研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

分割表示 308 件中 121 - 140 件目／全件表示 >>

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

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

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

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

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

Vertebral Endplate Concavity in Lateral Lumbar Interbody Fusion: Tapered 3D-Printed Porous Titanium Cage versus Squared PEEK Cage 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

MEDICINA-LITHUANIA 59 巻 ( 2 ) 2023年2月

担当区分：責任著者記述言語：英語出版者・発行元：Medicina (Lithuania)

Background and Objectives: To prevent postoperative problems in extreme lateral interbody fusion (XLIF), it is critical that the vertebral endplate not be injured. Unintentional endplate injuries may depend on the cage. A novel porous titanium cage for XLIF has improved geometry with a tapered tip and smooth surface. We hypothesized that this new cage should lead to fewer endplate injuries. Materials and Methods: This retrospective study included 32 patients (mean 74.1 ± 6.7 years, 22 females) who underwent anterior and posterior combined surgery with XLIF for lumbar degenerative disease or adult spinal deformity from January 2018 to June 2022. A tapered 3D porous titanium cage (3DTi; 11 patients) and a squared PEEK cage (sPEEK; 21 patients) were used. Spinal alignment values were measured on X-ray images. Vertebral endplate concavity (VEC) was defined as concavity ≥ 1 mm of the endplate on computed tomography (CT) images, which were evaluated preoperatively and at 1 week and 3 months postoperatively. Results: There were no significant differences in the patient demographic data and preoperative and 3-month postoperative spinal alignments between the groups. A 3DTi was used for 25 levels and an sPEEK was used for 38 levels. Preoperative local lordotic angles were 4.3° for 3DTi vs. 4.7° for sPEEK (p = 0.90), which were corrected to 12.3° and 9.1° (p = 0.029), respectively. At 3 months postoperatively, the angles were 11.6° for 3DTi and 8.2° for sPEEK (p = 0.013). VEC was present in 2 levels (8.0%) for 3DTi vs. 17 levels (45%) for sPEEK (p = 0.002). After 3 months postoperatively, none of the 3DTi had VEC progression; however, eight (21%) levels in sPEEK showed VEC progression (p = 0.019). Conclusions: The novel 3DTi cage reduced endplate injuries by reducing the endplate load during cage insertion.

DOI： 10.3390/medicina59020372

Risk Factors for Early Mortality in Older Patients with Traumatic Cervical Spine Injuries-A Multicenter Retrospective Study of 1512 Cases 査読有り

Kobayashi, M; 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 ( 2 ) 2023年1月

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

For older patients with decreased reserve function, traumatic cervical spine injuries frequently lead to early mortality. However, the prognostic factors for early mortality remain unclear. This study included patients aged ≥65 years and hospitalized for treatment of traumatic cervical spine injuries in 78 hospitals between 2010 and 2020. Early mortality was defined as death within 90 days after injury. We evaluated the relationship between early mortality and the following factors: age, sex, body mass index, history of drinking and smoking, injury mechanisms, presence of a cervical spine fracture and dislocation, cervical ossification of the posterior longitudinal ligament, diffuse idiopathic skeletal hyperostosis, American Spinal Injury Association Impairment Scale, concomitant injury, pre-existing comorbidities, steroid administration, and treatment plan. Overall, 1512 patients (mean age, 75.8 ± 6.9 years) were included in the study. The early mortality rate was 4.0%. Multivariate analysis identified older age (OR = 1.1, p < 0.001), male sex (OR = 3.7, p = 0.009), cervical spine fracture (OR = 4.2, p < 0.001), complete motor paralysis (OR = 8.4, p < 0.001), and chronic kidney disease (OR = 5.3, p < 0.001) as risk factors for early mortality. Older age, male sex, cervical spine fracture, complete motor paralysis, and chronic kidney disease are prognostic factors for early mortality in older patients with traumatic cervical spine injuries.

DOI： 10.3390/jcm12020708

Clinical Outcomes of Condoliase Injection Therapy for Lateral Lumbar Disc Herniation Open Access

Kagami, Y; Nakashima, H; Segi, N; Shinjo, R; Imagama, S

SPINE SURGERY AND RELATED RESEARCH 7 巻 ( 4 ) 頁： 363 - 370 2023年

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

Introduction: This study aimed to evaluate the efficacy of condoliase injection therapy (CIT) for lateral lumbar disc herniation (LLDH). Methods: This retrospective study included 157 of 180 enrolled patients (70 males, 87 females; mean age: 52.6±16.9 years). These patients were divided into two groups (group L: LLDH, group M: medial LDH [subligamentous and transligamentous]). From baseline to 1 year after injection (final follow-up), leg pain was assessed using the visual analog scale (VAS) and the Japanese Orthopedic Association (JOA) scoring for CIT's clinical efficacy of CIT. Radiography and magnetic resonance imaging conducted before and 3 months after the injection were assessed. Patients with a VAS improvement of -50% at the final follow-up were defined as responders. The responder and nonresponder LLDH groups were also compared. Results: Groups L and M showed comparable responder rates (75.0% and 77.4%, respectively) (P=0.80). VAS and JOA scores at 1 year showed no significant differences between the groups (P=0.82 and 0.80, respectively). VAS score at 1 month after injection reduced considerably in the responder group compared with that in the nonresponder group (19.7 vs. 66.0, P<0.01) and continued to decrease at the last follow-up (3.5 vs. 52.0, P<0.001). Nonresponders had significantly lower disc heights after 3 months. However, intervertebral instability, alignment, and disc degeneration did not differ between the responders and nonresponders. Conclusions: The response rate of CIT for LLDH was comparable to that for medial LDH. Therefore, CIT is an effective treatment for LLDH.

DOI： 10.22603/ssrr.2022-0189

Impact of Obesity, Osteopenia, and Scoliosis on Interobserver Reliability of Measures of the Spinopelvic Sagittal Radiographic Parameters Open Access

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

SPINE SURGERY AND RELATED RESEARCH 7 巻 ( 6 ) 頁： 519 - 525 2023年

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

Introduction: We investigated the relationships between patient factors, including obesity, osteopenia, and scoliosis, and the reliability of measures of the spinopelvic sagittal parameters using conventional X-radiography (Xp) and slot-scanning Xp devices (EOS) and examined the differences in interobserver measurement reliability between them. Methods: We retrospectively enrolled 55 patients (52.7±25.3 years, 27 females) with conventional whole-spine Xp and EOS images taken within three months. Patients were classified according to obesity (Body mass index!25 kg/m2), osteopenia (T score<−1), and scoliosis (Cobb angle>20°). The associations between patient factors and reliability of radiological parameter measurements were examined with interobserver intraclass correlation coefficient (ICC), defined as poor, <.40; good, 40-.79; and excellent, !.80. Results: All parameters measured with EOS showed excellent reliability except for L4-S (ICC:.760, 95% CI:.295-.927) in the obesity+ group. All parameters measured with conventional Xp were excellent except for those classified as good: L 4-S (.608,.093-.868) and pelvic incidence (PI) (.512,.078-.832) in the obese+ group; T1 slope (.781,.237-.952), L4-S (.718,.112-.936), sacral slope (SS) (.792,.237-.955), pelvic tilt (PT) (.787,.300-.952), and center of acoustic meatus and femoral head offset (CAM-HA) (.690,.090-.928) in the osteopenia+ group; and lumbar lordosis (LL, L4-S) (.712,.349-.889), SS (.608,.178-.843), and CAM-HA (.781,.480-.917) in the scoliosis+ group. Conclusions: Reliability of EOS measurements was preferable except for L4-S in patients with obesity. The reliability of conventional Xp measurements of pelvic parameters SS, PT, and PI was affected by patient factors, including obesity, osteopenia, and scoliosis. When evaluating lower lumbar and pelvic parameters in patients with these factors, we recommend substituting thoracic parameters, LL (L1-S), sagittal vertical axis (SVA), and T1 pelvic angle (TPA), or combining computed tomography (CT) measurements.

DOI： 10.22603/ssrr.2023-0050

Nationwide Survey of the Surgical Complications Associated with Lateral Lumbar Interbody Fusion in 2015-2020 Open Access

Yagi, M; Fujita, N; Hasegawa, T; Inoue, G; Kotani, Y; Ohtori, S; Orita, S; Oshima, Y; Sakai, D; Sakai, T; Taneichi, H; Togawa, D; Nakanishi, K; Nakashima, H; Yoshii, T; Nakamura, M; Iwasaki, M; Watanabe, M; Haro, H; Kanemura, T; Hosogane, N

SPINE SURGERY AND RELATED RESEARCH 7 巻 ( 3 ) 頁： 249 - 256 2023年

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

Introduction: Lateral lumbar interbody fusion (LLIF) has been introduced in Japan in 2013. Despite the effectiveness of this procedure, several considerable complications have been reported. This study reported the results of a nationwide survey performed by the Japanese Society for Spine Surgery and Related Research (JSSR) on the complications associated with LLIF performed in Japan. Methods: JSSR members conducted a web-based survey following LLIF between 2015 and 2020. Any complications meeting the following criteria were included: (1) major vessel, (2) urinary tract, (3) renal, (4) visceral organ, (5) lung, (6) vertebral, (7) nerve, and (8) anterior longitudinal ligament injury; (9) weakness of psoas; (10) motor and (11) sensory deficit; (12) surgical site infection; and (13) other complications. The complications were analyzed in all LLIF patients, and the differences in incidence and type of complications between the transpsoas (TP) and prepsoas (PP) approaches were compared. Results: Among the 13,245 LLIF patients (TP 6,198 patients [47%] and PP 7,047 patients [53%]), 389 complications occurred in 366 (2.76%) patients. The most common complication was sensory deficit (0.5%), followed by motor deficit (0.43%) and weakness of psoas muscle (0.22%). Among the patient cohort, 100 patients (0.74%) required revision surgery during the survey period. Almost half of the complications developed in patients with spinal deformity (183 patients [47.0%]). Four patients (0.03%) died from complications. Statistically more frequent complications occurred in the TP approach than in the PP approach (TP vs. PP, 220 patients [3.55%] vs. 169 patients [2.40%]; p<0.001). Conclusions: The overall complication rate was 2.76%, and 0.74% of the patients required revision surgery because of complications. Four patients died from complications. LLIF may be beneficial for degenerative lumbar conditions with acceptable complications; however, the indication for spinal deformity should be carefully determined by the experience of the surgeon and the extent of the deformity.

DOI： 10.22603/ssrr.2022-0194

Prospective Investigation of Surgical Outcomes after Anterior Decompression with Fusion and Laminoplasty for the Cervical Ossification of the Posterior Longitudinal Ligament: A Propensity Score Matching Analysis 査読有り Open Access

Yoshii, T; Morishita, S; Egawa, S; Sakai, K; Kusano, K; Tsutsui, S; Hirai, T; Matsukura, Y; Wada, K; Katsumi, K; Koda, M; Kimura, A; Furuya, T; Maki, S; Nagoshi, N; 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; Inami, S; Fujibayashi, S; Katoh, H; Kanno, H; Taneichi, H; Imagama, S; Kawaguchi, Y; Takeshita, K; Matsumoto, M; Yamazaki, M; Okawa, A

JOURNAL OF CLINICAL MEDICINE 11 巻 ( 23 ) 2022年12月

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

The ideal surgical strategy for cervical ossification of the posterior longitudinal ligament (OPLL) remains controversial due to the lack of high-quality evidence. Herein, we prospectively investigated the surgical outcomes of anterior cervical decompression with fusion (ADF) and laminoplasty (LAMP) with cervical OPLL. Three hundred patients were included in this study (ADF: n = 89; LAMP: n = 211 patients), and propensity score matching yielded 67 pairs of patients with ADF and LAMP, in which clinical outcomes were compared. Crude analysis revealed that the ADF group showed greater neurological recovery in cervical Japanese Orthopedic Association scores at two years, compared with that in the LAMP group (53.1% vs. 44.3%, p = 0.037). The ratio of minimum clinically important difference (MCID) success was significantly greater in the ADF group (59.6% vs. 43.6%, p = 0.016). Multivariate analysis showed that the factors affecting MCID success were age, body mass index, duration of symptoms, and choice of ADF. In the 1:1 matched analysis, neurological improvement was more favorable in the ADF group (57.2%) compared to the LAMP group (46.8%) at two years (p = 0.049). However, perioperative complications, such as dysphagia and graft-related complications, were more common in the ADF group.

DOI： 10.3390/jcm11237012

特集整形外科領域における人工知能の応用各論深層学習を用いたMRIでの脊髄腫瘍自動位置検出システムの構築

伊藤定之, 中島宏彰, 町野正明, 世木直喜, 小田昌宏, 大内田隼, 森下和明, 森健策, 今釜史郎

臨床整形外科 57 巻 ( 10 ) 頁： 1189 - 1195 2022年10月

Does surgery improve neurological outcomes in older individuals with cervical spinal cord injury without bone injury? A multicenter study

Nori, S; Watanabe, K; Takeda, K; Yamane, J; Kono, H; Yokogawa, N; Sasagawa, T; Ando, K; Nakashima, H; Segi, N; Funayama, T; Eto, F; Yamaji, A; 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; Kiyasu, K; Iizuka, Y; Takasawa, E; Funao, H; Kaito, T; Yoshii, T; Ishihara, M; Okada, S; Imagama, S; Kato, S

SPINAL CORD 60 巻 ( 10 ) 頁： 895 - 902 2022年10月

記述言語：英語出版者・発行元：Spinal Cord

Study design: Retrospective multicenter study. Objectives: To investigate the neurological outcomes of older individuals treated with surgery versus conservative treatment for cervical spinal cord injury (CSCI) without bone injury. Setting: Thirty-three medical institutions in Japan. Methods: This study included 317 consecutive persons aged ≥65 years with CSCI without bone injury in participating institutes between 2010 and 2020. The participants were followed up for at least 6 months after the injury. Individuals were divided into surgery (n = 114) and conservative treatment (n = 203) groups. To compare neurological outcomes and complications between the groups, propensity score matching of the baseline factors (characteristics, comorbidities, and neurological function) was performed. Results: After propensity score matching, the surgery and conservative treatment groups comprised 89 individuals each. Surgery was performed at a median of 9.0 (3–17) days after CSCI. Baseline factors were comparable between groups, and the standardized difference in the covariates in the matched cohort was <10%. The American Spinal Injury Association (ASIA) impairment scale grade and ASIA motor score (AMS) 6 months after injury and changes in the AMS from baseline to 6 months after injury were not significantly different between groups (P = 0.63, P = 0.24, and P = 0.75, respectively). Few participants who underwent surgery demonstrated perioperative complications such as dural tear (1.1%), surgical site infection (2.2%), and C5 palsy (5.6%). Conclusion: Conservative treatment is suggested to be a more favorable option for older individuals with CSCI without bone injuries, but this finding requires further validation.

DOI： 10.1038/s41393-022-00818-6

Factors Affecting the Waiting Time from Injury to Surgery in Elderly Patients with a Cervical Spine Injury: A Japanese Multicenter Survey

Uehara M., Ikegami S., Takizawa T., Oba H., Yokogawa N., Sasagawa T., Ando K., Nakashima H., Segi N., Funayama T., Eto F., Yamaji A., Watanabe K., Nori S., Takeda K., Furuya T., Yunde A., Nakajima H., Yamada T., Hasegawa T., Terashima Y., Hirota R., Suzuki H., Imajo Y., 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., Otsuki B., Seki S., Miyazaki M., Ishihara M., Okada S., Imagama S., Kato S.

World Neurosurgery 166 巻頁： e815 - e822 2022年10月

出版者・発行元：World Neurosurgery

Objective: The management of cervical spine injuries in the elderly is often complicated by the presence of multiple medical comorbidities, and it is not uncommon for preoperative testing to reveal other conditions that require the postponement of surgery. However, the factors that affect the waiting time from injury to surgery have not been clarified. The purpose of this multicenter database study was to analyze the clinical features and identify the factors affecting the number of days waited between injury and surgery in elderly patients with a cervical spine injury. Methods: We retrospectively reviewed the case histories of 1512 Japanese patients with a cervical spinal injury, who were seen at 33 institutions. After excluding patients who were not initially receiving a surgery for cervical spinal injury, 694 patients were ultimately analyzed. Based on a multivariate mixed model, we determined the factors related to the number of days from injury to surgery. Results: The mean time from injury to surgery was 12.3 days. Multivariate analysis revealed delays of 10.7 days for a renal disorder, 7.3 days for anticoagulant use, and 15.2 days for non-surgical thoracolumbar fracture as factors prolonging wait time. In contrast, a C3 or lower spine injury was significantly associated with a shortening of 9.5 days to surgery. Conclusions: This multicenter database study identified several factors influencing the time between injury and cervical spine surgery in elderly patients. While renal impairment, anticoagulant use, and non-surgical thoracolumbar fracture may increase the number of days to surgery, trauma to C3 or lower may expedite surgical treatment.

DOI： 10.1016/j.wneu.2022.07.104

Factors Affecting the Waiting Time from Injury to Surgery in Elderly Patients with a Cervical Spine Injury: A Japanese Multicenter Survey

Uehara, M; Ikegami, S; Takizawa, T; Oba, H; Yokogawa, N; Sasagawa, T; Ando, K; Nakashima, H; Segi, N; Funayama, T; Eto, F; Yamaji, A; Watanabe, K; Nori, S; Takeda, K; Furuya, T; Yunde, A; Nakajima, H; Yamada, T; Hasegawa, T; Terashima, Y; Hirota, R; Suzuki, H; Imajo, Y; 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; Otsuki, B; Seki, S; Miyazaki, M; Ishihara, M; Okada, S; Imagama, S; Kato, S

WORLD NEUROSURGERY 166 巻頁： E815 - E822 2022年10月

A clinical trial of a unidirectional porous tricalcium phosphate filling for defects after resection of benign bone lesions: a prospective multicenter study Open Access

Ikuta, K; Nishida, Y; Ota, T; Tsukushi, S; Kozawa, E; Nakashima, H; Yamada, K; Yamashita, S; Imagama, S

SCIENTIFIC REPORTS 12 巻 ( 1 ) 頁： 16060 2022年9月

記述言語：英語出版者・発行元：Scientific Reports

Affinos (Kuraray, Japan) is a β-tricalcium phosphate bone substitute with a unidirectional porous structure. This study aimed to investigate its efficacy on the healing process after filling for bone defects. Fifty-six patients who met the inclusion criteria were divided into cohort 1 (n = 30), including bones other than phalanges and metacarpal/tarsal bones, and cohort 2 (n = 26), including phalanges and metacarpal/tarsal bones. Semi-quantified scores for material resorption and trabeculation through the defect were evaluated with radiographs after surgery. In some patients, levels of bone metabolic markers were assessed. The values of resorption and trabeculation increased steadily with time, and trabeculation progressed compared with resorption in both cohorts. In cohort 1, multiple regression analyses showed that the diaphyseal lesion, smaller defect volume, and increased resorption values at 3 months were associated with increased values of resorption 12 months after surgery (R2 = 0.66, p < 0.001). The trabeculation values at 2 months were positively related to the trabeculation values 12 months after surgery (R2 = 0.35, p = 0.002). In cohort 2, the increased resorption values at 2 months and smaller defect volume significantly correlated with the increased resorption values 12 months after surgery (R2 = 0.58, p < 0.001). The ratio from the baseline of pyridinoline cross-linked carboxyterminal telopeptide of type I collagen at 3 months was negatively associated with the trabeculation values 12 months after surgery (R = − 0.791, p = 0.004). Evaluation of radiographic images and bone metabolic markers in the early postoperative period may predict the healing status at 12 months postoperatively in the defects followed by Affinos filling.

DOI： 10.1038/s41598-022-20359-5

Differences in clinical characteristics of cervical spine injuries in older adults by external causes: a multicenter study of 1512 cases Open Access

Yokogawa, N; Kato, S; Sasagawa, T; Hayashi, H; Tsuchiya, H; Ando, K; Nakashima, H; Segi, N; Funayama, T; Eto, F; Yamaji, A; Nori, S; Yamane, J; 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; Watanabe, K

SCIENTIFIC REPORTS 12 巻 ( 1 ) 頁： 15867 2022年9月

記述言語：英語出版者・発行元：Scientific Reports

Although traumatic cervical spine injuries in older adults are commonly caused by minor traumas, such as ground-level falls, their prognosis is often unfavorable. Studies examining the clinical characteristics of cervical spine injuries in older adults according to the external cause of injury are lacking. This study included 1512 patients of ≥ 65 years of age with traumatic cervical spine injuries registered in a Japanese nationwide multicenter database. The relationship between the external causes and clinical characteristics, as well as factors causing unfavorable outcomes at the ground-level falls, were retrospectively reviewed and examined. When fall-induced cervical spine injuries were categorized and compared based on fall height, the patients’ backgrounds and injury statuses differed significantly. Of note, patients injured from ground-level falls tended to have poorer pre-injury health conditions, such as medical comorbidities and frailty, compared with those who fell from higher heights. For ground-level falls, the mortality, walking independence, and home-discharge rates at 6 months post-injury were 9%, 67%, and 80%, respectively, with preexisting medical comorbidities and frailty associated with unfavorable outcomes, independent of age or severity of neurological impairment at the time of injury.

DOI： 10.1038/s41598-022-19789-y

Impact of the hip joint mobility on whole-body sagittal alignment: prospective analysis in case with hip arthroplasty

Ouchida, J; Nakashima, H; Kanemura, T; Satake, K; Ando, K; Ito, K; Tsushima, M; Machino, M; Ito, S; Yamaguchi, H; Segi, N; Koshimizu, H; Tomita, H; Imagama, S

EUROPEAN SPINE JOURNAL 31 巻 ( 9 ) 頁： 2399 - 2407 2022年9月

記述言語：英語出版者・発行元：European Spine Journal

Purpose: To clarify the impact of restriction of hip extension on radiographic whole-body sagittal alignment with using postoperative changes of radiographical parameters for hip osteoarthritis. Methods: We prospectively enrolled 68 patients with hip osteoarthritis scheduled for arthroplasty. Variables included manual examination of hip range of motion (H-ROM) and radiographic whole-body sagittal alignment parameters including sagittal vertical axis (SVA), center of acoustic meatus and femoral head offset (CAM-HA), thoracic kyphosis (TK), lumbar lordosis, sacral slope (SS), and knee flexion angle (KF). We divided patients with preoperative hip extension angle < 0 into the extension restriction (ER) + group and ≥ 0 into the ER− group. Differences in H-ROM, radiographic parameters between groups and postoperative changes were comparatively analyzed. Results: Fifty-seven patients (The ER + group included 28 patients and the ER− group included 29 patients.) were available for the analysis. Pre-/postoperative H-ROM were 99.7 ± 24.9/118.1 ± 16.0 degrees (p <.01). Greater increases in SVA (5.4 ± 3.4 vs 3.4 ± 2.8 cm, p =.02) and in CAM-HA (3.9 ± 3.9 vs 2.8 ± 3.4 cm, p = 013) were found in the ER + group versus ER− group. Postoperatively, the ER + group showed an increase in TK (pre-/postoperative: 35.2 ± 9.7/37.4 ± 8.8 degrees, p =.04) and decreases in SS (36.5 ± 9.6/33.7 ± 9.9 degrees, p <.01) and KF (9.5 ± 7.0/6.9 ± 6.0 degrees, p =.02). Postoperative changes in radiographic parameters in the ER− group were not significant. Conclusion: Patients with restriction of hip extension showed global spine imbalance, and significant changes in TK, SS, and KF were observed after arthroplasty. The presence of hip joint disorder and H-ROM restriction must be considered when evaluating spinopelvic alignment and whole-body sagittal alignment.

DOI： 10.1007/s00586-022-07251-6

　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