出版者・発行元：三輪書店  

DOI： 10.11477/mf.091444120380020056

CiNii Research

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

Study Design: Retrospective cohort study. Objectives: Imaging changes in the vertebral body after posterior lumbar interbody fusion (PLIF) are determined to be trabecular bone remodeling (TBR). This study aimed to investigate the influence of cage materials on TBR and segment stabilization in PLIF by studying image changes. Methods: This was a retrospective study reviewing 101 cases who underwent one-level PLIF with three-dimensional porous titanium (3DTi) cages (53 patients) or polyether-ether-ketone (PEEK) cages (48 patients). Computed tomography images obtained 3 months, 1 year, and 2 years postoperatively were examined for TBR, vertebral endplate cyst formation as an instability sign, cage subsidence, and clear zone around pedicle screw (CZPS). Results: No significant differences in the TBR-positivity rates were observed between the two cages at 3 months, 1 year, and 2 years postoperatively. However, all 3DTi cage segments that were TBR-positive at 3 months postoperatively showed no CZPS and fewer final instability segments than the TBR-negative segments (0% vs 9%). In contrast, although the PEEK cage segments that were TBR-positive at 3 months postoperatively were not associated with future segmental stabilization, those that were TBR-positive at 1 year postoperatively had fewer final instability segments than the TBR-negative segments (0% vs 33%). Conclusions: The 3DTi cage segments with TBR 3 months postoperatively showed significant final segmental stabilization, whereas TBR at 1 year rather than 3 months postoperatively was useful in determining final segmental stabilization for the PEEK cage segments. The timing of TBR, a new osseointegration assessment, were associated with the cage material.

DOI： 10.1177/21925682241255686

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脊椎脊髄病学会  

DOI： 10.22603/ssrr.2024-0030

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PubMed

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脊椎脊髄病学会  

DOI： 10.22603/ssrr.2024-0013

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PubMed

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jos.2024.10.003

PubMed

記述言語：英語  

DOI： 10.1186/s13287-024-04044-0

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/21925682241297948

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PubMed

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 Orthopaedic Science  

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

DOI： 10.1016/j.jos.2023.10.005

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

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

DOI： 10.1007/s00586-024-08397-1

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

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

DOI： 10.1007/s00586-024-08380-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脊椎脊髄病学会  

DOI： 10.22603/ssrr.2023-0227

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CiNii Research

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 Bone and Joint Surgery  

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

DOI： 10.2106/JBJS.23.01475

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

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

DOI： 10.1177/21925682231170613

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Stem Cell Research and Therapy  

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

DOI： 10.1186/s13287-024-03842-w

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

Purpose: Spinopelvic sagittal alignment is crucial for assessing balance and determining treatment efficacy in patients with adult spinal deformity (ASD). Only a limited number of reports have addressed spinopelvic parameters and lumbosacral transitional vertebrae (LSTV). Our primary objective was to study spinopelvic sagittal parameter changes in patients with LSTV. A secondary objective was to investigate clinical symptoms and quality of life (QOL) in patients with LSTV. Methods: In this study, we investigated 371 participants who had undergone medical check-ups for the spine. LSTV was evaluated using Castellvi’s classification, and patients were divided into LSTV+ (type II-IV, L5 vertebra articulated or fused with the sacrum) and LSTV- groups. After propensity score matching for demographic data, we analyzed spinopelvic parameters, sacroiliac joint degeneration, clinical symptoms, and QOL for these two participant groups. Oswestry Disability Index (ODI) scores and EQ-5D (EuroQol 5 dimensions) indices were compared between the two groups. Results: Forty-four patients each were analyzed in the LSTV + and LSTV- groups. The LSTV + group had significantly greater pelvic incidence (52.1 ± 11.2 vs. 47.8 ± 10.0 degrees, P = 0.031) and shorter pelvic thickness (10.2 ± 0.9 vs. 10.7 ± 0.8 cm, P = 0.018) compared to the LSTV- group. The “Sitting” domain of ODI (1.1 ± 0.9 vs. 0.6 ± 0.7, P = 0.011) and “Pain/Discomfort” domain of EQ-5D (2.0 ± 0.8 vs. 1.6 ± 0.7, P = 0.005) were larger in the LSTV + group. Conclusion: There was a robust association between LSTV and pelvic sagittal parameters. Clinical symptoms also differed between the two groups in some domains. Surgeons should be aware of the relationship between LSTV assessment, radiographic parameters and clinical symptoms. Level of evidence: 3.

DOI： 10.1007/s00586-024-08378-4

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

C1-C2 fixation has been developed for the rigid fusion of atlantoaxial instability. C1 lateral mass screw (C1 LMS)-C2 pedicle screw fixation is used more frequently due to its rigid fixation and high bone fusion rate. However, C1 screw placement is relatively unsafe even with recently developed image-based navigation systems. Patient-specific screw guide templates (PSGT) were developed to improve the accuracy and safety of C1 screw placement. Herein, we investigated the outcomes of the C1-C2 posterior fixation technique using PSGT. This was a retrospective study of six patients who underwent posterior cervical spinal fusion using the PSGT between January 2022 and April 2023. Operative time, estimated blood loss, intraoperative radiation dose, surgical cost, and screw placement accuracy were evaluated and compared with those achieved with preoperative CT-based navigation (navigation group, n = 15). Screw accuracy was assessed using Neo’s classification. PSGT showed good results, although the differences were not statistically significant (operation time: 104.3 ± 9.7 min vs 116.4 ± 20.8 min; estimated blood loss: 56.7 ± 72.4 mL vs 123.2 ± 162.3 mL; and radiation dose: 1.8 ± 1.2 mSv vs 2.6 ± 0.8 mSv, respectively). PSGT was particularly better in terms of the accuracy of C1 LMS (PSGT: 100%, navigation: 83.3%). The deviation at the entry point was minimal, and the difference between the sagittal and transversal angles from the preoperative plan was small. We investigated the clinical efficacy of using the PSGT for C1-C2 posterior fixation. PSGT improved the accuracy of C1 LMS insertion.

DOI： 10.18999/nagjms.86.3.487

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出版者・発行元：三輪書店  

DOI： 10.11477/mf.5002202334

CiNii Research

出版者・発行元：三輪書店  

DOI： 10.11477/mf.5002202326

CiNii Research

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

Purpose: To determine the most valid bone health parameter to predict mechanical complications (MCs) following surgery for adult spinal deformity (ASD). Methods: This multicenter study retrospectively examined the records of patients who had undergone fusion of three or more motion segments, including the pelvis, with a minimum two-year follow-up period. Patients with moderate and severe global alignment and proportion scores were included in the study and divided into two groups: those who developed MCs and those who did not. Bone mineral density (BMD) of the lumbar spine and femoral neck was measured using dual-energy X-ray absorptiometry, and Hounsfield units (HUs) were measured in the lumbar spine on computed tomography. Radiographic parameters were evaluated preoperatively, immediately after surgery, and at final follow-up. Results: Of 108 patients, 30 (27.8%) developed MCs, including 26 cases of proximal junctional kyphosis/failure, 2 of distal junctional failure, 6 of rod fracture, and 11 reoperations. HUs were significantly lower in patients who experienced MCs (113.7 ± 41.1) than in those who did not (137.0 ± 46.8; P = 0.02). BMD did not differ significantly between the two groups. The preoperative and two-year postoperative global tilt, as well as the immediately postoperative sagittal vertical axis, were significantly greater in patients who developed MCs than in those who did not (P = 0.02, P < 0.01, and P = 0.01, respectively). Conclusion: Patients who experienced MCs following surgery for ASD had lower HUs than those who did not. HUs may therefore be more useful than BMD for predicting MCs following surgery for ASD.

DOI： 10.1007/s00586-024-08261-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Gait and Posture  

Background: Pelvic incidence (PI)–lumbar lordosis (LL) mismatch has a significant destabilizing effect on the center of gravity sway in the static standing position. However, the association between spinopelvic alignment and balance during gait in healthy volunteers is poorly understood. Research question: The degree of PI–LL mismatch and trunk anterior tilt in the static standing posture influences dynamic balance during gait. Methods: In this study, 131 healthy volunteers were divided into two groups: harmonious group (PI − LL ≤ 10°; n = 91) and unharmonious group (PI − LL > 10°; n = 40). A two-point accelerometer system was used for gait analysis; accelerometers were attached to the pelvis and upper trunk to measure acceleration in the forward–backward, right–left, and vertical directions so that sagittal (front–back) deviation width, coronal (right–left) width, and vertical width and their ratios were calculated. Measurements were compared between the two groups, and correlations between alignment and accelerometer data were examined. Results: The harmonious group showed a negative correlation between pelvic sagittal width and PI – LL, pelvic tilt (PT), and sagittal vertical axis (SVA) (correlation coefficient ρ = −0.42, −0.38, and −0.4, respectively), and a positive correlation between sagittal ratio and PI − LL (ρ = 0.35). The unharmonious group showed a positive correlation between pelvic sagittal width and PI and PT (ρ = 0.43 and 0.33, respectively) and between sagittal ratio and SVA (ρ = 0.32). The unharmonious group showed a positive correlation between upper trunk sagittal width and PI − LL and PT (ρ = 0.38 and 0.36, respectively). Significance: The association between spinal alignment and gait parameters differs depending on the presence or absence of PI–LL mismatch. The degree of pelvic compensation and trunk anterior tilt during static standing were associated with unstable gait balance.

DOI： 10.1016/j.gaitpost.2024.04.013

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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 Medicine  

(1) Background: Patients with primary vertebral fracture (VF) are at high risk of re-fracture and mortality. However, approximately two-thirds of patients with VFs receive minimal clinical attention. (2) Methods: The current study aimed to investigate the factors associated with asymptomatic VFs in middle-aged and elderly individuals who underwent resident health examinations. (3) Results: The current study included 217 participants aged > 50 years. VFs were diagnosed based on lateral radiographic images using Genant’s semiquantitative (SQ) method. The participants were divided into non-VF (N; SQ grade 0) and asymptomatic VF (F; SQ grades 1–3) groups. Data on body composition, blood tests, quality of life measures, and radiographic parameters were assessed. A total of 195 participants were included in the N group (mean age, 64.8 ± 7.8 years), and 22 were in the F group (mean age, 66.1 ± 7.9 years). The F group had a significantly higher body mass index (BMI), body fat percentage (BF%), and proportion of patients with knee osteoarthritis (KOA) than the N group. The F group had a significantly higher knee joint pain visual analog scale (VAS) score and painDETECT score than the N group. Logistic regression analysis showed that BF% was associated with asymptomatic VFs. (4) Conclusions: Middle-aged and elderly individuals with asymptomatic VF presented with high BMIs, BF%, and incidence of KOA.

DOI： 10.3390/jcm13072063

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記述言語：日本語   出版者・発行元：日本転倒予防学会  

DOI： 10.11335/tentouyobou.10.1_19

CiNii Research

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 Orthopaedic Science  

Background: This study aimed to characterize the anatomical relationship between the spine, the celiac artery (CA), and the median arcuate ligament using preoperative contrast-enhanced computed tomography (CT) images of patients with spinal deformity who underwent surgical correction. Methods: This retrospective study included 81 consecutive patients (34 males, 47 females; average age: 70.2 years). The spinal level at which the CA originated, the diameter, extent of stenosis, and calcification were determined using CT sagittal images. Patients were divided into two groups: CA stenosis group and non-stenosis group. Factors associated with stenosis were examined. Results: CA stenosis was observed in 17 (21%) patients. CA stenosis group had significantly higher body mass index (24.9 ± 3.9 vs. 22.7 ± 3.7, p = 0.03). In the CA stenosis group, J-type CA (upward angling of the course by more than 90° immediately after descending) was more frequently observed (64.7% vs. 18.8%, p < 0.001). The CA stenosis group had lower pelvic tilt (18.6 ± 6.7 vs. 25.1 ± 9.9, p = 0.02) than non-stenosis group. Conclusions: High BMI, J-type, and shorter distance between CA and MAL were risk factors for CA stenosis in this study. Patients with high BMI undergoing fixation of multiple intervertebral corrective fusions at the thoracolumbar junction should undergo preoperative CT evaluation of the anatomy of CA to assess the poteitial risk of celiac artery compression syndrome.

DOI： 10.1016/j.jos.2023.02.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurology(R) neuroimmunology &amp; neuroinflammation  

BACKGROUND AND OBJECTIVES: This study aimed to identify disease-related autoantibodies in the serum of patients with immune-mediated neuropathies including chronic inflammatory demyelinating polyneuropathy (CIDP) and to investigate the clinical characteristics of patients with these antibodies. METHODS: Proteins extracted from mouse brain tissue were used to react with sera from patients with CIDP by western blotting (WB) to determine the presence of common bands. Positive bands were then identified by mass spectrometry and confirmed for reactivity with patient sera using enzyme-linked immunosorbent assay (ELISA) and WB. Reactivity was further confirmed by cell-based and tissue-based indirect immunofluorescence assays. The clinical characteristics of patients with candidate autoantibody-positive CIDP were analyzed, and their association with other neurologic diseases was also investigated. RESULTS: Screening of 78 CIDP patient sera by WB revealed a positive band around 60-70 kDa identified as dihydrolipoamide S-acetyltransferase (DLAT) by immunoprecipitation and mass spectrometry. Serum immunoglobulin G (IgG) and IgM antibodies' reactivity to recombinant DLAT was confirmed using ELISA and WB. A relatively high reactivity was observed in 29 of 160 (18%) patients with CIDP, followed by patients with sensory neuropathy (6/58, 10%) and patients with MS (2/47, 4%), but not in patients with Guillain-Barré syndrome (0/27), patients with hereditary neuropathy (0/40), and healthy controls (0/26). Both the cell-based and tissue-based assays confirmed reactivity in 26 of 33 patients with CIDP. Comparing the clinical characteristics of patients with CIDP with anti-DLAT antibodies (n = 29) with those of negative cases (n = 131), a higher percentage of patients had comorbid sensory ataxia (69% vs 37%), cranial nerve disorders (24% vs 9%), and malignancy (20% vs 5%). A high DLAT expression was observed in human autopsy dorsal root ganglia, confirming the reactivity of patient serum with mouse dorsal root ganglion cells. DISCUSSION: Reactivity to DLAT was confirmed in patient sera, mainly in patients with CIDP. DLAT is highly expressed in the dorsal root ganglion cells, and anti-DLAT antibody may serve as a biomarker for sensory-dominant neuropathies.

DOI： 10.1212/NXI.0000000000200199

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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 Orthopaedic Science  

Introduction: The importance of lower-limb compensation in patients with spinal malalignment due to spinal pathologies has been emphasized. The latest whole-body X-ray images (WBX) have enabled evaluations of whole-body alignment from head to toe. However, WBX is still not commonly available. Thus, the present study aimed to examine an alternative measurement method of the femoral angle on usual full-spine X-ray images (FSX) that approximates the femoral angle on WBX. Methods: A total of 50 patients (age, 52.8 ± 25.3 years; female, n = 26; male, n = 24) underwent WBX and FSX. The following parameters were measured on lateral view X-rays: WBX and FSX femoral angle (angle between the femoral axis and a perpendicular line); FSX femoral distance (distance from the center of femoral head to the distal femur on FSX); WBX intersection length (length between the center of the femoral head and the intersection point [the point at which the line connecting the center of the femoral head and the midpoint of the femoral condyle intersects the center line of the femur] on WBX). Results: The WBX femoral angle, and FSX femoral angle were 0.16 ± 4.2°, and −0.53 ± 4.1°, respectively. The FSX femoral distance was 102.7 ± 41.1 mm. An ROC curve analysis revealed that the cut-off value of the FSX femoral distance associated with minimal difference in the WBX and FSX femoral angles (<3°) was 73 mm (sensitivity 83.3%, specificity 87.5%, AUC 0.80). The WBX intersection length was 105.3 ± 27.3 mm. Conclusion: To calculate the femoral angle on FSX that approximates the WBX femoral angle, the femoral distance on FSX ≥73 mm is preferable. We suggest using the FSX femoral distance within the range of 80 mm–130 mm as a simple numerical value that meets all criteria.

DOI： 10.1016/j.jos.2023.02.007

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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 Medicine  

During the COVID-19 pandemic, this study investigated the potential of exercise habits to improve quality of life (QOL) and prevent locomotive syndrome (LS) in residents of Yakumo-cho, Hokkaido, Japan. Participants from the 2018 health checkup were surveyed in February 2022, focusing on 200 respondents. These individuals were divided based on their 2018 exercise habits (at least 1 h per week): the exercise group (E group) and the non-exercise group (N group), further categorized in 2022 into the 2022E and 2022N groups. QOL was measured using the SF-36 (physical functioning, general health, physical role, physical pain, vitality, social functioning, emotional role, and mental health) and EuroQoL 5-dimension 5-level questionnaires (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and LS was assessed with the 25-question geriatric locomotive function scale. These showed no significant change in exercise habits from 2018 to 2022. In the non-LS group, the 2022E group had higher vitality and emotional role functioning scores compared to the 2022N group. For those with LS, the 2022E group reported less physical pain. Notably, the LS incidence was significantly lower in the 2022E group. This study concludes that consistent exercise habits positively impact QOL and reduce the LS risk, underscoring the importance of regular physical activity, especially during challenging times like a pandemic. These findings highlight the broader benefits of maintaining exercise routines for public health, particularly in periods of global health crises. Based on our findings, we recommend that people continue to exercise at least one hour per week to prevent LS.

DOI： 10.3390/jcm13051385

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PubMed

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 Medicine  

Background: Previous studies have demonstrated that the center of gravity (COG) is more unstable in the elderly than in young people. However, it is unclear whether aging itself destabilizes the COG. This study aimed to investigate changes in COG sway and gait kinematics over time by a longitudinal study of middle-aged and elderly adults. Methods: This study included 198 healthy middle-aged and elderly people who underwent stabilometry at ten-year intervals. The participants’ mean age at baseline was 62.9 ± 6.5 years, and 77 (39%) of them were male. The results of stabilometry (mean velocity, sway area, postural sway center in the medial–lateral direction [X center], and postural sway center in the anterior–posterior direction [Y center]), and results of exercise tests (the height-adjusted maximum stride length [HMSL] and the 10 m walk test [10MWT]) were analyzed. The destabilized group with 11 participants, whose mean velocity exceeded 3 cm/s after 10 years, was compared with the stable group with 187 participants, whose mean velocity did not exceed 3 cm/s. Results: Mean velocity increased significantly over ten years (open-eye, from 1.53 ± 0.42 cm to 1.86 ± 0.67 cm, p < 0.001); however, the sway area did not change significantly. X center showed no significant change, whereas Y center showed a significant negative shift (open-eye, from −1.03 ± 1.28 cm to −1.60 ± 1.56 cm, p < 0.001). Although the results of 10MWT and initial HMSL did not differ significantly, the HMSL in the destabilized group at ten years was 0.64, which was significantly smaller than the 0.72 of others (p = 0.019). Conclusions: The ten-year changes in COG sway in middle-aged and elderly adults were characterized by a significant increase in mean velocity but no significant difference in sway area. Because the destabilized group had significantly smaller HMSL at ten years, instability at the onset of movement is likely to be affected by COG instability.

DOI： 10.3390/jcm13041081

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記述言語：英語   出版者・発行元：Global Spine Journal  

DOI： 10.1177/21925682231162860

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

Study Design: Retrospective cohort study. Objectives: We newly found that trabecular bone remodeling (TBR) often appeared in the fixed adjacent vertebrae during bony fusion. Thus, TBR might indicate osteointegration. Hence, we aimed to investigate whether TBR in the early postoperative period could predict future bony fusion after posterior lumbar interbody fusion (PLIF). Methods: We retrospectively analyzed 78 patients who underwent one-level PLIF. Demographic data were reviewed. Using computed tomography (CT) images taken at 3 months and 1 year postoperatively, we investigated the vertebral endplate cyst (VEC) formation, TBR in the vertebral body, cage subsidence, and clear zone around pedicle screw (CZPS). Results: TBR had high interobserver reliability regardless of cage materials. VECs, TBR, and both were found in 30, 53, and 16 patients at 3 months postoperatively and in 30, 65, and 22 patients at 1 year postoperatively, respectively. The incidence of VEC, which indicates poor fixation, was lower in early (3 months postoperatively) TBR-positive patients, with a significant difference at 1 year postoperatively (3 months, P =.074; 1 year, P =.003). Furthermore, 3 (5.7%) of the 53 early TBR-positive patients had CZPS without instability at 1 year postoperatively. In 25 TBR-negative patients, 1 (4.0%) had pedicle screw cutout requiring reoperation, 1 (4.0%) had pseudarthrosis, and 4 (16%) had CZPS. Conclusions: Patients with early TBR (3 months) did not experience pedicle screw cutout nor pseudarthrosis and had significantly fewer VECs than those without early TBR. Thus, TBR may be a new radiological marker of initial fixation after PLIF.

DOI： 10.1177/21925682221090484

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記述言語：英語   出版者・発行元：The Japanese Society for Spine Surgery and Related Research  

<p><b>Introduction:</b> Proper cervical sagittal alignment is essential for maintaining overall spinal stability and function. A crucial measure of this alignment is the T1 slope, which is an important indicator. However, lateral cervical spine radiographs often fail to clearly show the T1 slope owing to several factors, such as shoulder anatomy or variations in body shape. In this study, we aimed to evaluate the differences in cervical alignment between individuals with visible and invisible T1 slopes.</p><p><b>Methods:</b> This study was a retrospective cohort analysis involving 60 patients diagnosed with cervical spine conditions and evaluated via radiographic imaging. The patients were categorized into two groups based on whether the T1 slope was clearly visible or not. Key radiographic measurements, such as the C2–C7 sagittal vertical axis (SVA) and C2–C7 Cobb angles in the neutral, flexion, and extension postures, were recorded and statistically analyzed.</p><p><b>Results:</b> Significant differences were observed in the C2–C7 SVA between the groups, particularly among men. Men in the invisible T1 slope group had an average SVA of 28.9 mm, whereas those in the visible group had a mean SVA of 16.0 mm (<i>P</i> < 0.05). Although no notable differences were observed in the Cobb angles for the neutral and flexion positions, a substantial reduction in the extension Cobb angle was noted in the invisible than in the visible group (24.4° vs. 37.6°, <i>P</i> < 0.05).</p><p><b>Conclusions:</b> Male patients with obscured T1 slopes exhibited unique radiographic features, including higher C2–C7 SVA and diminished extension capacity. This suggests that the visibility of the T1 slope plays a pivotal role in the evaluation of cervical alignment. Furthermore, the exclusion of patients with an invisible T1 slope from research studies could lead to biased results.</p>

DOI： 10.22603/ssrr.2024-0253

CiNii Research

記述言語：日本語   出版者・発行元：公益社団法人 日本生体医工学会  

<p>術中脊髄モニタリングでは，運動誘発電位の正確な評価法が十分に確立されておらず，術中に迅速かつ客観的に脊髄機能を評価することが難しいという課題がある．</p><p>本研究では，機械学習を用いて術中に得られる運動誘発電位の異常を検出する機械学習モデルの開発を試みた．</p><p>患者797名の術中脊髄モニタリングで得られた各部位の軽頭蓋刺激運動誘発電位の波形データ，術前後に行われる徒手筋力検査（MMT）のスコアを利用した．</p><p>本解析では，次の条件を満たす症例を除外した； 1）両足の大腿四頭筋，前脛骨筋，ハムストリング，下腿三頭筋のうちどれかが取得されていない．2）総取得数の8割以上で波形が取得できていない．</p><p>術前のMMTスコアが全て５かつ術後も全て5の症例を正常，術前のスコアが全て5かつ術後が全て5でない症例を異常と定義した．</p><p>本研究では，異常検知手法の一つであるLong Short Term Memory Autoencoderを用いて正常波形を学習し，MMT評価が低下した症例について術中での異常波形を検知する機械学習モデルの構築した．正常データを学習：検証：テスト＝7:1:2に分割し，異常データは全てテストデータとして使用した．</p><p>モデルをテストデータに適用した結果，偽陽性率は4%，感度は0.48，AUCは0.79であった．正しく異常と判定できた10例中6例は手術終盤に異常判定が頻発しており，脊髄の異常を反映している可能性がある．</p>

DOI： 10.11239/jsmbe.annual62.186_1

CiNii Research

記述言語：英語   出版者・発行元：The Japanese Society for Spine Surgery and Related Research  

<p>Introduction: Cervical pedicle screw (CPS) placement is crucial for posterior cervical fusion surgery due to its strong fixation ability. However, CPS insertion is associated with risks, including screw perforation, which can lead to complications such as vertebral artery injury and neurological deficits. Although previous studies have explored some morphological factors affecting CPS placement, comprehensive data on specific parameters contributing to perforation remains limited. This study aimed to investigate cervical vertebrae features associated with CPS perforation and established threshold values for improved preoperative planning.</p><p>Methods: A retrospective analysis of 36 patients who underwent posterior cervical fusion surgery with CPS placement was conducted using preoperative computed tomography (CT) -based navigation. Cases with CPS insertion at C1 or C2 were excluded.. The key morphological parameters—optimal screw trajectory angle, pedicle diameter, and distance from the entry point to the pedicle isthmus (DEP) —were measured on preoperative CT images. CPS placement accuracy was assessed postoperatively using Neo' s classification. The receiver operating characteristic (ROC) curve analysis determined the cutoff values for predicting CPS perforation.</p><p>Results: Among the 102 CPSs placed from C3 to C7, the overall perforation rate was 25.5%. C3 had the highest perforation rate (45.5%), whereas C7 had the lowest (3.1%). The vertebrae with CPS perforation exhibited a significantly larger optimal screw trajectory angle (45.5° vs. 38.0°, p < 0.001), smaller pedicle diameter (4.2 mm vs. 5.2 mm, p < 0.001), and longer DEP (13.2 mm vs. 11.9 mm, p = 0.002). The ROC analysis identified the following cutoff values: 44.0° for the optimal angle, 4.35 mm for the pedicle diameter, and 12.7 mm for the DEP. These morphological parameters strongly predicted the risk of CPS perforation.</p><p>Conclusions: Establishing key morphological thresholds enhances preoperative planning for CPS placement, improves accuracy and patient safety, and minimizes complications.</p>

DOI： 10.22603/ssrr.2024-0243

CiNii Research

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

Ossification of the ligaments progresses slowly in the initial stages, and most patients are unaware of the disease until obvious myelopathy symptoms appear. Consequently, treatment and clinical outcomes are not satisfactory. This study is aimed at developing an automated system for the detection of the thoracic ossification of the posterior longitudinal ligament (OPLL) using deep learning and plain radiography. We retrospectively reviewed the data of 146 patients with thoracic OPLL and 150 control cases without thoracic OPLL. Plain lateral thoracic radiographs were used for object detection, training, and validation. Thereafter, an object detection system was developed, and its accuracy was calculated. The performance of the proposed system was compared with that of two spine surgeons. The accuracy of the proposed object detection model based on plain lateral thoracic radiographs was 83.4%, whereas the accuracies of spine surgeons 1 and 2 were 80.4% and 77.4%, respectively. Our findings indicate that our automated system, which uses a deep learning-based method based on plain radiographs, can accurately detect thoracic OPLL. This system has the potential to improve the diagnostic accuracy of thoracic OPLL.

DOI： 10.1155/2023/8495937

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脊椎脊髄病学会  

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

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脊椎脊髄病学会  

Introduction: Scoliosis is the three-dimensional (3D) deformity of the spine. Scoliosis curvatures, such as the lower lumbar curve and the angle of the upper endplate of the sacrum observable on radiographs, are associated with postoperative outcomes; however, the relationship between postoperative outcomes and sacral morphology remains unknown. This study aimed to investigate sacral morphology in patients with adolescent idiopathic scoliosis (AIS) and to clarify its relationship with wedge-shaped deformity of the first sacral vertebra and radiographic parameters. Methods: This study included 94 patients who underwent fusion surgery for AIS (scoliosis group). As the control group, 25 patients without scoliosis (<10°) under 50 years of age were also investigated. S1 wedging angle (S1WA) using 3D Computed tomography (CT) and Cobb angle, L4 tilt, and sacral slanting using radiography were measured. The relationship between S1WA and other radiographic parameters was analyzed using correlation coefficients. Differences in sacral morphology between the Lenke lumbar modifier types A and C were also investigated. Results: S1WA was significantly larger in the scoliosis group than the control group (scoliosis: 1.7°±2.5°, control: 0.1°± 1.5°, p=0.002). Furthermore, the number of patients with S1WA >3° or >5° was significantly higher in the scoliosis group (>3°: 33%, 8%, p=0.012; >5°: 16%, 0%, p=0.039). S1WA correlated with sacral slanting (r=0.45, p<0.001) and L4 tilt (r= 0.35, p<0.001) and was significantly greater with Lenke lumbar modifier C than A (2.4°±2.6°, 0.8°±2.0°; p<0.001). Conclusions: The S1 vertebra was deformed and wedge-shaped in AIS, especially in cases with a large lumbar curve. Additionally, S1WA is associated with sacral slanting and L4 tilt on radiography in AIS.

DOI： 10.22603/ssrr.2023-0134

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

Purpose: To examine inherent differences adjusted for age and clinical score in whole-body sagittal (WBS) alignment involving the lower extremities between Asians and Caucasians, and to determine the relationship between age and WBS parameters by race and sex. Methods: A total of 317 individuals consisting of 206 Asians and 111 Caucasians participated. WBS parameters including C2-7 lordotic angle, lower lumbar lordosis (lower LL, L4-S), pelvic incidence (PI), pelvic thickness, knee flexion (KF), sagittal vertical axis (SVA), and T1 pelvic angle (TPA) were evaluated radiologically. Propensity score-matching adjustments for age and the Oswestry Disability Index scores for comparative analysis between the two race cohorts and correlation analysis between age and WBS parameters for all subjects by race and sex were conducted. Results: The comparative analysis included 136 subjects (age: Asians 41.1 ± 13.5, Caucasians 42.3 ± 16.2 years, p = 0.936). Racial differences in WBS parameters were observed in C2-7 lordotic angle (−1.8 ± 12.3 vs. 6.3 ± 12.2 degrees, p = 0.001), and lower LL (34.0 ± 6.6 vs. 38.0 ± 6.1 degrees, p <.001). In correlation analysis with age, moderate or more significant correlations with age were found in KF for all groups, and in SVA and TPA for females of both racial groups. Age-related changes in pelvic parameters of PI and pelvic thickness were more significant in Caucasian females. Conclusion: Analysis of the correlation between age and WBS parameters suggested that age-related WBS changes vary between races and should be considered during corrective spinal surgery.

DOI： 10.1007/s00586-023-07829-8

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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 Medicine  

The relationship between hearing and motor function as a function of aging is unclear. Therefore, we aimed to clarify the relationship between age-related hearing loss and locomotive syndrome. In total, 240 participants aged ≥40 years, whose hearing acuity and motor function had been measured, were included in this study. Patients with a hearing acuity of <35 dB and ≥35 dB were categorized into normal and low hearing acuity groups, respectively. Motor function was compared according to sex between the groups. Among men, those in the low hearing acuity group (51/100) were older, had a significantly slower walking speed, and had a higher prevalence of locomotive syndrome than those in the normal group. Among women, those in the low hearing group (14/140) were older and had a significantly slower gait speed than those in the normal group. The multivariate analysis showed that, in the low hearing acuity group, age and gait speed were risk factors in men, while age was the only risk factor in women. In conclusion, hearing loss was associated with walking speed. The association between hearing loss and locomotive syndrome was observed only in men. In the multivariate analysis, hearing loss was associated with walking speed only in men.

DOI： 10.3390/jcm12175626

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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 Orthopaedic Science  

Background: This study aims to investigate the utility of the Doppler effect on ultrasonography for the diagnosis of very early- and early-stage lumbar spondylolysis in adolescent patients. Methods: In total, 76 adolescent patients with acute and subacute low back pain were prospectively enrolled, with 46 having lumbar spondylolysis and the remaining 30 having low back pain without spondylolysis. MRI and/or computed tomograms scans revealed very early- and early-stage lumbar spondylolysis. Furthermore, positive Doppler findings in ultrasonography around the area from the facet joint to the laminae were investigated. Results: There were no significant differences in age (p > 0.99) and body mass index (p = 0.11) between cases with and without spondylolysis. Very early- and early-stage spondylolysis were observed in 27.6% and 72.4% of patients, respectively. Positive power Doppler was 91.3% and 33.3% in cases with and without spondylolysis, respectively, which was significantly higher in spondylolysis (p < 0.001). The sensitivity and specificity of this positive power Doppler were 91.4% and 66.7%, respectively. Furthermore, the rate of positive power Doppler was significantly higher in early-stage spondylolysis (p = 0.02), with 75.0% and 97.6% sensitivity in very early- and early-stage spondylolysis, respectively. Conclusions: A positive Doppler effect on ultrasonography is effective for screening very early- and early-stage spondylolysis in adolescent patients in an outpatient clinic.

DOI： 10.1016/j.jos.2022.06.019

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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 Medicine  

Spinal cord tumors are infrequently identified spinal diseases that are often difficult to diagnose even with magnetic resonance imaging (MRI) findings. To minimize the probability of overlooking these tumors and improve diagnostic accuracy, an automatic diagnostic system is needed. We aimed to develop an automated system for detecting and diagnosing spinal schwannomas and meningiomas based on deep learning using You Only Look Once (YOLO) version 4 and MRI. In this retrospective diagnostic accuracy study, the data of 50 patients with spinal schwannomas, 45 patients with meningiomas, and 100 control cases were reviewed, respectively. Sagittal T1-weighted (T1W) and T2-weighted (T2W) images were used for object detection, classification, training, and validation. The object detection and diagnosis system was developed using YOLO version 4. The accuracies of the proposed object detections based on T1W, T2W, and T1W + T2W images were 84.8%, 90.3%, and 93.8%, respectively. The accuracies of the object detection for two spine surgeons were 88.9% and 90.1%, respectively. The accuracies of the proposed diagnoses based on T1W, T2W, and T1W + T2W images were 76.4%, 83.3%, and 84.1%, respectively. The accuracies of the diagnosis for two spine surgeons were 77.4% and 76.1%, respectively. We demonstrated an accurate, automated detection and diagnosis of spinal schwannomas and meningiomas using the developed deep learning-based method based on MRI. This system could be valuable in supporting radiological diagnosis of spinal schwannomas and meningioma, with a potential of reducing the radiologist’s overall workload.

DOI： 10.3390/jcm12155075

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

Axons of terminally differentiated neurons in the mammalian central nervous system (CNS) are unable to regenerate after dissection. One of the mechanisms underlying this is the inhibition of axonal regeneration by chondroitin sulfate (CS) and its neuronal receptor, PTPσ. Our previous results demonstrated that the CS–PTPσ axis disrupted autophagy flux by dephosphorylating cortactin, which led to the formation of dystrophic endballs and to the inhibition of axonal regeneration. In contrast, juvenile neurons vigorously extend axons toward their targets during development and maintain regenerative activity for axons even after injury. Although several intrinsic and extrinsic mechanisms have been reported to mediate the differences, the detailed mechanisms are still elusive. Here, we report that Glypican-2, a member of heparan sulfate proteoglycans (HSPG), which are able to antagonize CS–PTPσ by competing with the receptor, is specifically expressed in the axonal tips of embryonic neurons. Glypican-2 overexpression in adult neurons rescues the dystrophic endball back to a healthy growth cone on the CSPG gradient. Consistently, Glypican-2 restored cortactin phosphorylation in the axonal tips of adult neurons on CSPG. Taken together, our results clearly demonstrated Glypican-2's pivotal role in defining the axonal response to CS and provided a new therapeutic target for axonal injury.

DOI： 10.1016/j.expneurol.2023.114444

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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 Medicine  

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

DOI： 10.3390/jcm12144690

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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 Medicine  

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

DOI： 10.3390/jcm12083041

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出版者・発行元：三輪書店  

DOI： 10.11477/mf.5002201908

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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 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

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   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

Web of Science

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   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

Web of Science

Scopus

PubMed

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

担当区分：筆頭著者   記述言語：英語  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

記述言語：日本語   出版者・発行元：(一社)日本脊椎脊髄病学会  

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