研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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西村由介, 永島吉孝, 齋藤竜太

脊椎脊髄ジャーナル 34 巻 ( 12 ) 頁： 896 - 901 2022年3月

Increased Risk of Thyroid Dysfunction by PD-1 and CTLA-4 Blockade in Patients Without Thyroid Autoantibodies at Baseline 国際誌 Open Access

Iwama, S; Kobayashi, T; Yasuda, Y; Okuji, T; Ito, M; Ando, M; Zhou, X; Yamagami, A; Onoue, T; Kawaguchi, Y; Miyata, T; Sugiyama, M; Takagi, H; Hagiwara, D; Suga, H; Banno, R; Hase, T; Morise, M; Wakahara, K; Yokota, K; Kato, M; Nishio, N; Tanaka, C; Miyata, K; Ogura, A; Ito, T; Sawada, T; Shimokata, T; Niimi, K; Ohka, F; Ishigami, M; Gotoh, M; Hashimoto, N; Saito, R; Kiyoi, H; Kajiyama, H; Ando, Y; Hibi, H; Sone, M; Akiyama, M; Kodera, Y; Arima, H

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 107 巻 ( 4 ) 頁： E1620 - E1630 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Clinical Endocrinology and Metabolism

Background: Previous studies showed that although the risk of thyroid dysfunction [thyroid immune-related adverse events (irAEs)] induced by anti-programmed cell death-1 antibodies (PD-1-Ab) was as low as 2% to 7% in patients negative for anti-thyroid antibodies (ATAs) at baseline, it was much higher (30%-50%) in patients positive for ATAs. However, whether a similar increase occurs with combination therapy using PD-1-Ab plus anti-cytotoxic T-lymphocyte antigen-4 antibody (CTLA-4-Ab) is unknown. Methods: A total of 451 patients with malignancies treated with PD-1-Ab, CTLA-4-Ab, or a combination of PD-1-Ab and CTLA-4-Ab (PD-1/CTLA-4-Abs) were evaluated for ATAs at baseline and for thyroid function every 6 weeks for 24 weeks after treatment initiation and then observed until the last clinical visit. Results: Of the 451 patients, 51 developed thyroid irAEs after immunotherapy [41 of 416 (9.9%) treated with PD-1-Ab, 0 of 8 (0%) treated with CTLA-4-Ab, and 10 of 27 (37.0%) treated with PD-1/CTLA-4-Abs]. The cumulative incidence of thyroid irAEs was significantly higher in patients who were positive vs negative for ATAs at baseline after both PD-1-Ab [28/87 (32.2%) vs 13/329 (4.0%), P < 0.001] and PD-1/CTLA-4-Abs [6/10 (60.0%) vs 4/17 (23.5%), P < 0.05] treatments. The risk of thyroid irAEs induced by PD-1/CTLA-4Abs, which was significantly higher than that induced by PD-1-Ab, in patients negative for ATAs at baseline was not statistically different from that induced by PD-1-Ab in patients positive for ATAs at baseline. Conclusions: This study showed that the incidence of thyroid irAEs was high and not negligible after PD-1/CTLA-4-Abs treatment even in patients negative for ATAs at baseline.

DOI： 10.1210/clinem/dgab829

Mesencephalic developmental venous anomaly causing obstructive hydrocephalus: illustrative case 査読有り国際誌 Open Access

Hiraga, K; Hayashi, S; Oshima, R; Kondo, T; Kanamori, F; Saito, R

JOURNAL OF NEUROSURGERY-CASE LESSONS 5 巻 ( 12 ) 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurosurgery: Case Lessons

BACKGROUND Developmental venous anomalies (DVAs) are congenital anatomical variants of the normal deep parenchymal veins. DVAs are occasionally found incidentally on brain imaging, and most cases are asymptomatic. However, they rarely cause central nervous disorders. Herein, a case of mesencephalic DVA that caused aqueduct stenosis and hydrocephalus and discuss its diagnosis and treatment is reported. OBSERVATIONS The patient was a 48-year-old female who presented with depression. Computed tomography and magnetic resonance imaging (MRI) of the head revealed obstructive hydrocephalus. Contrast-enhanced MRI revealed an abnormally distended linear region with enhancement on the top of the cerebral aqueduct, which was confirmed as a DVA by digital subtraction angiography. An endoscopic third ventriculostomy (ETV) was performed to improve the patient’s symptoms. Intraoperative endoscopic imaging showed obstruction of the cerebral aqueduct by the DVA. LESSONS This report describes a rare case of obstructive hydrocephalus caused by DVA. It highlights the usefulness of contrast-enhanced MRI for diagnosing cerebral aqueduct obstructions due to DVAs and the effectiveness of ETV as a treatment option.

DOI： 10.3171/CASE22563

Surgical management of brain metastasis as a part of systematic metastases from adenoid cystic carcinoma of the external auditory canal: illustrative case 国際誌 Open Access

Kuramitsu, S; Motomura, K; Nakajima, Y; Tsujiuchi, T; Motomura, A; Matsuo, M; Fukaya, N; Kageyama, A; Kojima, I; Ohno, M; Saito, R

JOURNAL OF NEUROSURGERY-CASE LESSONS 3 巻 ( 11 ) 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurosurgery: Case Lessons

BACKGROUND Adenoid cystic carcinoma (ACC) of the external auditory canal (EAC) is a rare tumor that accounts for approximately 5% of all EAC tumors. ACC is generally known as a slow-growing tumor, but patients often experience recurrence or distant metastasis in the long clinical course. While the major pattern of recurrence is pulmonary metastasis, brain metastasis of ACC of the EAC is rare. OBSERVATIONS The authors describe the case of a 72-year-old male who was diagnosed with ACC of the EAC. Approximately 7 years later, brain magnetic resonance imaging revealed an intra-axial homogenously enhancing mass lesion that had no direct connection with the skull base in the left frontal lobe. The patient underwent tumor resection and histopathological examination revealed a mixture of cribriform and tubular patterns. The image and pathological characteristics of the tumor were similar to those of primary ACC or ACC from other sites of origin. LESSONS While patients with ACC of the EAC often experience recurrence or distant metastasis in the long clinical course, they survive for a relatively long period of time, even though an optimal treatment has not been established. The authors therefore recommend surgical resection for brain metastasis of ACC of the EAC to improve neurological symptoms.

DOI： 10.3171/CASE21673

その他リンク： https://thejns.org/downloadpdf/journals/j-neurosurg-case-lessons/3/11/article-CASE21673.xml

Magnetic resonance-guided focused ultrasound thalamotomy restored distinctive resting-state networks in patients with essential tremor 国際誌

Kato, S; Maesawa, S; Bagarinao, E; Nakatsubo, D; Tsugawa, T; Mizuno, S; Kawabata, K; Tsuboi, T; Suzuki, M; Shibata, M; Takai, S; Ishizaki, T; Torii, J; Mutoh, M; Saito, R; Wakabayashi, T; Katsuno, M; Ozaki, N; Watanabe, H; Sobue, G

JOURNAL OF NEUROSURGERY 138 巻 ( 2 ) 頁： 306 - 317 2022年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurosurgery

OBJECTIVE Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy ameliorates symptoms in patients with essential tremor (ET). How this treatment affects canonical brain networks has not been elucidated. The purpose of this study was to clarify changes of brain networks after MRgFUS thalamotomy in ET patients by analyzing resting-state networks (RSNs). METHODS Fifteen patients with ET were included in this study. Left MRgFUS thalamotomy was performed in all cases, and MR images, including resting-state functional MRI (rsfMRI), were taken before and after surgery. MR images of 15 age- and sex-matched healthy controls (HCs) were also used for analysis. Using rsfMRI data, canonical RSNs were extracted by performing dual regression analysis, and the functional connectivity (FC) within respective networks was compared among pre-MRgFUS patients, post-MRgFUS patients, and HCs. The severity of tremor was evaluated using the Clinical Rating Scale for Tremor (CRST) score pre- and postoperatively, and its correlation with RSNs was examined. RESULTS Preoperatively, ET patients showed a significant decrease in FC in the sensorimotor network (SMN), primary visual network (VN), and visuospatial network (VSN) compared with HCs. The decrease in FC in the SMN correlated with the severity of tremor. After MRgFUS thalamotomy, ET patients still exhibited a significant decrease in FC in a small area of the SMN, but they exhibited an increase in the cerebellar network (CN). In comparison between pre- and post- MRgFUS patients, the FC in the SMN and the VSN significantly increased after treatment. Quantitative evaluation of the FCs in these three groups showed that the SMN and VSN increased postoperatively and demonstrated a trend toward those of HCs. CONCLUSIONS The SMN and CN, which are considered to be associated with the cerebello-thalamo-cortical loop, exhibited increased connectivity after MRgFUS thalamotomy. In addition, the FC of the visual network, which declined in ET patients compared with HCs, tended to normalize postoperatively. This could be related to the hypothesis that visual feedback is involved in tremor severity in ET patients. Overall, the analysis of the RSNs by rsfMRI reflected the patho-physiology with the intervention of MRgFUS thalamotomy in ET patients and demonstrated a possibility of a biomarker for successful treatment.

DOI： 10.3171/2022.5.JNS22411

Paradoxical symptomatic cerebral blood flow decreases after combined revascularization surgery for patients with pediatric moyamoya disease: illustrative case 国際誌 Open Access

Araki, Y; Yokoyama, K; Uda, K; Kanamori, F; Kurimoto, M; Shiba, Y; Mamiya, T; Takayanagi, K; Ishii, K; Nishihori, M; Takeuchi, K; Tanahashi, K; Nagata, Y; Nishimura, Y; Okamoto, S; Sumitomo, M; Izumi, T; Saito, R

JOURNAL OF NEUROSURGERY-CASE LESSONS 3 巻 ( 3 ) 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurosurgery: Case Lessons

BACKGROUND Transient neurological deficits (TNDs) develop after cerebral revascularization in patients with moyamoya disease (MMD). The authors report a rare pediatric MMD case with extensive decreased cerebral blood flow (CBF) and prolonged TNDs after combined revascularization. OBSERVATIONS A 9-year-old boy presented with transient left upper limb weakness, and MMD was diagnosed. A right-sided combined surgery was performed. Two years after the surgery, frequent but transient facial (right-sided) and upper limb weakness appeared. The left internal carotid artery terminal stenosis had progressed. Therefore, a left combined revascularization was performed. The patient’s motor aphasia and right upper limb weakness persisted for approximately 10 days after surgery. Magnetic resonance angiography showed that the direct bypass was patent, but extensive decreases in left CBF were observed using single photon emission tomography. With adequate fluid therapy and blood pressure control, the neurological symptoms eventually disappeared, and CBF improved. LESSONS The environment of cerebral hemodynamics is heterogeneous after cerebral revascularization for MMD, and the exact mechanism of CBF decreases was not identified. TNDs are significantly associated with the onset of stroke during the early postoperative period. Therefore, appropriate treatment is desired after determining complex cerebral hemodynamics using CBF studies.

DOI： 10.3171/CASE21628

[Diffuse midline glioma].

Saito R

No shinkei geka. Neurological surgery 50 巻 ( 1 ) 頁： 29 - 38 2022年1月

Multitier Network Analysis Using Resting-state Functional MRI for Epilepsy Surgery Open Access

Maesawa, S; Bagarinao, E; Nakatsubo, D; Ishizaki, T; Takai, S; Torii, J; Kato, S; Shibata, M; Wakabayashi, T; Saito, R

NEUROLOGIA MEDICO-CHIRURGICA 62 巻 ( 1 ) 頁： 45 - 55 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Neurologia Medico-Chirurgica

Resting-state functional MRI (rs-fMRI) has been utilized to visualize large-scale brain networks. We evaluated the usefulness of multitier network analysis using rs-fMRI in patients with focal epilepsy. Structural and rs-fMRI data were retrospectively evaluated in 20 cases with medically refractory focal epilepsy, who subsequently underwent surgery. First, structural changes were examined using voxel-based morphometry analysis. Second, alterations in large-scale networks were evaluated using dual-regression analysis. Third, changes in cortical hubs were analyzed and the relationship between aberrant hubs and the epileptogenic zone (EZ) was evaluated. Finally, the relationship between the hubs and the default mode network (DMN) was examined using spectral dynamic causal modeling (spDCM). Dual-regression analysis revealed significant decrease in functional connectivity in several networks including DMN in patients, although no structural difference was seen between groups. Aberrant cortical hubs were observed in and around the EZ (EZ hubs) in 85% of the patients, and a strong degree of EZ hubs correlated to good seizure outcomes postoperatively. In spDCM analysis, facilitation was often seen from the EZ hub to the contralateral side, while inhibition was seen from the EZ hub to nodes of the DMN. Some cognition-related networks were impaired in patients with focal epilepsy. The EZ hub appeared in the vicinity of EZ facilitating connections to distant regions in the early phase, which may eventually generate secondary focus, while inhibiting connections to the DMN, which may cause cognitive deterioration. Our results demonstrate pathological network alterations in epilepsy and suggest that earlier surgical intervention may be more effective.

DOI： 10.2176/nmc.oa.2021-0173

Reliability of IDH1-R132H and ATRX and/or p53 immunohistochemistry for molecular subclassification of Grade 2/3 gliomas

Nishikawa, T; Watanabe, R; Kitano, Y; Yamamichi, A; Motomura, K; Ohka, F; Aoki, K; Hirano, M; Kato, A; Yamaguchi, J; Maeda, S; Kibe, Y; Saito, R; Wakabayashi, T; Kato, Y; Sato, S; Ogino, T; Natsume, A; Ito, I

BRAIN TUMOR PATHOLOGY 39 巻 ( 1 ) 頁： 14 - 24 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Brain Tumor Pathology

Since the World Health Organization 2016 classification (2016 WHO), genetic status has been incorporated into the diagnosis of Grade 2/3 gliomas (lower-grade gliomas). Therefore, immunohistochemistry (IHC) of IDH1-R132H, ATRX, and p53 have been used in place of genetic status. We report the associations between histological findings, IHC, and genetic status. We performed IHC of IDH1-R132H, ATRX, and p53 in 76 lower-grade gliomas and discussed its validity based on the 2016 WHO and the upcoming 2021 WHO classification. The sensitivity and specificity of anti-ATRX, p53, and IDH1-R132H IHC were 40.9%/98.1%, 78.6%/85.4%, and 90.5%/84.6%, respectively. Among 21 IDH1-mutant gliomas without 1p/19q codeletion, two gliomas (9.5%) mimicked the so-called classic for oligodendroglioma (CFO) in their morphology. Of the 42 gliomas with 1p/19q codeletion, four cases were difficult to diagnose as oligodendroglioma through morphological examination. Moreover, there were three confusing cases with ATRX mutations but with retained ATRX-IHC positivity. The lessons learned from this study are as follows: (1) ATRX-IHC and p53-IHC should be supplementary to morphological diagnosis, (2) rare IDH mutations other than IDH1 R132H should be considered, and (3) there is no complete alternative test to detect molecular features of glioblastoma under the 2021 WHO classification.

DOI： 10.1007/s10014-021-00418-x

胸部大動脈ステントグラフト治療の既往がある急性主幹動脈閉塞症に対しsurgical embolectomyが奏功した1例

村松佑亮, 布施佑太郎, 太田慎次, 中村茂和, 栗本太志, 渡邉和彦, 齋藤竜太

脳卒中 44 巻 ( 6 ) 頁： 664 - 669 2022年

記述言語：日本語出版者・発行元：一般社団法人日本脳卒中学会

<p>症例は83歳男性．突然の右半身麻痺および失語を呈し，当院に救急搬送された．来院時，全失語，右半身完全麻痺の状態であった．頭部造影CTと脳MRIで左MCA急性閉塞を認めた．機械的血栓回収療法を検討したが，胸部大動脈瘤に対するステントグラフト留置（thoracic endovascular aortic repair: TEVAR）の既往があり，経大動脈的アプローチは困難と予測された．そのため，緊急で顕微鏡下のsurgical embolectomyを施行した．術後症状は著明に改善し，NIHSS 3点，mRS 2点で自宅退院となった．発症から来院までの時間が短いMCA急性閉塞症に対して，機械的血栓回収療法のリスクが高い場合にsurgical embolectomyを行い，良好な転帰を得た．急性期脳主幹動脈閉塞に対して，大動脈アプローチが困難と予想される場合には，surgical embolectomyをはじめから治療の選択肢に加えることを検討してもよいかもしれない．</p>

DOI： 10.3995/jstroke.11028

CiNii Research

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Delayed Recurrence of Choroid Plexus Carcinoma in the Sacral Spinal Cord 17 Years after Its Initial Presentation. Open Access

Nagai A, Kanamori M, Shimoda Y, Watanabe M, Saito R, Kumabe T, Aizawa T, Tominaga T

NMC case report journal 9 巻 ( 0 ) 頁： 301 - 306 2022年

Diagnosis and Treatment Strategies for Arachnoiditis Ossificans Following Subarachnoid Hemorrhage: A Case Report. Open Access

Nagashima Y, Nishimura Y, Ito H, Nishii T, Oyama T, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 295 - 299 2022年

Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report. Open Access

Hanyu T, Nishihori M, Izumi T, Motomura K, Ohka F, Goto S, Araki Y, Yokoyama K, Uda K, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 289 - 294 2022年

Atypical Incomplete Detachment Following PulseRider Deployment Open Access

Goto, S; Izumi, T; Nishihori, M; Araki, Y; Yokoyama, K; Uda, K; Saito, R

JOURNAL OF NEUROENDOVASCULAR THERAPY 16 巻 ( 8 ) 頁： 409 - 412 2022年

Contrast-Enhanced Magnetic Resonance Imaging Suggested a Possibility of Transvenous Embolization in the Superior Petrosal Sinus Dural Arteriovenous Fistula: A Case Report Open Access

Nishihori, M; Izumi, T; Tsukada, T; Kato, Y; Uda, K; Yokoyama, K; Araki, Y; Saito, R

JOURNAL OF NEUROENDOVASCULAR THERAPY 16 巻 ( 3 ) 頁： 163 - 169 2022年

頚椎症性脊髄症が疑われたACTH単独欠損症の1例

齋藤剛, 吉田光宏, 中林規容, 相見有理, 石田衛, 濱﨑一, 寺尾和一, 中嶋祥子, 苗代朋樹, 齋藤竜太

脊髄外科 36 巻 ( 1 ) 頁： 88 - 93 2022年

Laminectomy triggers symptomatic growth of spinal schwannoma in a patient with schwannomatosis. 国際誌 Open Access

Oyama T, Nishimura Y, Nagashima Y, Nishii T, Hara M, Takayasu M, Sakakibara A, Saito R

Surgical neurology international 13 巻頁： 261 - 261 2022年

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

Background: Schwannomatosis (SWN) is genetically similar to neurofibromatosis type 2 (NF2) and represents a NF2 gene mutation. Previous studies have shown that these mutations in both neurons and Schwann cells can lead to the development of schwannomas after nerve crush injuries. Here, we reviewed the potential pathoanatomical mechanisms for the development of a trauma-induced spinal schwannomas in a 55-year-old male with SWN. Case Description: A 49-year-old male had originally undergone a L3-L5 lumbar laminectomy for stenosis; the schwannomas seen on the preoperative magnetic resonance imaging (MRI) were not resected. Now at age 55, he newly presented with low back pain and numbness in the left L5 dermatome, and he was diagnosed with an L4 vertebral level cauda equina tumor on MRI. Following gross-total resection, the histopathological assessment revealed a Ki-67 labeling index 5-10% in hotspots (i.e., slightly higher than the normal range of schwannomas) and a 20% mosaic loss of SMARCB1. Based on these criteria, he was diagnosed as having SWN. Conclusion: In this patient with SWN, compression/physical trauma to nerves of the cauda equina during the L3-L5 laminectomy 6 years ago likely caused the progression of schwannoma.

DOI： 10.25259/SNI_453_2022

Downward penetrating endplate screw technique under O-arm navigation posterior fusion in patients with osteoporotic vertebral body fractures associated with diffuse idiopathic skeletal hyperostosis. 国際誌 Open Access

Shiraishi D, Yamamoto Y, Motonori I, Nishimura Y, Hara M, Saito R, Takayasu M

Surgical neurology international 13 巻頁： 436 - 436 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Surgical Neurology International

Background: A downward penetrating endplate screw (PES) technique combined with caudal anchor screws inserted in the upward direction under O-arm navigation (i.e., crossing screw technique) avoided screw backout and proximal junctional kyphosis (PJK) in three patients with osteoporotic vertebral body fractures and diffuse idiopathic skeletal hyperostosis (DISH). Methods: The PES techniques were utilized for patients with T12 (one patient) and L1 (two patients) spontaneous fusion across the targeted vertebrae, with minimal damage to the involved endplates/intervertebral discs. The average number of instrumented vertebrae was 5.3. Results: There were no perioperative complications over the mean follow-up period of 28.7 months; no screw loosening, and no PJK. Conclusion: The PES technique prevented screw backout, and PJK in three patients with lumbar osteoporotic vertebral fractures and DISH.

DOI： 10.25259/SNI_762_2022

The preoperative focal cerebral blood flow status may be associated with slow flow in the bypass graft after combined surgery for moyamoya disease. 査読有り Open Access

Araki Y, Yokoyama K, Uda K, Kanamori F, Mamiya T, Takayanagi K, Ishii K, Shintai K, Nishihori M, Tsukada T, Takeuchi K, Tanahashi K, Nagata Y, Nishimura Y, Tanei T, Nagashima Y, Muraoka S, Izumi T, Seki Y, Saito R

Surgical neurology international 13 巻頁： 511 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Surgical Neurology International

Background: The aim of this study was to investigate the association between early postoperative slow flow in bypass grafts and preoperative focal cerebral blood flow (CBF) in patients who underwent combined surgery for moyamoya disease (MMD). Methods: The subjects were 18 patients (22 surgeries) who underwent single photon emission computed tomography (SPECT) before surgery. The CBF value of the middle cerebral artery territory was extracted from the SPECT data, and the value relative to the ipsilateral cerebellar CBF (relative CBF, or RCBF) was calculated. The association between RCBF and early postoperative slow flow in the bypass graft was investigated. In addition, the correlation between the revascularization effect and preoperative RCBF was analyzed. Results: In four of 22 surgeries (18.2%), slow flow in the bypass graft was identified in the early postoperative period. Preoperative RCBF in the slow flow and patent groups was 0.86 ± 0.15 and 0.87 ± 0.15, respectively, with no significant difference (P = 0.72). The signal intensity of four slow-flowed bypasses was improved in all cases on magnetic resonance angiography images captured during the chronic phase (mean of 3.3 months postoperatively). The revascularization scores were 2 ± 0.82 and 2.1 ± 0.68 in the slow flow and patent groups, respectively, and did not differ significantly (P = 0.78). A significant correlation was not observed between preoperative RCBF and the revascularization effect. Conclusion: No significant association was observed between preoperative RCBF and early postoperative slow flow in bypass grafts in patients with MMD undergoing combined surgery. Given the high rate of improved depiction of slow-flowed bypass in the chronic postoperative phase, the conceptual significance of an opportune surgical intervention is to maintain CBF by supporting the patient's own intracranial-extracranial conversion function.

DOI： 10.25259/SNI_772_2022

Unilateral laminotomy for bilateral decompression and balloon kyphoplasty to decompress lumber canal stenosis aggravated by osteoporotic vertebral compression fractures: A technical note. 国際誌

Nagashima Y, Nishimura Y, Ishii M, Nishii T, Fukaya N, Oyama T, Abe T, Kato H, Tsukamoto E, Tanei T, Saito R

Surgical neurology international 13 巻頁： 538 - 538 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Surgical Neurology International

Background: The optimal treatment of lumbar canal stenosis (LCS) associated with osteoporotic vertebral fractures (OVFs) remains unclear. Here, we have combined a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) alone with balloon kyphoplasty (BKP) for LCS aggravated by OVF. Methods: ULBD with BKP was performed in three patients who showed LCS associated with OVFs on MR images with progressive lower extremity neurological deficits. Clinical outcomes were assessed using the numerical rating scale (NRS) and the Japanese Orthopaedic Association (JOA) score. Radiological outcomes were evaluated using multiple parameters (i.e., fractured vertebral body height, lumbar lordosis [LL], and focal angle of the fractured vertebral body). Results: Over 6 postoperative months, the NRS and JOA scores were clearly improved while radiological parameters remained maintained (i.e., loss of fractured vertebral body height was only 0.3-1.4 mm in all cases). Two of the three cases showed restoration of LL and focal angle postoperatively. Conclusion: The combination of ULBD with BKP is an effective option for LCS aggravated by OVF.

DOI： 10.25259/SNI_971_2022

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論文 - 齋藤　竜太