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Takahashi I, Watanabe Y, Sonoda H, Tsunoda D, Amano I, Koibuchi N, Iizuka H, Shimokawa N. Calcium sensing and signaling are impaired in the lumbar spine of a rat model of congenital kyphosis. Eur Spine J 2023; 32:3403-3412. [PMID: 37555955 DOI: 10.1007/s00586-023-07877-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE Kyphosis involves spines curving excessively backward beyond their physiological curvature. Although the normal structure of the spinal vertebrae is extremely important for maintaining posture and the normal function of the thoracic and abdominal organs, our knowledge concerning the pathogenesis of the disease is insufficient. We herein report that the downregulation of the calcium signaling pathway is involved in the pathogenesis of congenital kyphosis. METHODS The third to fifth lumbar spine segments, the kyphotic region of Ishibashi (IS) rats, which are used as a model of congenital kyphoscoliosis, were collected. A DNA microarray, quantitative PCR, Western blotting, and immunohistochemistry were used to measure the expression of genes and proteins related to intracellular calcium signaling. RESULTS We found that the expression of calcium-sensing receptor (CaSR) and transient receptor potential vanilloid 1 (Trpv1)-two receptors involved in the calcium signaling-was decreased in the lumbar spine of IS rats. We also observed that the number of CaSR-immunoreactive and Trpv1-immunoreactive cells in the lumbar spine of IS rats was lower than in wild-type rats. Furthermore, the expression of intracellular molecules downstream of these receptors, such as phosphorylated protein kinase C, c-Jun N-terminal kinase, and neural EGFL-like 1, was also reduced. In fact, the calcium content in the lumbar spine of IS rats was significantly lower than that in wild-type rats. CONCLUSION These results indicate that adequate calcium signaling is extremely important for the regulation of normal bone formation and may also be a key factor for understanding the pathogenesis of congenital kyphosis.
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Affiliation(s)
- Itsuki Takahashi
- Department of Nutrition, Takasaki University Graduate Scholl of Health and Welfare, 37-1 Nakaorui-Machi, Takasaki, Gunma, 370-0033, Japan
| | - Yusuke Watanabe
- Department of Nutrition, Takasaki University Graduate Scholl of Health and Welfare, 37-1 Nakaorui-Machi, Takasaki, Gunma, 370-0033, Japan
| | - Hiroyuki Sonoda
- Orthopaedic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Daisuke Tsunoda
- Spine Surgery, Higashi-Maebashi Orthopaedic Hospital, Maebashi, Gunma, Japan
| | - Izuki Amano
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Noriyuki Koibuchi
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Haku Iizuka
- Orthopedic Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan.
| | - Noriaki Shimokawa
- Department of Nutrition, Takasaki University Graduate Scholl of Health and Welfare, 37-1 Nakaorui-Machi, Takasaki, Gunma, 370-0033, Japan.
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
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Ishiwata S, Iizuka Y, Shitara H, Mieda T, Takasawa E, Tsunoda D, Kakuta Y, Honda A, Ito S, Inomata K, Sasaki T, Hamano N, Tajika T, Chikuda H. The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy. Global Spine J 2022; 12:1375-1379. [PMID: 33375855 PMCID: PMC9393992 DOI: 10.1177/2192568220980441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Case series study. OBJECTIVE We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). METHODS We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. RESULTS Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. CONCLUSION RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.
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Affiliation(s)
- Sho Ishiwata
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan,Sho Ishiwata, MD, Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
| | - Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tokue Mieda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Eiji Takasawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Daisuke Tsunoda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yohei Kakuta
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Akira Honda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shunsuke Ito
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kazuhiro Inomata
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Noritaka Hamano
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Kakuta Y, Iizuka Y, Mieda T, Sonoda H, Ishiwata S, Honda A, Tsunoda D, Takasawa E, Tajika T, Chikuda H. Transdural cauda equina herniation after uneventful lumbar surgery: A case report and review of the literature. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2021.101090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ito S, Iizuka Y, Nishinome M, Yanagawa T, Koshi H, Tokue A, Mieda T, Takasawa E, Tsunoda D, Ishiwata S, Honda A, Inomata K, Tajika T, Chikuda H. Primary epidural extra-osseous Ewing sarcoma/peripheral primitive neuroectodermal tumor of the cervical spine curatively treated by surgery and adjuvant chemoradiotherapy: A case report and review of the literature. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2020.101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Honda A, Iizuka Y, Mieda T, Sonoda H, Ishiwata S, Kakuta Y, Tsunoda D, Takasawa E, Tajika T, Koshi H, Chikuda H. Paraplegia due to Thoracic Mobile Schwannoma after Myelography. Case Rep Orthop 2020; 2020:6709819. [PMID: 33005466 PMCID: PMC7509573 DOI: 10.1155/2020/6709819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Spinal mobile tumors are very rare. We herein report a case of paraplegia caused by migration and incarceration of thoracic mobile schwannoma after myelography. Case Presentation. A 25-year-old man who had weakness and numbness in both his legs also had pain radiating to the back that was induced by back flexion or extension and jumping. Magnetic resonance imaging (MRI) showed an intradural extramedullary lesion at the T10 and T11 levels. Myelography was performed but discontinued due to his back and lower limb pain. Computed tomography after myelography revealed a rostrally migrated intradural mass with a discrepancy in the exact location in comparison to the MRI findings. He underwent a second lumbar puncture and drained the cerebrospinal fluid (CSF) to aid the spinal cord, because the symptoms gradually worsened and led to paraplegia. After the drainage of the CSF, his symptoms were immediately resolved. The day after myelography, he underwent complete resection of the tumor with the diagnosis of schwannoma. One year after the surgery, he had been working despite having hyperreflexia in his lower limbs with no weakness or sensory disturbance. CONCLUSION Severe neurological deficits associated with spinal cord damage can occur due to migration of mobile tumors.
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Affiliation(s)
- Akira Honda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Tokue Mieda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Hiroyuki Sonoda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Sho Ishiwata
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Yohei Kakuta
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Daisuke Tsunoda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Eiji Takasawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Hiromi Koshi
- Clinical Department of Pathology, Gunma University Hospital, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan
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Ishiwata S, Iizuka H, Sonoda H, Tsunoda D, Tajika Y, Chikuda H, Koibuchi N, Shimokawa N. Upregulated miR-224-5p suppresses osteoblast differentiation by increasing the expression of Pai-1 in the lumbar spine of a rat model of congenital kyphoscoliosis. Mol Cell Biochem 2020; 475:53-62. [PMID: 32748313 DOI: 10.1007/s11010-020-03859-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/26/2020] [Indexed: 01/08/2023]
Abstract
Congenital scoliosis is defined by the presence of structural anatomical malformations that arise from failures of vertebral formation or segmentation before and after birth. The understanding of genetic background and key genes for congenital scoliosis is still poor. We herein report that the excess expression of plasminogen activator inhibitor-1 (Pai-1) induced by the upregulation of miR-224-5p is involved in the pathogenesis of congenital kyphoscoliosis through impaired osteoblast differentiation. We first investigated the variety and progression of abnormalities of the lumbar spines in Ishibashi (IS) rats, a rat model of congenital kyphoscoliosis. The rats had already shown fusion and division of the primary ossification center at postnatal day 4. Over time, the rats showed various abnormalities of the lumbar spine, including the fusion of the annular epiphyseal nucleus. At postnatal day 42, spinal curvature was clearly observed due to the fusion of the vertebral bodies. Using a microRNA array, we found that the expression of miR-224-5p was increased in the lumbar spine of the rats at postnatal day 4. The expression of Pai-1, which is involved in osteoblast differentiation regulated by miR-224-5p, was also increased, while the levels of type I collagen, a marker of osteoblast differentiation, were decreased in the lumbar spine. These results indicate that the aberrant expression of miRNA-224-5p and its target genes is involved in the impaired osteoblast differentiation and may provide a partial molecular explanation for the pathogenesis of congenital scoliosis.
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Affiliation(s)
- Sho Ishiwata
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Haku Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- Isesaki Municipal Hospital, Isesaki, Japan
| | - Hiroyuki Sonoda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
- Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Daisuke Tsunoda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yuki Tajika
- Department of Anatomy, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Noriyuki Koibuchi
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Noriaki Shimokawa
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
- Department of Nutrition, Takasaki University of Health and Welfare, 31-1 Nakaorui-machi, Takasaki, Gunma, 370-0033, Japan.
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Sonoda H, Iizuka H, Ishiwata S, Tsunoda D, Abe M, Takagishi K, Chikuda H, Koibuchi N, Shimokawa N. The retinol‐retinoic acid metabolic pathway is impaired in the lumbar spine of a rat model of congenital kyphoscoliosis. J Cell Biochem 2019; 120:15007-15017. [DOI: 10.1002/jcb.28762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 12/16/2018] [Accepted: 01/10/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroyuki Sonoda
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
- Department of Integrative Physiology Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Haku Iizuka
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Sho Ishiwata
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Daisuke Tsunoda
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Masako Abe
- Department of Nutrition Takasaki University of Health and Welfare Takasaki Gunma Japan
| | - Kenji Takagishi
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Hirotaka Chikuda
- Department of Orthopedic Surgery Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Noriyuki Koibuchi
- Department of Integrative Physiology Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Noriaki Shimokawa
- Department of Integrative Physiology Gunma University Graduate School of Medicine Maebashi Gunma Japan
- Department of Nutrition Takasaki University of Health and Welfare Takasaki Gunma Japan
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Iizuka H, Iizuka Y, Mieda T, Tsunoda D, Kobayashi R, Sorimachi Y. The relationship between the degree of displacement of the atlas to axis and the clinical data in atlanto-axial subluxation due to rheumatoid arthritis. Arch Orthop Trauma Surg 2018; 138:453-458. [PMID: 29256183 DOI: 10.1007/s00402-017-2858-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The most common type of anatomical cervical spine involvement is atlanto-axial subluxation (AAS) in rheumatoid arthritis (RA). The purpose of this study was to clarify the relationship between the displacement of the atlas to axis and the clinical data obtained in patients with AAS due to RA. METHODS Fifty patients with AAS due to RA that were treated by surgery are herein reviewed. Based on the findings of preoperative lateral cervical radiographs in the neutral position, the patients were classified into two groups as follows: a 10 + group with an atlanto-dental interval (ADI) of ≧ 10 mm, and a 10 - group with an ADI < 10 mm. RESULTS Preoperative lateral cervical radiographs demonstrated 15 cases to belong to the 10 + group, while 35 cases belonged to the 10 - group. In the preoperative MR imaging, an intramedullary high signal intensity was observed in seven cases that belonged to the 10 + group and in four cases belonging to the 10 - group. Regarding the neurological severity, the 10 + group included significantly more cases showing severe neurological deficits before surgery; however, there was no significant difference between the two groups regarding the presence of severe deficits even after surgery. CONCLUSIONS The severe displacement group included significantly more cases showing an intramedullary high signal intensity in the preoperative MR images. Our results also suggest that a severe displacement before surgery affected the presence of neurological deficits before surgery; however, it did not affect the neurological recovery from such severe neurological deficits.
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Affiliation(s)
- Haku Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Yoichi Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Tokue Mieda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Daisuke Tsunoda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Ryoichi Kobayashi
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Yasunori Sorimachi
- Department of Orthopedic Surgery, Japanese Red Cross Maebashi Hospital, 3-21-36, Asahi, Maebashi, Gunma, 371-0014, Japan
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Iizuka H, Iizuka Y, Mieda T, Tsunoda D, Kobayashi R, Sorimachi Y. The clinical outcomes of atlanto-axial arthrodesis in patients with rheumatoid arthritis - Assessment according to the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). J Orthop Sci 2017; 22:401-404. [PMID: 28215392 DOI: 10.1016/j.jos.2017.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 01/15/2017] [Accepted: 01/25/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical outcomes of atlanto-axial arthrodesis in rheumatoid arthritis (RA) patients with cervical myelopathy using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). METHODS Twenty patients who underwent surgery to treat atlanto-axial subluxation (AAS) were reviewed. RESULTS The rates of success rates for each domain were as follows: cervical spine function, 11 of 18 patients (61.1%); upper extremity function, 3 of 15 patients (20%); lower extremity function, 8 of 18 patients (44.4%); bladder function, 5 of 13 patients (38.5%); and quality of life, 3 of 20 patients (15%). Significant differences of success rate were found between the following domains: cervical spine function and upper extremity function, cervical spine function and the quality of life, and lower-extremity function and quality of life. There were significant differences in the pre- and post-surgery visual analogue scale (VAS) scores for pain or stiffness in the neck or shoulders, and pain or numbness in the arms and hands. CONCLUSION Atlanto-axial arthrodesis in RA patients provided a better outcome for cervical spine function, with improvement in VAS scores for pain or stiffness in the neck or shoulders. This surgery provided improvement of pain or numbness of the upper extremities but not of upper-extremity function. In contrast, the surgery achieved a relatively good recovery in lower-extremity function but little improvement of pain or numbness of the lower extremities. The success rate with regard to quality of life was found to be significantly lower than the success rates observed for cervical spine function and lower-extremity function.
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Affiliation(s)
- Haku Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan.
| | - Yoichi Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan
| | - Tokue Mieda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan
| | - Daisuke Tsunoda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan
| | - Ryoichi Kobayashi
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan
| | - Yasunori Sorimachi
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511 Japan
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Tajika T, Kobayashi T, Kaneko T, Tsunoda D, Tsunoda K, Sutou T, Yamamoto A, Takagishi K. Epidemiological study for personal risk factors and quality of life related to Dupuytren's disease in a mountain village of Japan. J Orthop Sci 2014; 19:64-70. [PMID: 24129389 DOI: 10.1007/s00776-013-0478-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 09/20/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study investigated the etiology, personal risk factors, and quality of life related to Dupuytren's disease among residents of a mountain village in Japan. METHODS Medical examinations were conducted of 401 adult residents (163 men, 238 women; average age of 66.7 years, range 40-92) of a mountain village in Japan. All had completed a self-administered questionnaire including items for gender, weight, height, dominant hand, occupation, history of diabetes mellitus, and frequency of smoking tobacco and drinking alcohol, in addition to EuroQol-5-Dimensions-3-level Japanese version. Blood samples were collected and assessed for biochemical markers related to Dupuytren's disease. The Dupuytren's disease diagnosis was based on clinical signs. Meyerding's classification was used to ascertain the disease severity. After examining background data and physical examination data related to Dupuytren's disease, we evaluated the association of Dupuytren's disease with those factors using univariate and logistic regression analysis. RESULTS Dupuytren's disease was diagnosed in 28 subjects (7.0%). Univariate analysis revealed associations of age, male gender, occupation, history of diabetes mellitus, and alcohol intake with Dupuytren's disease. Logistic regression analysis after adjustment for age revealed a significant association between Dupuytren's disease and male gender, occupation, and history of alcohol intake. No significant difference was found between Dupuytren's disease patients and participants without this disease in the scoring and visual analog scale of EuroQol. No relation was found in scoring, the visual analog scale of EuroQol, or grading of Meyerding's classification in participants with Dupuytren's disease. CONCLUSION This cross-sectional study revealed Dupuytren's disease in 7.0% of 401 subjects among the general population of a mountain village in Japan. The prevalence is higher with age and is apparently associated with male gender, occupation and alcohol intake. Risk factors associated with Dupuytren's disease were identified as age, male gender, occupation, and alcohol consumption habits.
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Affiliation(s)
- Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan,
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Tsunoda D, Iizuka H, Iizuka Y, Nishinome M, Takagishi K. Wrist drop and muscle weakness of the fingers induced by an upper cervical spine anomaly. Eur Spine J 2013; 23 Suppl 2:218-21. [PMID: 24057282 DOI: 10.1007/s00586-013-3038-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/15/2013] [Accepted: 09/15/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly. METHODS A 77-year-old male complained of severe muscle weakness of the right hand. Cervical spine MRI showed a severe and sharp compression of the spinal cord from the dorsal side between C2 and C3 with intramedullary intensity changes and mild stenosis at C3/4 and C4/5. RESULTS The patient underwent laminectomy of C2, cranial side laminotomy of C3, and laminectomy of C4. Decompression of the spinal cord was demonstrated 1 year after surgery. The patient achieved full recovery of the muscle weakness 1 year after undergoing surgery. CONCLUSIONS The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
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Affiliation(s)
- Daisuke Tsunoda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
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Tsunoda D, Iizuka Y, Iizuka H, Nishinome M, Kobayashi R, Ara T, Yamamoto A, Takagishi K. Associations between neck and shoulder pain (called katakori in Japanese) and sagittal spinal alignment parameters among the general population. J Orthop Sci 2013; 18:216-9. [PMID: 23232803 DOI: 10.1007/s00776-012-0341-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 11/14/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neck and shoulder pain (NSP), called katakori in Japanese, is one of the most common medical symptoms in the Japanese population; however, the pathogenesis of NSP has not yet been adequately elucidated. The purpose of this study was to investigate the associations between NSP and sagittal spinal alignment among the general population in Japan. MATERIALS AND METHODS Medical examinations were conducted in the northeast village of Gunma, Japan. A questionnaire regarding NSP was distributed among 329 Japanese subjects (125 men and 204 women). Regarding the prevalence of NSP, the participants were asked to report the occurrence of NSP over the previous two weeks. For each participant, the parameters for sagittal spinal alignment, including thoracic kyphosis angle, lumbar lordosis angle, and spinal inclination relative to a perpendicular line, were measured with a SpinalMouse(®) (Idiag, Vplkerswill, Switzerland), an electronic computer-aided measuring device. We investigated the associations between the prevalence of NSP and the parameters obtained with the SpinalMouse(®). Statistical analyses were performed using Student's t test, Welch's t test, the chi-squared test, and a multivariate logistic regression analysis. A P value of 0.05 was considered to be statistically significant. RESULTS The prevalence of NSP within the two weeks prior to questioning was 52.0 % (171 of 329 subjects). The subjects in the NSP group were significantly younger than those in the non-NSP group. There was a significant gender difference between the NSP group and the non-NSP group, as significantly more females complained of NSP than males. No significant association between the thoracic kyphosis angle and NSP was observed. However, the lumbar lordosis angles measured in the subjects in the NSP group were significantly larger than those in the non-NSP group, and the inclinations relative to a perpendicular line measured in the subjects in the NSP group were significantly larger than those in the non-NSP group. Furthermore, we performed a logistic regression analysis on each factor that showed a significant difference; age, gender, and the lumbar lordosis angle were each found to be significant. CONCLUSIONS We investigated the associations between NSP and spinal sagittal alignment using the SpinalMouse(®) system, and demonstrated that some spinal alignment parameters are associated with NSP.
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Affiliation(s)
- Daisuke Tsunoda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
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Tsunoda D. Clinical snapshot: acute myocardial infarction. Am J Nurs 1996; 96:38-9. [PMID: 8644794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- D Tsunoda
- National Naval Medical Center, Bethesda, MD, USA
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