研究者詳細 - 中島　宏彰

論文 - 中島　宏彰

分割表示 308 件中 161 - 180 件目／全件表示 >>

Intradural Lumbar Disc Herniation From the Lateral Inner Surface of the Dura Without a Penetration Hole: A Case Report

Segi, N; Ando, K; Nakashima, H; Machino, M; Imagama, S

CUREUS JOURNAL OF MEDICAL SCIENCE 14 巻 ( 2 ) 頁： e22418 2022年2月

Meclozine ameliorates skeletal muscle pathology and increases muscle forces in<i> mdx</i> mice Open Access

Kawamura, Y; Hida, T; Ohkawara, B; Matsushita, M; Kobayashi, T; Ishizuka, S; Hiraiwa, H; Tanaka, S; Tsushima, M; Nakashima, H; Ito, K; Imagama, S; Ito, M; Masuda, A; Ishiguro, N; Ohno, K

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 592 巻頁： 87 - 92 2022年2月

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

We screened pre-approved drugs for the survival of the Hu5/KD3 human myogenic progenitors. We found that meclozine, an anti-histamine drug that has long been used for motion sickness, promoted the proliferation and survival of Hu5/KD3 cells. Meclozine increased expression of MyoD, but reduced expression of myosin heavy chain and suppressed myotube formation. Withdrawal of meclozine, however, resumed the ability of Hu5/KD3 cells to differentiate into myotubes. We examined the effects of meclozine on mdx mouse carrying a nonsense mutation in the dystrophin gene and modeling for Duchenne muscular dystrophy. Intragastric administration of meclozine in mdx mouse increased the body weight, the muscle mass in the lower limbs, the cross-sectional area of the paravertebral muscle, and improved exercise performances. Previous reports show that inhibition of phosphorylation of ERK1/2 improves muscle functions in mouse models for Emery-Dreifuss muscular dystrophy and cancer cachexia, as well as in mdx mice. We and others previously showed that meclozine blocks the phosphorylation of ERK1/2 in cultured cells. We currently showed that meclozine decreased phosphorylation of ERK1/2 in muscles in mdx mice but not in wild-type mice. This was likely to be one of the underlying mechanisms of the effects of meclozine on mdx mice.

DOI： 10.1016/j.bbrc.2022.01.003

Degenerative Cervical Myelopathy: Development and Natural History [AO Spine RECODE-DCM Research Priority Number 2] Open Access

Nouri, A; Tessitore, E; Molliqaj, G; Meling, T; Schaller, K; Nakashima, H; Yukawa, Y; Bednarik, J; Martin, AR; Vajkoczy, P; Cheng, JS; Kwon, BK; Kurpad, SN; Fehlings, MG; Harrop, JS; Aarabi, B; Rahimi-Movaghar, V; Guest, JD; Davies, BM; Kotter, MRN; Wilson, JR

GLOBAL SPINE JOURNAL 12 巻 ( 1_SUPPL ) 頁： 39S - 54S 2022年2月

記述言語：英語出版者・発行元：Global Spine Journal

Study Design: Narrative review. Objectives: To discuss the current understanding of the natural history of degenerative cervical myelopathy (DCM). Methods: Literature review summarizing current evidence pertaining to the natural history and risk factors of DCM. Results: DCM is a common condition in which progressive arthritic disease of the cervical spine leads to spinal cord compression resulting in a constellation of neurological symptoms, in particular upper extremity dysfunction and gait impairment. Anatomical factors including cord-canal mismatch, congenitally fused vertebrae and genetic factors may increase individuals’ risk for DCM development. Non-myelopathic spinal cord compression (NMSCC) is a common phenomenon with a prevalence of 24.2% in the healthy population, and 35.3% among individuals >60 years of age. Clinical radiculopathy and/or electrophysiological signs of cervical cord dysfunction appear to be risk factors for myelopathy development. Radiological progression of incidental Ossification of the Posterior Longitudinal Ligament (OPLL) is estimated at 18.3% over 81-months and development of myelopathy ranges between 0-61.5% (follow-up ranging from 40 to 124 months between studies) among studies. In patients with symptomatic DCM undergoing non-operative treatment, 20-62% will experience neurological deterioration within 3-6 years. Conclusion: Current estimates surrounding the natural history of DCM, particularly those individuals with mild or minimal impairment, lack precision. Clear predictors of clinical deterioration for those treated with non-operative care are yet to be identified. Future studies are needed on this topic to help improve treatment counseling and clinical prognostication.

DOI： 10.1177/21925682211036071

DNA methylation is associated with muscle loss in community-dwelling older men -the Yakumo study- : a preliminary experimental study 査読有り Open Access

Kato, D; Takegami, Y; Seki, T; Nakashima, H; Osawa, Y; Suzuki, K; Yamada, H; Hasegawa, Y; Imagama, S

NAGOYA JOURNAL OF MEDICAL SCIENCE 84 巻 ( 1 ) 頁： 60 - 68 2022年2月

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

Frailty is a state of reduced muscle strength and activity in older people. DNA methylation is associated with osteoporosis and muscle loss in murine and other animal studies, but there are no epidemiological studies in humans. This study aimed to assess the association of osteoporosis and muscle loss with DNA methylation in community-dwelling older people. This cross-sectional study was performed in a rural part of Japan. We analyzed 204 subjects (98 men and 106 women). In univariate analysis, the two groups were compared according to the presence or absence of osteoporosis and of muscle loss. Logistic regression analysis was performed to determine predictors of frailty in the muscle loss group. We used age, sex, body mass index, smoking history, drinking history, serum albumin and C-reactive protein levels, diabetes, hypertension, hyperlipidemia, heart disease history, and LINE-1 DNA methylation as the factors. Probability values < 0.05 were considered to be statistically significant. The levels of LINE-1 DNA methylation in leukocytes were associated with muscle loss in men over the age of 60. LINE-1 DNA methylation levels were not associated with bone mineral density in either the men or women over the age of 60. LINE-1 DNA methylation levels in leukocytes correlated significantly with the risk of frailty in men over the age of 60. Promoting an understanding of DNA methylation may lead to a better understanding of the pathophysiology of muscle loss

DOI： 10.18999/nagjms.84.1.60

Nutritional Influences on Locomotive Syndrome Open Access

Ito, S; Nakashima, H; Ando, K; Machino, M; Seki, T; Ishizuka, S; Takegami, Y; Wakai, K; Hasegawa, Y; Imagama, S

JOURNAL OF CLINICAL MEDICINE 11 巻 ( 3 ) 2022年2月

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

Healthy dietary habits are important to prevent locomotive syndrome (LS). We investi-gated the relationship between LS and nutritional intake using community health checkup data. We included 368 participants who underwent LS staging, blood sampling, and nutritional intake assessments. Participants (163 adults < 65: 205 older adults ≥ 65) were divided into normal (N; LS stage 0) and LS (L; LS stage 1–2) groups, and blood sample data and nutritional intake were compared between groups. Among adults (N group, 71; L group, 92), low-density lipoprotein cholesterol (LDL-C) was significantly lower, and Vitamin B1 intake was significantly higher in the L than in the N group; LDL-C, p = 0.033; Vitamin B1, 0.029. Among older adults (N group, 85; L group, 120), hemoglobin (Hb), albumin, and calcium levels were significantly lower, and sodium, monounsatu-rated fatty acids (MUFA), and n-6 polyunsaturated fatty acids (n-6 PUFA) were significantly higher in the L than the N group; Hb, p = 0.036; albumin, 0.030; calcium, 0.025; sodium; 0.029; MUFA; 0.047, n-6 PUFA; 0.0233). Logistic regression analysis indicated that sodium was the risk factor for the L group (exp (B) 1.001, 95% CI: 1–1.001, p = 0.032). In conclusion, salt intake was associated with LS.

DOI： 10.3390/jcm11030610

Trends in the numbers of spine surgeries and spine surgeons over the past 15 years 査読有り

Kobayashi, K; Sato, K; Kato, F; Kanemura, T; Yoshihara, H; Sakai, Y; Shinjo, R; Ohara, T; Yagi, H; Matsubara, Y; Ando, K; Nakashima, H; Imagama, S

NAGOYA JOURNAL OF MEDICAL SCIENCE 84 巻 ( 1 ) 頁： 155 - 162 2022年2月

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

The purpose of this study is to examine trends in spine surgeries at ten facilities over 15 years, and to analyze relationships with the number of spine surgeons at these facilities. The subjects were patients who underwent spine surgery at the ten facilities from 2003 to 2017. Data were collected every year via a questionnaire designed to obtain clinicopathological and surgical information. There were 37,601 spine surgeries (60.2% male) recorded in the registry at 9 facilities in the Nagoya Spine Group (NSG) between 2003 and 2017, with an increase in the annual number of surgeries by 2.4 times over 15 years. On the other hand, the number of spine surgeons has increased by just under 1.5 times. Instrumentation surgeries increased from 959 in 2003 to 2,276 in 2017 (2.3 times). There was a particularly marked increase in surgeries for spinal degenerative disease from 1,075 in 2003 to 2,821 in 2017 (2.6 times). The number of surgeries performed per surgeon increased from 61.4 in 2003 to 102.8 in 2017, while the average number of spine surgeons per hospital increased from 2.6 in 2003 to 3.7 in 2017. In conclusion, with heavier burden on spine surgeons and the major changes in the spine surgery environment, training and increasing surgeons with advanced expertise and skills will become increasingly important

DOI： 10.18999/nagjms.84.1.155

Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament Open Access

Nakashima, H; Imagama, S; Yoshii, T; Egawa, S; Sakai, K; Kusano, K; Nakagawa, Y; Hirai, T; Wada, K; Katsumi, K; Fujii, K; Kimura, A; Furuya, T; Kanchiku, T; Nagamoto, Y; Oshima, Y; Nagoshi, N; 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; Li, YY; Yatsuya, H; Koda, M; Kawaguchi, Y; Takeshita, K; Matsumoto, M; Yamazaki, M; Okawa, A

SCIENTIFIC REPORTS 12 巻 ( 1 ) 頁： 748 2022年1月

記述言語：英語出版者・発行元：Scientific Reports

This prospective multicenter study, established by the Japanese Ministry of Health, Labour and Welfare and involving 27 institutions, aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL), in order to address the controversy surrounding the role of instrumented fusion in cases of posterior surgical decompression for OPLL. 478 patients were considered for participation in the study; from among them, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, there were no significant differences among the participants in terms of patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments. The overall risk of perioperative complications was found to be lower with LM (odds ratio [OR] 0.40, p = 0.006), and the rate of C5 palsy occurrence was significantly lower with LM (OR 0.11, p = 0.0002) than with PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients who had PF was significantly smaller than in those who had LM. However, multivariable logistic regression analysis showed no significant difference among the participants in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in the LM group than in the PF group (OR 2.73, p = 0.0002). Both LM and PF for cervical myelopathy due to OPLL had resulted in comparable postoperative outcomes at 2 years after surgery.

DOI： 10.1038/s41598-021-04727-1

Differences in the prevalence of locomotive syndrome and osteoporosis in Japanese urban and rural regions: The Kashiwara and Yakumo studies 査読有り

Tanaka, S; Ando, K; Kobayashi, K; Nakashima, H; Seki, T; Ishizuka, S; Machino, M; Ito, S; Kanbara, S; Kanemura, T; Hasegawa, Y; Imagama, S

MODERN RHEUMATOLOGY 32 巻 ( 1 ) 頁： 199 - 204 2022年1月

記述言語：英語出版者・発行元：Modern Rheumatology

Objectives: To clarify whether the prevalence of locomotive syndrome (LS) and osteoporosis differed according to region, gender, and physical functions in Japan. Methods: Data were collected in Kashiwara City (urban region) and Yakumo Town (rural region). Totally, 208 participants from the urban region and 782 participants from the rural region were included in this study. LS was assessed using the 25-item Geriatric Locomotive Function Scale and osteoporosis was assessed using a quantitative ultrasound. Physical functions were measured using grip strength and the 3-m timed up-and-go test. Differences between urban and rural regions were investigated using standardized incidence ratio and multivariate analysis. Results: The prevalence of LS and osteoporosis was 24.5% and 42.8% in the urban region and 10.9% and 28.8% in the rural region, respectively. The standardized incidence ratio of the urban region versus the rural region was 1.80 (95% confidence intervals [CI] = 1.35-2.39) for LS and 1.21 (95% CI = 1.32-2.43) for osteoporosis, showing that the prevalence of LS was significantly higher in the urban region. Multivariate analysis indicated that LS was significantly associated with the urban sample and timed up-and-go was significantly longer in the urban sample. Conclusion: Regional differences may be considered when evaluating LS in health checkups. Understanding the results of this study may help reduce LS prevalence.

DOI： 10.1080/14397595.2021.1899890

Differences in Demographic and Radiographic Characteristics between Patients with Visible and Invisible T1 Slopes on Lateral Cervical Radiographic Images Open Access

Ito, S; Nakashima, H; Matsumoto, A; Ando, K; Machino, M; Segi, N; Tomita, H; Koshimizu, H; Imagama, S

JOURNAL OF CLINICAL MEDICINE 11 巻 ( 2 ) 2022年1月

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

Introduction: The T1 slope is important for cervical surgical planning, and it may be invisible on radiographic images. The prevalence of T1 invisible cases and the differences in demographic and radiographic characteristics between patients whose T1 slopes are visible or invisible remains unexplored. Methods: This pilot study aimed to evaluate the differences in these characteristics between outpatients whose T1 slopes were visible or invisible on radiographic images. Patients (n = 60) who underwent cervical radiography, whose T1 slope was confirmed clearly, were divided into the visible (V) group and invisible (I) group. The following radiographic parameters were measured: (1) C2-7 sagittal vertical axis (SVA), (2) C2-7 angle in neutral, flexion, and extension positions. Results: Based on the T1 slope visibility, 46.7% of patients were included in group I. The I group had significantly larger C2-7 SVA than the V group for males (p < 0.05). The C2-7 SVA tended to be larger in the I group, without significant difference for females (p = 0.362). Discussion: The mean C2-7 angle in neutral and flexion positions was not significantly different between the V and I groups for either sex. The mean C2-7 angle in the extension position was greater in the V group. The T1 slope was invisible in males with high C2-7 SVA.

DOI： 10.3390/jcm11020411

Cicatricial Fibromatosis Causing Cervical Myelopathy Due to Rapid Growth after Removal of Meningioma: A Case Report Open Access

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

SPINE SURGERY AND RELATED RESEARCH 6 巻 ( 1 ) 頁： 90 - 92 2022年

Assessment of Ureters at Dangerous Locations in Lateral Lumbar Interbody Fusion Open Access

Kagami, Y; Nakashima, H; Satake, K; Ito, K; Tanaka, S; Segi, N; Ouchida, J; Morita, M; Ando, K; Kobayashi, K; Machino, M; Imagama, S; Kanemura, T

SPINE SURGERY AND RELATED RESEARCH 6 巻 ( 1 ) 頁： 38 - 44 2022年

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

Introduction: This study aimed to investigate the ureteral running position from the viewpoint of the spine, and to identify the spinal level and left-right difference in the ureter at a dangerous location of ureteral injury during surgery. Methods: This retrospective study included 100 consecutive patients (39 males and 61 females; average age, 70.4 years). Preoperative contrast-enhanced computerized tomography (CT) scans obtained in the supine position for patients who underwent lateral lumbar interbody fusion (LLIF) were analyzed. The ureter location was divided into four regions on the axial CT images based on the lumbar disk levels as follows: A (ventral-medial), B (ventral-lateral), C (dorsal-medial), and D (dorsal-lateral). The C region surrounded by the vertebral body and the psoas muscle was assumed to have the highest probability of ureteral injury. We examined the characteristics of the ureteral position at each disc level. Results: In the upper lumbar spine, the ureter was outside the lateral dorsoventral axis from the contact point of the psoas muscle, while in the lower lumbar spine, it was inside the axis. The ureters located in the C region increased significantly in the lower lumbar disk levels (L1-L2 and L2-L3: 0%; L3-L4: 5.5%; L4-L5: 14.8%; L5-S: 31.5%). Comparing the left and right sides, especially at L4-L5, the ureter in the C region was observed in 21% of all ureters on the left side and in 9% on the right side. With respect to gender differences, the ureters present in the C region were significantly more common in women at lumbar disk levels L3-L4, L4-L5, and L5-S. Conclusions: The ureters in the C region were common on the left side and at lower lumbar disk levels. To avoid ureteral injury, it is necessary to confirm the location of the ureter by using preoperative images and performing LLIF carefully.

DOI： 10.22603/ssrr.2021-0013

Influence of Age and Gender on Intervertebral Disk Degeneration and Height in the Thoracolumbar Spine Open Access

Machino, M; Nakashima, H; Ito, K; Tsushima, M; Ando, K; Kobayashi, K; Imagama, S

SPINE SURGERY AND RELATED RESEARCH 6 巻 ( 4 ) 頁： 379 - 387 2022年

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

Introduction: Intervertebral disk degeneration is a universal and natural process. However, no reports have summarized anatomical age-related intervertebral disk height and disk degenerative changes in the thoracolumbar spine or examined sex-specific differences. This study aimed to establish age-related changes and gender-specific differences of intervertebral disk height and disk degeneration of the thoracolumbar spine in a large cohort of relatively healthy subjects and also to evaluate the relationship between the degree of thoracolumbar disk height and disk degeneration. Methods: Six hundred and twenty-seven relatively healthy subjects (307 males and 320 females; average age, 49.6±16.5 years) were enrolled. We included at least 50 males and 50 females in each decade of life between the 20s and the 70s. We measured intervertebral disk height from T10/T11 to L5/S1, vertebral body height from T10 to S1 on lateral neutral radiographs. Lumbar disk degeneration was defined according to the Pfirrmann classification in sagittal plane magnetic resonance imaging. Results: Age-related decreases in intervertebral disk height were most prominent at L4/L5 in middle-aged and elderly individuals of both sexes. The grade of disk degeneration significantly increased with age in both genders at every level. Mild disk degeneration was observed even in the 20s. The disk degeneration occurred around the L4/L5 level. Although grade V disk degeneration was not identified for males in the 20s and the 30s, it appeared after the 40s and then increased further with age. The intervertebral disk height at the lower lumbar disks decreased with a progression in the disk degeneration grade in both genders. Conclusions: This large-scale cross-sectional analysis of the thoracolumbar spine in relatively healthy subjects demonstrated that lumbar disk height narrowing progresses with age and is correlated with the progression of disk degeneration.

DOI： 10.22603/ssrr.2021-0187

Is Blood Loss Greater in Elderly Patients under Antiplatelet or Anticoagulant Medication for Cervical Spine Injury Surgery? A Japanese Multicenter Survey Open Access

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; Orita, S; 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; Ohba, T; Otsuki, B; Seki, S; Miyazaki, M; Ishihara, M; Okada, S; Aoki, Y; Harimaya, K; Murakami, H; Ishii, K; Ohtori, S; Imagama, S; Kato, S

SPINE SURGERY AND RELATED RESEARCH 6 巻 ( 4 ) 頁： 366 - 372 2022年

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

Introduction: In elderly patients with cervical spinal cord injury, comorbidities such as cardiovascular and cerebrovascular diseases are common, with frequent administration of antiplatelet/anticoagulant (APAC) drugs. Such patients may bleed easily or unexpectedly during surgery despite prior withdrawal of APAC medication. Few reports have examined the precise relationship between intraoperative blood loss and history of APAC use regarding surgery for cervical spine injury in the elderly. The present multicenter database survey aimed to answer the question of whether the use of APAC drugs affected the amount of intraoperative blood loss in elderly patients with cervical spinal cord trauma. Methods: The case histories of 1512 patients with cervical spine injury at 33 institutes were retrospectively reviewed. After excluding cases without spinal surgery or known blood loss volume, 797 patients were enrolled. Blood volume loss was the outcome of interest. We calculated propensity scores using the inverse probability of treatment weighting (IPTW) method. As an alternative sensitivity analysis, linear mixed model analyses were conducted as well. Results: Of the 776 patients (mean age: 75.1±6.4 years) eligible for IPTW calculation, 157 (20.2%) were taking APAC medications before the injury. After weighting, mean estimated blood loss was 204 mL for non-APAC patients and 215 mL for APAC patients. APAC use in elderly patients was not significantly associated with surgical blood loss according to the IPTW method with propensity scoring or linear mixed model analyses. Thus, it appeared possible to perform surgery expecting comparable blood loss in APAC and non-APAC cases. Conclusions: This multicenter study revealed no significant increase in surgical blood loss in elderly patients with cervical trauma taking APAC drugs. Surgeons may be able to prioritize patient background, complications, and preexisting conditions over APAC use before injury when examining the surgical indications for cervical spine trauma in the elderly.

DOI： 10.22603/ssrr.2021-0183

Thoracic myelopathy due to ossification of the posterior longitudinal ligament shown on dynamic MR. 査読有り

Segi N, Ando K, Nakashima H, Machino M, Ito S, Koshimizu H, Tomita H, Imagama S

Surgical neurology international 13 巻頁： 51 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Magnetic resonance (MR) and computed tomography (CT) studies combined are the optimal studies for diagnosing thoracic ossification of the posterior longitudinal ligament (OPLL) contributing to myelopathy. Here, we report a 71-year-old female, whose additional dynamic thoracic MR demonstrated transient T6-T9 anterior OPLL with cord compression. Case Description: A 71-year-old female presented with a progressive myelopathy originally attributed to cervical cord compression resulting in a cervical laminoplasty. However, when she failed to improve postoperatively, a dynamic thoracic MR was performed. On the flexion study, it demonstrated significant although transient T6-T9 anterior thoracic cord compression due to both OPLL and kyphosis. The patient's symptoms resolved following a posterior thoracic fusion alone (i.e., no decompression was warranted). Conclusion: Dynamic MR studies (i.e., flexion studies) in addition to the routine MR and CT evaluations should be performed for patients with myelopathy attributed to thoracic OPLL/kyphosis.

DOI： 10.25259/SNI_14_2022

Recurrent ossification of the posterior longitudinal ligament in the upper thoracic region 10 years after initial decompression. 査読有り Open Access

Segi N, Ando K, Nakashima H, Machino M, Ito S, Koshimizu H, Tomita H, Imagama S

Surgical neurology international 13 巻頁： 17 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Posterior decompression surgery consisting of laminoplasty is generally considered be the treatment of choice for upper thoracic OPLL. Here, we describe a patient who, 10 years following a C3-T4 level laminectomy, developed recurrent OPLL at the T2-3 level with kyphosis requiring a posterior fusion. Case Description: A 64-year-old male with CT documented OPLL at the C3-4, C6-7, and T1-4 levels, originally underwent a cervicothoracic laminectomy with good results. However, 10 years later, when T2-3 OPLL recurred along with kyphosis, he warranted an additional posterior fusion. Conclusion: Due to the long-term risks of developing kyphotic deformity/instability, more patients undergoing initial decompressive surgery alone for upper thoracic OPLL should be considered for primary fusions.

DOI： 10.25259/SNI_1187_2021

Lumbar Thecal Sac Dimensions and Axial Spinal Cord Areas on Magnetic Resosnace Imaging in 626 Healthy Subjects

Nakashima, H; Ito, K; Katayama, Y; Matsumoto, T; Tsushima, M; Ando, K; Kobayashi, K; Machino, M; Imagama, S

SPINE 46 巻 ( 24 ) 頁： E1327 - E1333 2021年12月

記述言語：英語出版者・発行元：Spine

Study Design. A cross-sectional study. Objective. The aim of this study was to investigate the lumbar thecal sac dimensions and spinal cord area on magnetic resonance (MR) imaging in healthy volunteers. Summary of Background Data. There are few reports regarding lumbar spine MRI in healthy subjects, and the difference in spinal canal dimensions by age remains unclear. Methods. A total of 629 healthy volunteers were enrolled, including ≥50 males, females, and subjects in each of the 20s to 70s age decades. The anteroposterior and transverse diameters of the thecal sac and axial areas of the thecal sac and spinal cord were measured at the disc levels on T2-weighted axial MR images. The anteroposterior-to-transverse ratio of the thecal sac (APTR) was calculated. Results. The thecal sac area from T12/L1 to L4/5 was reduced in older age group, but there was no significant difference in L5/ S1. The thecal sac area was significantly reduced in older age group: 89.9%, 86.0%, 84.6%, 80.3% at T12/L1, L1/2, L2/3, and L3/4, respectively, and 79.9% at L4/5 in subjects in their 70 s relative to that in subjects in their 20 s. The APTR was significantly reduced in older age group from T11/12 to L2/L3 in males and at T10/11, L3/4 and from T11/12 to L2/3 in females. Narrow thecal sac areas <80mm2 were found in 10 subjects. The spinal cord area was significantly reduced in older age group at T10/11 in males and at T9/10, T10/11, and T11/12 in females. The area was 92.0% at T10/11 in subjects in their 70s relative to the area of subjects in their 20s. Conclusion. The thecal sac area was reduced in older age group from T12/L1 to L4/5, and the thecal sac area was reduced in the anteroposterior and all directions in the upper and lower lumbar area in age group, respectively. Approximately, 3.0% of healthy population in their 50s or older will have severe asymptomatic stenosis.

DOI： 10.1097/BRS.0000000000004143

Comparison of Surgical Outcomes After Open- and Double-Door Laminoplasties for Patients with Cervical Ossification of the Posterior Longitudinal Ligament <i>A Prospective Multicenter Study</i> 査読有り

Nagoshi, N; Yoshii, T; Egawa, S; Sakai, K; Kusano, K; Nakagawa, Y; Hirai, T; Wada, K; Katsumi, K; Fujii, K; Kimura, A; Furuya, T; 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; Watanabe, K; Imagama, S; Koda, M; Kawaguchi, Y; Takeshita, K; Nakamura, M; Matsumoto, M; Yamazaki, M; Okawa, A

SPINE 46 巻 ( 23 ) 頁： E1238 - E1245 2021年12月

記述言語：英語出版者・発行元：Spine

Study Design.A prospective multicenter study.Objective.To evaluate and compare the surgical outcomes after open-door (OD) and double-door (DD) laminoplasties in subjects with cervical ossification of the posterior longitudinal ligament (OPLL).Summary of Background Data.Although previous studies compared clinical results after OD and DD laminoplasties, they were performed at a single institution with a relatively small sample size targeting mixed pathologies, including cervical spondylotic myelopathy.Methods.This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of these, 41 and 164 patients received OD and DD laminoplasties, respectively. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, and visual analog scale scores.Results.Age, sex, symptom duration, and comorbidities were not significantly different between the groups. Segmental ossification was the most frequent in both the groups. No significant differences in K-line type, canal occupying ratio, C2 to C7 angles, and range of motion were found. Both the procedures reduced the cervical range of motion postoperatively. A comparable frequency of perioperative complications was observed between the groups. The cervical Japanese Orthopaedic Association scores showed a similar improvement at 2 years postopera- tively. The reduction in visual analog scale score for neck pain was favorable in the OD group (P = 0.02), while other pain assessments did not show any significant differences between the groups. The functional outcomes assessed using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire presented equivalent effective rates.Conclusion.The results demonstrated almost comparable surgical outcomes between OD and DD laminoplasties. Lamino- plasty is a valuable technique as a therapeutic option for cervical OPLL.Level of Evidence: 2.

DOI： 10.1097/BRS.0000000000004094

Comparison of Outcomes between Minimally Invasive Lateral Approach Vertebral Reconstruction Using a Rectangular Footplate Cage and Conventional Procedure Using a Cylindrical Footplate Cage for Osteoporotic Vertebral Fracture Open Access

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

JOURNAL OF CLINICAL MEDICINE 10 巻 ( 23 ) 2021年12月

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

The aim of the current study was to compare outcomes between lateral access vertebral reconstruction (LAVR) using a rectangular footplate cage and the conventional procedure using a cylindrical footplate cage in patients with osteoporotic vertebral fracture (OVF). We included 46 patients who underwent anterior–posterior combined surgery for OVF: 24 patients underwent LAVR (Group L) and 22 underwent the conventional procedure (Group C). Preoperative, postoperative, and 1‐ and 2‐year follow‐up X‐ray images were used to measure local lordotic angle, correction loss, and cage subsidence (>2 mm in vertebral endplate depression). In anterior surgery, the operation time was significantly shorter (183 vs. 248 min, p < 0.001) and the blood loss was significantly less (148 vs. 406 mL, p = 0.01) in Group L than in Group C. In Group C, two patients had anterior instrumentation failure. Correction loss was significantly smaller in Group L than in Group C (1.9° vs. 4.9° at 1 year, p = 0.02; 2.5° vs. 6.5° at 2 years, p = 0.04, respectively). Cage subsidence was significantly less in Group L than in Group C (29% vs. 80%, p < 0.001). LAVR using a rectangular footplate cage is an effective treatment for OVF to minimize surgical invasiveness and postoperative correction loss.

DOI： 10.3390/jcm10235664

Does pulmonary function improve after surgical correction of adult idiopathic scoliosis? 査読有り

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

SPINE DEFORMITY 9 巻 ( 6 ) 頁： 1609 - 1616 2021年11月

記述言語：英語出版者・発行元：Spine Deformity

Purpose: The aim was to investigate pulmonary function after surgical correction of adult idiopathic scoliosis. Methods: This study included 146 adult scoliosis patients aged 20–50 years (main curve in thoracic spine). Respiratory function was assessed as predicted forced vital capacity (%FVC) and the ratio of forced expiratory volume in 1 s / FVC (%FEV1) preoperatively and 2 years postoperatively and classified as a normal function (≥ 80%), mild impairment (≥ 65% and < 80%), and moderate impairment (< 65%). Results: Preoperative %FVC and %FEV1 were 85.3% and 85.4%, which were 81.5% and 87.5% at 2 years post-surgery. The preoperative %FVC was mild and moderate in 39 (26.7%) and 12 patients (11.6%), respectively. The %FVC significantly improved (+ 6.2% ± 11.4%, P < 0.001) postoperatively for moderate severity but significantly decreased postoperatively (− 6.4% ± 9.4%, P < 0.001) for normal function. The preoperative %FEV1 was mild and moderate in 27 (18.5%) and 0 patients, respectively. The %FEV1 significantly improved postoperatively (6.3% ± 5.3%, P < 0.001) for mild severity but did not significantly change for normal severity. Twenty-three (15.8%) and 41 (28.1%) patients showed improved ⊿%FVC and ⊿% FEV1 > 5%. Logistic regression analysis showed that preoperative %FVC and %FEV1 severities were independent factors affecting postoperative recovery of %FVC (OR 0.95) and %FEV1 (OR 0.85). Conclusion: Pulmonary function improved in patients with preoperative pulmonary impairment of < 65% in %FVC and < 80% in %FEV1, and the real improvement was limited to patients with severe preoperative impairment.

DOI： 10.1007/s43390-021-00379-3

Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry Open Access

Koda, M; Yoshii, T; Egawa, S; Sakai, K; Kusano, K; Nakagawa, Y; Hirai, T; Wada, K; Katsumi, K; Kimura, A; Furuya, T; Maki, S; Nagoshi, N; Watanabe, K; Kanchiku, T; Nagamoto, Y; Oshima, Y; Ando, K; Nakashima, H; 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; Takahashi, H; Fujii, K; Miyagi, M; Inoue, G; Takaso, M; Imagama, S; Kawaguchi, Y; Takeshita, K; Nakamura, M; Matsumoto, M; Okawa, A; Yamazaki, M

JOURNAL OF CLINICAL MEDICINE 10 巻 ( 21 ) 2021年11月

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

Postoperative neck pain has been reported as an unsolved postoperative complication of surgery for cervical ossification of the posterior longitudinal ligament (OPLL). The aim of the present study was to elucidate factors having a significant association with postoperative deterioration of neck pain in cervical OPLL patients. We studied a cohort of patients in a prospective registry of 478 patients who had undergone cervical spine surgery for cervical OPLL. We excluded those without evaluation of preoperative neck pain. Therefore, 438 patients were included in the present study. Neck pain was evaluated with the visual analogue scale (VAS, 0–100 mm). Postoperative neck pain deterioration was defined as a ≥20 mm increase of VAS neck pain. Patient factors, neurological status, imaging factors and surgical factors were assessed. Univariate analyses followed by multivariate analysis using stepwise logistic regression was performed. Six months after surgery, 50 (11.6%) patients showed postoperative neck pain deterioration and 76 (17.4%) patients showed postoperative neck pain deterioration 2 years after surgery. Six months after surgery, the rate of neck pain deterioration was significantly higher in patients who had undergone posterior surgery. Two years after surgery, the number of levels fused was significantly correlated with neck pain deterioration.

DOI： 10.3390/jcm10215026

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