 males, 505 females) from 33 nationwide institutions, and 391 (26%) of the participants had digital subtraction angiography and/or computed tomography angiography. Fifty-three patients were diagnosed as having BCVI by angiography. We assessed neurological evaluation, comorbidities and classification of CSI in the elderly patients with/without BCVI and collected 6-month follow-up data on treatment, complications, and patient outcome. We also statistically analyzed the relative risk (RR) and relationship between BCVI and other factors. Significant differences were identified between BCVI (+) (n = 53) and (-) (n = 1459) patients with American Spinal Injury Association Impairment Scale (ASIA) A, C, D, cervical fracture, C3-7 injury level (AO type F and/or C), cervical dislocation, spinal surgery for CSI, tetraplegia type of SCI, and/or head injury. Fifty-three (3.5%) elderly patients had CSI complicated by BCVI including 10 (19%) cases of Denver grade I, four (7%) of grade II, 1 (2%) of grade III, 29 (55%) of grade IV, and nine (17%) of grade V. Sixteen cases were treated by interventional radiology. Rates of mortality and brain infarction from BCVI were 0.13% and 0.40%, respectively. RR of BCVI was significantly higher in the elderly cervical injury patients with head injury, severe neurological deficit, ASIA A (RR: 4.33), cervical fracture at the C3-7 level (RR: 7.39), and cervical dislocation at the C1-6 level (RR: 3.06-7.18). In conclusion, 53 (3.5%) elderly patients were complicated with BCVI. BCVI more frequently complicated head injury, severe neurological deficit (ASIA A or tetraplegia), AO type F, and/or C fractures and cervical dislocation in these patients. Six patients (11%) suffered brain infarction and two patients died from BCVI.

DOI： 10.1089/neu.2022.0180

Relationship between lumbosacral transitional vertebra and postoperative outcomes of patients with Lenke 5C adolescent idiopathic scoliosis: a minimum 5-year follow-up study 査読有り

Yamauchi, I; Nakashima, H; Machino, M; Ito, S; Segi, N; Tauchi, R; Ohara, T; Kawakami, N; Imagama, S

EUROPEAN SPINE JOURNAL 32 巻 ( 6 ) 頁： 2221 - 2227 2023年6月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: To assess the incidence of lumbosacral transitional vertebra (LSTV) in Lenke 5C adolescent idiopathic scoliosis (AIS) and evaluate the relationship between postoperative outcomes and LSTV when the lowest instrumented vertebra (LIV) is fixed at L3. Methods: The study included 61 patients with Lenke 5C AIS who underwent fusion surgery of L3 as the LIV who were followed-up for a minimum of 5 years. Patients were divided into two groups: LSTV + and LSTV-. Demographic, surgical, and radiographic data, including L4 tilt and thoracolumbar/lumbar (TL/L) Cobb angle, were obtained and analyzed. Results: LSTV was observed in 15 patients (24.5%). The L4 tilt was not significantly different between the two groups preoperatively (P = 0.54); however, it was significantly greater in the LSTV group postoperatively (2 weeks: LSTV + = 11.7 ± 3.1, LSTV − = 8.8 ± 3.2, P = 0.013; 2 years: LSTV + = 11.5 ± 3.5, LSTV − = 7.9 ± 4.1, P = 0.006; 5 years: LSTV + = 9.8 ± 3.1, LSTV − = 7.3 ± 4.5, P= 0.042). The postoperative TL/L curve was greater in the LSTV + group, with significant differences at 2 weeks and 2 years postoperatively (preoperative: LSTV + = 53.5 ± 11.2, LSTV − = 51.7 ± 10.3,P = 0.675; 2 weeks: LSTV + = 16.1 ± 5.0, LSTV- = 12.2 ± 6.6, P = 0.027; 2 years: LSTV + = 21.7 ± 5.9, LSTV − = 17.6 ± 5.9, P = 0.035; 5 years: LSTV + = 18.7 ± 5.8, LSTV − = 17.0 ± 6.1, P = 0.205). Conclusion: The prevalence of LSTV in Lenke 5C AIS patients was 24.5%. Lenke 5C AIS patients with LSTV with the LIV at L3 had a significantly greater postoperative L4 tilt than those without LSTV and retained the TL/L curve.

DOI： 10.1007/s00586-023-07752-y

新しい医療技術新しいLLIFの手術手技　ACR法

伊藤研悠, 金村徳相, 中島宏彰, 都島幹人, 富田浩之, 種市洋

整形・災害外科 66 巻 ( 6 ) 頁： 737 - 742 2023年5月

Metabolic syndrome reduces spinal range of motion: The Yakumo study 査読有り Open Access

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

JOURNAL OF ORTHOPAEDIC SCIENCE 28 巻 ( 3 ) 頁： 547 - 553 2023年5月

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

Background: Excess visceral fat can accumulate owing to lack of exercise. The relationship between metabolic syndrome (MetS) and spinal range of motion (ROM) is not clear. The purpose of this study was to investigate the relationship between MetS and spinal alignment and ROM. Methods: Orthopedic evaluation was prospectively performed in 544 participants. The participants were classified into two groups on the basis of the Japanese-specific MetS criteria proposed by the Japanese Committee of the Criteria for MetS (JCCMS). Lower back pain (LBP), knee joint pain with the visual analog scale (VAS), Kellgren–Lawrence (K–L) grade for knee osteoarthritis, body mass index (BMI), and spinal alignment and ROM were evaluated. Results: Forty-four (8.1%) were diagnosed as having MetS. The prevalence rate of K–L grade 4 in the MetS group was significantly higher than that in the non-MetS group (p < 0.05). When sex, age, and BMI were evaluated as covariates, there were significant differences in the VAS score for knee pain (non-MetS group vs MetS group: 13.7 vs 23.3, p < 0.05), L1–S1 flexion spinal ROM (44.1° vs 38.1°, p < 0.001), flexion spinal inclination angle (SIA) ROM (107.6° vs 99.3°, p < 0.01), and SIA ROM (135.4° vs 124.0°, p < 0.05). Conclusions: Knee pain increased and flexion spinal ROM decreased significantly in the MetS group as compared with non-MetS group. Systemic factors associated with MetS may have a specific impact on spinal ROM while promoting knee osteoarthrosis and increased knee pain.

DOI： 10.1016/j.jos.2022.02.008

特集脊椎脊髄領域の画像診断-最新の知識と進歩 Ⅴ.AIを用いた脊椎脊髄疾患の画像診断の進歩深層学習を用いたMRIでの脊髄腫瘍自動診断システム

伊藤定之, 中島宏彰, 町野正明, 小田昌宏, 森健策, 今釜史郎

整形・災害外科 66 巻 ( 5 ) 頁： 657 - 665 2023年4月

Anatomical Analysis of the Gonadal Veins and Spine in Lateral Lumbar Interbody Fusion 査読有り Open Access

Kagami, Y; Nakashima, H; Satake, K; Ito, K; Tsushima, M; Segi, N; Tomita, H; Ouchida, J; Morita, Y; Ode, Y; Imagama, S; Kanemura, T

JOURNAL OF CLINICAL MEDICINE 12 巻 ( 8 ) 2023年4月

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

Background: The current study aimed to investigate the anatomical position of the gonadal veins (GVs) from the viewpoint of spine surgery and the risk factors associated with lateral lumbar interbody fusion (LLIF). Methods: This retrospective study included 99 consecutive patients. The GV locations were divided into the ventral (V), dorsal medial (DM), and dorsal lateral (DL) sides based on lumbar disk levels on axial contrast-enhanced computed tomography images. The DM region surrounded by the vertebral body and psoas muscle had the highest risk of GV injury. The GV at each intervertebral disk level was examined in terms of laterality and sex. The patients were divided into group M (which included those with GV in the DM region at any vertebral level) and group O (which included those without GV in the DM region at any vertebral level). Then, the two groups were compared. Results: In the case of lower lumbar levels and in women, the GVs were commonly observed in the DM region. Group M had a higher incidence of degenerative scoliosis than group O and a significantly larger Cobb angle. Conclusions: We should pay close attention to the GV location on the preoperative image when using LLIF, particularly in female patients with degenerative scoliosis.

DOI： 10.3390/jcm12083041

Association between Postoperative Neck Pain and Intraoperative Transcranial Motor-Evoked Potential Waveforms of the Trapezius Muscles in Patients with Cervical Myelopathy Who Underwent Cervical Laminoplasty 査読有り Open Access

Ito, S; Sakai, Y; Ando, K; Nakashima, H; Machino, M; Segi, N; Tomita, H; Koshimizu, H; Hida, T; Ito, K; Harada, A; Imagama, S

ASIAN SPINE JOURNAL 17 巻 ( 2 ) 頁： 330 - 337 2023年4月

記述言語：英語出版者・発行元：Asian Spine Journal

Study Design: Retrospective study. Purpose: Cervical laminoplasty is safe and effective for treating cervical myelopathy but has a higher frequency of postoperative axial pain compared to other methods. Several studies have reported on the causes of postoperative axial pain, but none have fully elucidated them. This study aimed to investigate the association between postoperative neck pain and intraoperative transcranial motor-evoked potential (MEP) waveforms of the trapezius muscles using transcranial MEPs. Overview of Literature: Few studies have investigated the association between postoperative neck pain and intraoperative transcranial MEP waveforms of the trapezius muscles in patients with cervical laminoplasty. Methods: A total of 79 patients with cervical myelopathy who underwent cervical laminoplasty at our facility between June 2010 and March 2013 were included in this study. Intraoperative control and final waveform were evaluated based on the trapezius muscle MEPs by measuring the latency and amplitude. A neck pain group comprised patients with higher neck pain Visual Analog Scale scores from preoperative value to 1 year postoperatively. The cross-sectional areas of the trapezius muscles and the MEP latencies and amplitudes were compared between patients with and without neck pain. Results: The latency and amplitude of the control waveforms were not significantly different between groups. The neck pain group had a significantly shorter final waveform latency (neck pain: 23.6±2.5, no neck pain: 25.8±4.5; p =0.019) and significantly larger amplitude (neck pain: 2,125±1,077, no neck pain: 1,630±966; p =0.041) than the no neck pain group. Conclusions: Postoperative neck pain was associated with the final waveform latency and amplitude of the trapezius muscle MEPs during cervical laminoplasty. Intraoperative electrophysiological trapezius muscle abnormalities could cause postoperative neck pain

DOI： 10.31616/asj.2022.0120

特集低侵襲脊椎手術の功罪腰椎変性疾患に対するLLIFの功罪

金村徳相, 伊藤研悠, 都島幹人, 富田浩之, 長谷康弘, 大島和馬, 大内田隼, 中島宏彰, 今釜史郎

脊椎脊髄ジャーナル 35 巻 ( 9 ) 頁： 593 - 601 2023年3月

Comparison of the Relationship between Visual Acuity and Motor Function in Non-Elderly and Elderly Adults 査読有り Open Access

Ito, S; Nakashima, H; Machino, M; Segi, N; Ishizuka, S; Takegami, Y; Takeuchi, J; Ouchida, J; Hasegawa, Y; Imagama, S

JOURNAL OF CLINICAL MEDICINE 12 巻 ( 5 ) 2023年3月

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

This study aimed to clarify the relationship between visual acuity and motor function in younger and elderly participants and to compare differences between non-elderly and elderly participants. In total, 295 participants who underwent visual and motor functional examinations were included; participants with visual acuity ≥0.7 were assigned to the normal group (N group) and those with visual acuity ≤0.7 were assigned to the low-visual-acuity group (L group). Motor function was compared between the N and L groups; the analysis was performed by grouping participants into those aged >65 years (elderly) and those aged <65 years (non-elderly). The non-elderly group (average age, 55.6 ± 6.7 years) had 105 and 35 participants in the N and L groups, respectively. Back muscle strength was significantly lower in the L group than in the N group. The elderly group (average age, 71.1 ± 5.1 years) had 102 and 53 participants in the N and L groups, respectively. Gait speed was significantly lower in the L group than in the N group. These results reveal differences in the relationship between vision and motor function in non-elderly and elderly adults and indicate that poor vision is associated with lower back-muscle strength and walking speed in younger and elderly participants, respectively.

DOI： 10.3390/jcm12052008

Effects of Dementia on Outcomes after Cervical Spine Injuries in Elderly Patients: Evaluation of 1512 Cases in a Nationwide Multicenter Study in Japan 査読有り Open Access

Yamada, Y; Yokogawa, N; Kato, S; Sasagawa, T; Tsuchiya, H; Nakashima, H; Segi, N; Ito, S; Funayama, T; Eto, F; Yamaji, A; Yamane, J; Nori, S; Furuya, T; Yunde, A; Nakajima, H; Yamada, T; Hasegawa, T; Terashima, Y; Hirota, R; Suzuki, H; Imajo, Y; Ikegami, S; Uehara, M; Tonomura, H; Sakata, M; Hashimoto, K; Onoda, Y; Kawaguchi, K; Haruta, Y; Suzuki, N; Kato, K; Uei, H; Sawada, H; Nakanishi, K; Misaki, K; Terai, H; Tamai, K; Kuroda, A; Inoue, G; Kakutani, K; Kakiuchi, Y; Kiyasu, K; Tominaga, H; Tokumoto, H; Iizuka, Y; Takasawa, E; Akeda, K; Takegami, N; Funao, H; Oshima, Y; Kaito, T; Sakai, D; Yoshii, T; Ohba, T; Otsuki, B; Seki, S; Miyazaki, M; Ishihara, M; Okada, S; Imagama, S; Watanabe, K

JOURNAL OF CLINICAL MEDICINE 12 巻 ( 5 ) 2023年3月

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

We aimed to retrospectively investigate the demographic characteristics and short-term outcomes of traumatic cervical spine injuries in patients with dementia. We enrolled 1512 patients aged ≥ 65 years with traumatic cervical injuries registered in a multicenter study database. Patients were divided into two groups according to the presence of dementia, and 95 patients (6.3%) had dementia. Univariate analysis revealed that the dementia group comprised patients who were older and predominantly female and had lower body mass index, higher modified 5-item frailty index (mFI-5), lower pre-injury activities of daily living (ADLs), and a larger number of comorbidities than patients without dementia. Furthermore, 61 patient pairs were selected through propensity score matching with adjustments for age, sex, pre-injury ADLs, American Spinal Injury Association Impairment Scale score at the time of injury, and the administration of surgical treatment. In the univariate analysis of the matched groups, patients with dementia had significantly lower ADLs at 6 months and a higher incidence of dysphagia up to 6 months than patients without dementia. Kaplan–Meier analysis revealed that patients with dementia had a higher mortality than those without dementia until the last follow-up. Dementia was associated with poor ADLs and higher mortality rates after traumatic cervical spine injuries in elderly patients.

DOI： 10.3390/jcm12051867

Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture 査読有り Open Access

Tamai, K; Terai, H; Nakamura, H; Yokogawa, N; Sasagawa, T; Nakashima, H; Segi, N; Ito, S; Funayama, T; Eto, F; Yamaji, A; Watanabe, K; Yamane, J; Takeda, K; Furuya, T; Yunde, A; Nakajima, H; Yamada, T; Hasegawa, T; Terashima, Y; Hirota, R; Suzuki, H; Imajo, Y; Ikegami, S; Uehara, M; Tonomura, H; Sakata, M; Hashimoto, K; Onoda, Y; Kawaguchi, K; Haruta, Y; Suzuki, N; Kato, K; Uei, H; Sawada, H; Nakanishi, K; Misaki, K; Kuroda, A; Inoue, G; Kakutani, K; Kakiuchi, Y; Kiyasu, K; Tominaga, H; Tokumoto, H; Iizuka, Y; Takasawa, E; Akeda, K; Takegami, N; Funao, H; Oshima, Y; Kaito, T; Sakai, D; Yoshii, T; Ohba, T; Otsuki, B; Seki, S; Miyazaki, M; Ishihara, M; Okada, S; Imagama, S; Kato, S

JOURNAL OF CLINICAL MEDICINE 12 巻 ( 6 ) 2023年3月

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

The number of elderly patients with cervical trauma is increasing. Such patients are considered to be at high risk for delirium, which is an acute neuropsychological disorder that reduces the patient’s capacity to interact with their environment due to impairments in cognition. This study aimed to establish a risk score that predicts delirium in elderly patients with cervical SCI and/or cervical fracture regardless of treatment type. This retrospective cohort study included 1512 patients aged ≥65 years with cervical SCI and/or cervical fracture. The risk factors for delirium according to treatment type (surgical or conservative) were calculated using multivariate logistic regression. A delirium risk score was established as the simple arithmetic sum of points assigned to variables that were significant in the multivariate analyses. Based on the statistical results, the delirium risk score was defined using six factors: old age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, dependence on pre-injury mobility, and comorbid diabetes. The score’s area under the curve for the prediction of delirium was 0.66 (p < 0.001). Although the current scoring system must be validated with an independent dataset, the system remains beneficial because it can be used after screening examinations upon hospitalization and before deciding the treatment strategy.

DOI： 10.3390/jcm12062387

Characteristics of the cervical spine and cervical cord injuries in older adults with cervical ossification of the posterior longitudinal ligament 査読有り Open Access

Okuwaki, S; Funayama, T; Koda, M; Eto, F; Yamaji, A; Yokogawa, N; Sasagawa, T; Ando, K; Nakashima, H; Segi, N; Watanabe, K; Nori, S; Takeda, K; Furuya, T; Yunde, A; Nakajima, H; Yamada, T; Hasegawa, T; Terashima, Y; Hirota, R; Suzuki, H; Imajo, Y; Ikegami, S; Uehara, M; Tonomura, H; Sakata, M; Hashimoto, K; Onoda, Y; Kawaguchi, K; Haruta, Y; Suzuki, N; Kato, K; Uei, H; Sawada, H; Nakanishi, K; Misaki, K; Terai, H; Tamai, K; Shirasawa, E; Inoue, G; Kakutani, K; Kakiuchi, Y; Kiyasu, K; Tominaga, H; Tokumoto, H; Iizuka, Y; Takasawa, E; Akeda, K; Takegami, N; Funao, H; Oshima, Y; Kaito, T; Sakai, D; Yoshii, T; Ohba, T; Otsuki, B; Seki, S; Miyazaki, M; Ishihara, M; Okada, S; Imagama, S; Kato, S

SCIENTIFIC REPORTS 13 巻 ( 1 ) 頁： 2689 2023年2月

記述言語：英語出版者・発行元：Scientific Reports

Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010–2020. We analyzed CSCI etiology in OPLL patients. We performed propensity score-adjusted analyses to compare neurological outcomes between patients with and without OPLL. Cases were matched based on variables influencing neurological prognosis. The primary neurological outcome was rated according to the American Spine Injury Association (ASIA) impairment scale (AIS) and ASIA motor score (AMS). In 332 OPLL patients, the male-to-female ratio was approximately 4:1. Half of all patients displayed low-energy trauma-induced injury and one-third had CSCI without a bony injury. Propensity score matching created 279 pairs. There was no significant difference in the AIS grade and AMS between patients with and without OPLL during hospitalization, 6 months, and 12 months following injury. OPLL patients tended to exhibit worse neurological findings during injury; nevertheless, OPLL was not associated with poor neurological improvement in older CSCI patients.

DOI： 10.1038/s41598-023-29877-2

Comparison of radiological characteristics between diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis: a multicenter study 査読有り Open Access

Takahashi, T; Yoshii, T; Mori, K; Kobayashi, S; Inoue, H; Tada, K; Tamura, N; Hirai, T; Sugimura, N; Nagoshi, N; Maki, S; Katsumi, K; Koda, M; Murata, K; Takeuchi, K; Nakashima, H; Imagama, S; Kawaguchi, Y; Yamazaki, M; Okawa, A

SCIENTIFIC REPORTS 13 巻 ( 1 ) 頁： 1849 2023年2月

記述言語：英語出版者・発行元：Scientific Reports

To evaluate the radiological differences between diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) using whole spine computed tomography (CT), including the spine and sacroiliac joint (SIJ). The ossification and bridging of spinal ligament and fusion of the facet joint and SIJ were evaluated in 111 patients who were diagnosed with DISH and 27 patients with AS on the whole spine CT. The number of anterior bridging and shape of bridging (candle-wax-type/ smooth-type) were also evaluated. We further evaluated patients with DISH and AS by matching their age and sex. Complete SIJ fusion was more common in AS, whereas anterior and posterior bony bridging around SIJ was more common in DISH. However, 63% of patients with DISH had a partial or complete fusion. In spinal anterior bony bridging, the majority of patients with AS had the smooth-type, whereas those with DISH had the candle-wax-type. However, some of the patients with DISH (11%) had smooth-type. Intervertebral facet joint fusion is more common in AS. The number of anterior spinal bony bridging was greater in AS than in DISH, especially in the lumbar spine. These results are useful in differentiating DISH from AS and should therefore be considered when making a diagnosis.

DOI： 10.1038/s41598-023-28946-w

Neck pain after cervical laminoplasty is associated with postoperative atrophy of the trapezius muscle 査読有り Open Access

Ito, S; Sakai, Y; Ando, K; Nakashima, H; Machino, M; Segi, N; Tomita, H; Koshimizu, H; Hida, T; Ito, K; Harada, A; Imagama, S

NAGOYA JOURNAL OF MEDICAL SCIENCE 85 巻 ( 1 ) 頁： 103 - 112 2023年2月

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

Cervical laminoplasty is a safe and effective treatment for cervical myelopathy. However, it has a higher frequency of postoperative axial pain than other methods. A variety of causes of postoperative axial pain have been reported, but these have not been fully elucidated. This study aimed to investigate the association between postoperative axial pain and changes in the posterior neck muscles before and after surgery. The study included 93 patients with cervical myelopathy who underwent surgery at our institute between June 2010 and March 2013. The patients with greater preoperative and 1-year postoperative neck pain visual analog scale scores comprised the neck pain group. The cross-sectional area of the cervical posterior extensor muscles and the trapezius muscle were measured by magnetic resonance imaging before and 1 year after surgery at the C3/4, C4/5, and C5/6 levels to compare with neck pain. The total cross-sectional area atrophy rate (C3/C4, C4/C5, and C5/C6) of the trapezius muscle was significantly larger in patients with neck pain (12.8 ± 13.2) than in those without (6.2 ± 14.4; p<0.05). The cross-sectional area atrophy rate of the trapezius muscle at only the C5/6 level was significantly higher in patients with neck pain (16.7 ± 11.7) compared to those without (3.3 ± 14.4; p<0.001). No significant differences were found in the cross-sectional areas of the cervical posterior extensor muscles. Trapezius atrophy, especially at the lower cervical vertebrae, was associated with neck pain after cervical laminoplasty.

DOI： 10.18999/nagjms.85.1.103

The age-specific normative values of standing whole-body sagittal alignment parameters in healthy adults: based on international multicenter data 査読有り Open Access

Ouchida, J; Nakashima, H; Kanemura, T; Okamoto, M; Hatsushikano, S; Imagama, S; Le Huec, JC; Hasegawa, K

EUROPEAN SPINE JOURNAL 32 巻 ( 2 ) 頁： 562 - 570 2023年2月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: To investigate the age-specific normative values of whole-body sagittal alignment (WBSA) including global balance parameters in healthy adults and to clarify the correlations among parameters based on the data from three international multicenter. Methods: Three hundred and seventeen healthy subjects (range: 20–84 y.o., mean: 43.8 ± 14.7 y.o.) were included and underwent whole-body biplanar X-ray imaging system. Spinopelvic parameters and knee flexion (KF), the center of acoustic meatus (CAM)-hip axis (HA), and C2 dentiform apophyse (OD)-HA, the cranial center (Cr)-HA were evaluated radiologically. Sub-analysis for correlation analysis between age and parameters and among parameters was performed to investigate age-specific change and compensatory mechanisms. Results: For age-related change, C2-7 angle (r =.326 for male/.355 for female), KF (r =.427/.429), and SVA (r =.234/.507) increased with age in both male and female group. For global parameters related to the center of the gravity, correlations with age were not significant (r =.120/.161 for OD-HA, r =.163/.275 for Cr-HA, r =.149/.262 for CAM-HA). Knee flexion (KF) has correlation with global parameters (i.e., SVA, OD-HA, Cr-HA, CAM-HA) and does not have correlations with local spinopelvic alignment. Conclusion: While several local alignment changes with age were found, changes in global parameters related to the center of gravity were kept relatively mild by the chain of compensation mechanisms including the lower limbs. We showed the normative values for a comprehensive WBSA in standing posture from large international healthy subjects’ database.

DOI： 10.1007/s00586-022-07445-y

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