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Mori K, North TD, Cheng KJ, Baek S, Alvis HB, Kwon YH. Effects of two-step golf swing drills on rhythm and clubhead speed in competitive juniors. Sports Biomech 2024:1-15. [PMID: 38623642 DOI: 10.1080/14763141.2024.2336946] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
Vertical and horizontal rhythms are crucial aspects of a dynamic golf swing, and the two-step swing drills (TSSD) were specifically designed to promote rhythmic unloading and loading of the legs. The purpose of this study was to evaluate the effects of a TSSD training session on the swing rhythm and clubhead speed (CHS) among competitive junior golfers (3.1 ± 4.4 hcp). The driver swings (7 swings each) of 10 competitive junior golfers (aged 15-18) were captured before and after a TSSD session consisting of four stages (lasting less than 45 minutes). Post-TSSD training, there were significant increases in CHS (p < .001), maximum unweighting (p = .006), the trail-side push (p = .009), the horizontal motion ranges of the body and pelvis (p = .005-.031), the upward/downward motion range of the body in the backswing (p = .042/.024), and the backswing/downswing angular velocity peaks of the axle-chain system (p < .033). The stepping-like leg actions primarily facilitated horizontal motion rhythm over vertical motion and unweighting over push in terms of ground interaction. These findings suggest that TSSD can serve as an effective method for developing a rhythmic and dynamic motion pattern while increasing CHS.
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Affiliation(s)
- Kanji Mori
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
| | - Taylor D North
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
| | - Kai-Jen Cheng
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
| | - Seungho Baek
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
| | - Hunter B Alvis
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
| | - Young-Hoo Kwon
- Biomechanics & Motor Behavior Laboratory, Texas Woman's University, Denton, TX, USA
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2
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Sanada T, Kinoshita M, Sasaki T, Yamamoto S, Fujikawa S, Fukuyama S, Hayashi N, Fukai J, Okita Y, Nonaka M, Uda T, Arita H, Mori K, Ishibashi K, Takano K, Nishida N, Shofuda T, Yoshioka E, Kanematsu D, Tanino M, Kodama Y, Mano M, Kanemura Y. Prediction of MGMT promotor methylation status in glioblastoma by contrast-enhanced T1-weighted intensity image. Neurooncol Adv 2024; 6:vdae016. [PMID: 38410136 PMCID: PMC10896622 DOI: 10.1093/noajnl/vdae016] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Background The study aims to explore MRI phenotypes that predict glioblastoma's (GBM) methylation status of the promoter region of MGMT gene (pMGMT) by qualitatively assessing contrast-enhanced T1-weighted intensity images. Methods A total of 193 histologically and molecularly confirmed GBMs at the Kansai Network for Molecular Diagnosis of Central Nervous Tumors (KANSAI) were used as an exploratory cohort. From the Cancer Imaging Archive/Cancer Genome Atlas (TCGA) 93 patients were used as validation cohorts. "Thickened structure" was defined as the solid tumor component presenting circumferential extension or occupying >50% of the tumor volume. "Methylated contrast phenotype" was defined as indistinct enhancing circumferential border, heterogenous enhancement, or nodular enhancement. Inter-rater agreement was assessed, followed by an investigation of the relationship between radiological findings and pMGMT methylation status. Results Fleiss's Kappa coefficient for "Thickened structure" was 0.68 for the exploratory and 0.55 for the validation cohort, and for "Methylated contrast phenotype," 0.30 and 0.39, respectively. The imaging feature, the presence of "Thickened structure" and absence of "Methylated contrast phenotype," was significantly predictive of pMGMT unmethylation both for the exploratory (p = .015, odds ratio = 2.44) and for the validation cohort (p = .006, odds ratio = 7.83). The sensitivities and specificities of the imaging feature, the presence of "Thickened structure," and the absence of "Methylated contrast phenotype" for predicting pMGMT unmethylation were 0.29 and 0.86 for the exploratory and 0.25 and 0.96 for the validation cohort. Conclusions The present study showed that qualitative assessment of contrast-enhanced T1-weighted intensity images helps predict GBM's pMGMT methylation status.
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Affiliation(s)
- Takahiro Sanada
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
- Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan
| | - Takahiro Sasaki
- Department of Neurological Surgery, Wakayama Medical University School of Medicine, Wakayama, Japan
- Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama, Japan
| | - Shota Yamamoto
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
- Department of Neurosurgery, Osaka General Medical Center, Osaka, Japan
| | - Seiya Fujikawa
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
- Department of Neurosurgery, Japanese Red Cross Kitami Hospital, Kitami, Japan
| | - Shusei Fukuyama
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Nobuhide Hayashi
- Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama, Japan
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Yoshiko Okita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Neurosurgery, NHO Osaka National Hospital, Osaka, Japan
| | - Masahiro Nonaka
- Department of Neurosurgery, NHO Osaka National Hospital, Osaka, Japan
- Department of Neurosurgery, Kansai Medical University, Hirakata, Japan
| | - Takehiro Uda
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hideyuki Arita
- Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kanji Mori
- Department of Neurosurgery, Yao Municipal Hospital, Yao, Japan
| | - Kenichi Ishibashi
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Koji Takano
- Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan
- Department of Neurosurgery, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Namiko Nishida
- Department of Neurosurgery, Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tomoko Shofuda
- Department of Biomedical Research and Innovation, Institute for Clinical Research, NHO Osaka National Hospital, Osaka, Japan
| | - Ema Yoshioka
- Department of Biomedical Research and Innovation, Institute for Clinical Research, NHO Osaka National Hospital, Osaka, Japan
| | - Daisuke Kanematsu
- Department of Biomedical Research and Innovation, Institute for Clinical Research, NHO Osaka National Hospital, Osaka, Japan
| | - Mishie Tanino
- Department of Diagnostic Pathology, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Yoshinori Kodama
- Department of Neurosurgery, NHO Osaka National Hospital, Osaka, Japan
- Department of Biomedical Research and Innovation, Institute for Clinical Research, NHO Osaka National Hospital, Osaka, Japan
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Masayuki Mano
- Department of Central Laboratory and Surgical Pathology, NHO Osaka National Hospital, Osaka, Japan
| | - Yonehiro Kanemura
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
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Wakao N, Furuya T, Yoshii T, Arima H, Yamato Y, Nakashima H, Imagama S, Imajo Y, Miyamoto H, Inoue G, Miyagi M, Kanbara S, Iizuka Y, Chikuda H, Watanabe K, Kobayashi K, Tsushima M, Miyazaki M, Yagi M, Suzuki S, Takahata M, Hongo M, Koda M, Nagata K, Mori K, Suzuki A, Kaito T, Murotani K, Miyakoshi N, Hashizume H, Matsuyama Y, Kawakami M, Haro H. A nationwide multicenter study of the cost effectiveness of five leading drugs for pharmacological management of cervicobrachial symptoms. J Orthop Sci 2023:S0949-2658(23)00334-2. [PMID: 38151393 DOI: 10.1016/j.jos.2023.12.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/24/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Cervicobrachial pain frequently affects the quality of life (QOL) of the general public and has a significant economic impact on the health care systems of various countries. There are a number of treatment options for this disease, including widely-used drug therapy, but the effectiveness of each option is indeterminate, and there have been no published cost-effectiveness analysis studies so far. This prospective observational study aimed to examine the cost-effectiveness of drug treatment for cervicobrachial symptoms. METHODS A 6-month medication regimen for each of five frequently-prescribed drugs for cervicobrachial symptoms was administered to 322 patients at 24 centers in Japan. Outcome measures, including of the EuroQol Group 5D, Short Form-8, and Visual Analog Scale (VAS), were investigated at baseline and every month thereafter. Incremental cost-effectiveness ratios (ICERs) of the drug cost to quality-adjusted life years (QALYs) were calculated. A stratified analysis of patient characteristics was also performed to identify baseline factors potentially affecting cost-effectiveness. RESULTS The ICER of entire drug treatment for cervicobrachial symptoms was 7,491,640 yen. Compared with the reference willingness-to-pay, the ICER was assumed to not be cost-effective. A certain number of QALYs were gained during the first 3 months after the treatment intervention, but almost no QALYs were gained during the following 3 months. Stratified analysis showed that cost-effectiveness was extremely low for patients with high baseline VAS and high QOL. CONCLUSIONS The available medications for cervicobrachial symptoms did not have excellent cost-effectiveness. Although a certain number of QALYs were gained during the first 3 months after medication, no QALYs were gained in the latter half of the study period, suggesting that it is not advisable to continue the medication needlessly. LEVEL OF EVIDENCE II, prospective cohort study.
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Affiliation(s)
- Norimitsu Wakao
- Departments of Orthopaedic Surgery, Aichi Medical University, Nagakute, Aichi, Japan.
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Toshitaka Yoshii
- Section of Orthopaedic Surgery; and Spinal Surgery, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan.
| | - Hideyuki Arima
- Department of Orthopaedic Surgery, Hamamatsu University, School of Medicine, Hamamatsu, Japan.
| | - Yu Yamato
- Department of Orthopaedic Surgery, Hamamatsu University, School of Medicine, Hamamatsu, Japan.
| | - Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Yasuaki Imajo
- Department of Orthopaedic Surgery, Tokuyama Central Hospital, Shunan, Japan.
| | - Hiroshi Miyamoto
- Department of Orthopaedic Surgery, Kobe Rosai Hospital, Kobe, Japan.
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
| | - Shunsuke Kanbara
- Department of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya, Japan.
| | - Yoichi Iizuka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan.
| | - Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan.
| | - Mikito Tsushima
- Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan.
| | - Masashi Miyazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Yufu, Japan.
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan.
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
| | - Michio Hongo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Masao Koda
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
| | - Keiji Nagata
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Japan.
| | - Akinobu Suzuki
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan.
| | | | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Hiroshi Hashizume
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University, School of Medicine, Hamamatsu, Japan.
| | - Mamoru Kawakami
- Department of Orthopaedic Surgery, Saiseikai Wakayama Hospital, Wakayama, Japan.
| | - Hirotaka Haro
- Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Kofu, Japan.
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4
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Ito S, Nakashima H, Yoshii T, Egawa S, Sakai K, Kusano K, Tsutui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nagoshi N, Nishida N, Nagamoto Y, Oshima Y, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Oda M, Mori K, Taneichi H, Kawaguchi Y, Takeshita K, Matsumoto M, Yamazaki M, Okawa A, Imagama S. Deep learning-based prediction model for postoperative complications of cervical posterior longitudinal ligament ossification. Eur Spine J 2023; 32:3797-3806. [PMID: 36740608 DOI: 10.1007/s00586-023-07562-2] [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: 09/24/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE Postoperative complication prediction helps surgeons to inform and manage patient expectations. Deep learning, a model that finds patterns in large samples of data, outperform traditional statistical methods in making predictions. This study aimed to create a deep learning-based model (DLM) to predict postoperative complications in patients with cervical ossification of the posterior longitudinal ligament (OPLL). METHODS This prospective multicenter study was conducted by the 28 institutions, and 478 patients were included in the analysis. Deep learning was used to create two predictive models of the overall postoperative complications and neurological complications, one of the major complications. These models were constructed by learning the patient's preoperative background, clinical symptoms, surgical procedures, and imaging findings. These logistic regression models were also created, and these accuracies were compared with those of the DLM. RESULTS Overall complications were observed in 127 cases (26.6%). The accuracy of the DLM was 74.6 ± 3.7% for predicting the overall occurrence of complications, which was comparable to that of the logistic regression (74.1%). Neurological complications were observed in 48 cases (10.0%), and the accuracy of the DLM was 91.7 ± 3.5%, which was higher than that of the logistic regression (90.1%). CONCLUSION A new algorithm using deep learning was able to predict complications after cervical OPLL surgery. This model was well calibrated, with prediction accuracy comparable to that of regression models. The accuracy remained high even for predicting only neurological complications, for which the case number is limited compared to conventional statistical methods.
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Affiliation(s)
- Sadayuki Ito
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan.
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoru Egawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama, 332-8558, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kazuo Kusano
- Department of Orthopaedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, 102-0074, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shinji Tsutui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 KImiidera, Wakayama-city, Wakayama, 641-8510, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takashi Hirai
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yu Matsukura
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Keiichi Katsumi
- Department of Orthopaedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata, Niigata, 951-8520, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Atsushi Kimura
- Department of Orthopaedic, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-8670, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-8670, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Norihiro Nishida
- Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, 111 Minami Kogushi, Ube, Yamaguchi, 755-8505, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi, Osaka, 591-8025, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Myokencho 2-9, Showa Ward, Nagoya, Aichi, 466-8650, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kazuma Murata
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masayuki Miyagi
- Department of Orthopedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitazato, Minami-ku, Sagamiharashi, Kanagawa, 252-0375, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Tomohiro Banno
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Tetsuro Ohba
- Department of Orthopaedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi, 409-3898, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Inami
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hiroyuki Katoh
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Haruo Kanno
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masahiro Oda
- Information Strategy Office, Information and Communications, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
| | - Kensaku Mori
- Information Strategy Office, Information and Communications, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
- Department of Intelligent Systems, Nagoya University Graduate School of Informatics, Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
- Research Center for Medical Bigdata, National Institute of Informatics, 2-1-2 Hitotsubashi, Chiyoda-ku, Tokyo, 101-8430, Japan
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Katsushi Takeshita
- Department of Orthopaedic, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
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Harada H, Suefuji H, Mori K, Ishikawa H, Nakamura M, Tokumaru S, Murakami M, Ogino T, Iwata H, Tatebe H, Kubo N, Waki T, Yoshida D, Nakamura M, Aoyama H, Araya M, Nakajima M, Nakayama H, Satouchi M, Shioyama Y. Proton and Carbon Ion Radiotherapy for Operable Early-Stage Lung Cancer: 3-Year Results of a Prospective Nationwide Registry. Int J Radiat Oncol Biol Phys 2023; 117:e23. [PMID: 37784924 DOI: 10.1016/j.ijrobp.2023.06.698] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this analysis was to report subset analysis as to progression-free survival (PFS) and overall survival (OS) of particle-beam radiation therapy for operable early-stage lung cancer. MATERIALS/METHODS Patients of early-stage lung cancer (T1-T2aN0) who were eligible for radical surgery but did not wish to undergo surgery were treated by proton-ion (PT) or carbon-ion (CT) radiation therapy and enrolled in Japanese prospective registry. In this analysis, PFS and OS by clinical stage, tumor location, pathological confirmation and particle-ion type were evaluated. RESULTS A total of 274 patients were enrolled and included in efficacy and safety analyses. Most tumors were adenocarcinoma (44%), and 105 (38%) were not histologically confirmed and diagnosed clinically. 250 (91%) of 274 patients had tumors that were peripherally situated. 138 (50%) and 136 (50%) patients were treated by PT and CT, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7 - 49.0). No grade 3 or severe treatment-related toxicity was observed. 3-year PFS was 81% (95% CI;76-86) and OS was 93% (95% CI;89-96), respectively. As to particle-ion type, 3-year PFS were 79.0% and 81.9% in PT and CT (p = 0.19), and 3-year OS were 93.9% and 91.1% in PT and CT (P = 0.72), respectively. For PFS, pathological confirmation, clinical stage was significant factors but there were no significant differences by tumor location or particle-ion type; for OS, clinical stage was significant factor but there was no significant difference on pathological confirmation, tumor location or particle-ion type (Table1). Table 1. 3-year PFS and OS CONCLUSION: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS on each subset.
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Affiliation(s)
- H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - H Suefuji
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
| | - K Mori
- Shizuoka Cancer Center, Nagaizumi, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - M Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Koriyama, Japan
| | - T Ogino
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - H Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Japan
| | - H Tatebe
- Fukui Prefectural Hospital Proton Therapy Center, Fukui, Japan
| | - N Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Waki
- Tsuyama Chuo Hospital, Tsuyama, Japan
| | - D Yoshida
- Kanagawa Cancer Center, Yokohama, Japan
| | - M Nakamura
- University of Tsukuba, Tsukuba City 305-8575, Japan
| | - H Aoyama
- Department of Radiation oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Japan
| | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Nakayama
- Kanagawa Prefectural Hospital Organization, Yokohama, Japan
| | | | - Y Shioyama
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
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Adi NP, Nagata T, Odagami K, Nagata M, Kajiki S, Kuroishi M, Mori K. Association between lifestyle habits and presenteeism. Occup Med (Lond) 2023; 73:346-352. [PMID: 37471479 DOI: 10.1093/occmed/kqad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Presenteeism is affected by work-related and individual factors. Among individual factors, the effect of combining various lifestyle habits on presenteeism is unknown. AIMS This study aimed to determine the relationship between changes in multiple good lifestyle habits with a change in presenteeism and to examine the effect of psychological factors on this relationship. METHODS We performed a 1-year retrospective cohort study on employees of large Japanese companies. Data were collected from health check-ups and a self-administered questionnaire. Changes in presenteeism were measured using the Quality and Quantity method. Changes in lifestyle habits were measured using a modified form of Breslow's seven health practices. Psychological factors were measured using the Kessler 6-Item Psychological Distress Scale. Linear regression was used for statistical analysis. RESULTS The number of practised lifestyle habit changes was negatively correlated with a change in presenteeism. This result was consistent when adjusted for age, sex and company (B, -0.010; P < 0.05), but became non-significant when additionally adjusted for psychological distress (B, -0.006). When analysed separately, only an improvement in the body mass index (B, -0.054; P < 0.05) and a worsened sleep habit (B, 0.040; P < 0.01) influenced a change in presenteeism. CONCLUSIONS This study suggests that improving various practised lifestyle habits in combination, rather than improving a single lifestyle habit, is beneficial in reducing presenteeism. Our finding that psychological distress altered the relationship of practised lifestyle habit changes with presenteeism indicates the importance of organizational-level intervention in presenteeism.
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Affiliation(s)
- N P Adi
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, 10230,Indonesia
| | - T Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
| | - K Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
| | - M Nagata
- Department of Occupational Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
| | - S Kajiki
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
| | - M Kuroishi
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
| | - K Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, 807-8555, Japan
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Matsukura Y, Egawa S, Inose H, Sakai K, Kusano K, Tsutsui S, Hirai T, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nagoshi N, Nishida N, Nagamoto Y, Oshima Y, Ando K, Nakashima H, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Moridaira H, Fujibayashi S, Katoh H, Kanno H, Taneichi H, Imagama S, Kawaguchi Y, Takeshita K, Nakamura M, Matsumoto M, Yamazaki M, Okawa A, Yoshii T. Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures After Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament. Spine (Phila Pa 1976) 2023; 48:1259-1265. [PMID: 37368973 DOI: 10.1097/brs.0000000000004762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/02/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
STUDY DESIGN A prospective multicenter study. OBJECTIVE To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery. PATIENTS AND METHODS The study included 395 patients (291 men and 104 women; mean age, 63.7 ± 11.4 yr): 204 were treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation Questionnaire were used to assess clinical outcomes preoperatively and 2 years after surgery. Logistic regression analysis was used to identify factors associated with the achievement of minimum clinically important difference (MCID) after surgery. RESULTS The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared with the groups with durations of <0.5 years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy Evaluation Questionnaire in the upper extremity function score ( P < 0.001), lower extremity function ( P = 0.039), quality of life ( P = 0.053), and bladder function ( P = 0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms ( P = 0.001), age ( P < 0.001), and body mass index ( P < 0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (area under the curve, 0.616; sensitivity, 67.4%; specificity, 53.5%). CONCLUSIONS Symptom duration had a significant impact on neurological recovery and patient-reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Yu Matsukura
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Satoru Egawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Hiroyuki Inose
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital Kawaguchishi, Saitama, Japan
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku, Japan
| | - Shunji Tsutsui
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Niigata, Japan
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan
| | - Satoshi Maki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Norihiro Nishida
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Yamaguchi Prefecture, Japan
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka, Japan
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Hokkaido University, Sapporo, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedics and Rehabilitation Medicine, University of Fukui, Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kitazato Universiy Hospital, Minami-ku, Sagamiharashi, Kanagawa, Japan
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Tomohiro Banno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Moridaira
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Hiroshi Taneichi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Masaya Nakamura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Morio Matsumoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
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Mori K, Takahashi J, Oba H, Mimura T, Imai S. Reciprocal Change of Cervical Spine after Posterior Spinal Fusion for Lenke Type 1 and 2 Adolescent Idiopathic Scoliosis. J Clin Med 2023; 12:5599. [PMID: 37685668 PMCID: PMC10488443 DOI: 10.3390/jcm12175599] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Reciprocal sagittal alignment changes after adolescent idiopathic scoliosis (AIS) posterior corrective surgery have been reported in the cervical spine, but the evidence is not yet sufficient. Furthermore, much remains unknown about the effects of cervical kyphosis on clinical outcomes in AIS. Forty-five consecutive patients (4 males and 41 females) with AIS and Lenke type 1 or 2 curves underwent a posterior spinal fusion, and a minimum of 24-month follow-up was collected from our prospective database. We investigated radiographic parameters and SRS-22r. Before surgery, cervical kyphosis (cervical lordosis < 0°) was present in 89% and cervical hyperkyphosis (cervical lordosis < -10°) in 60%. There were no significant differences in age, sex, or Lenke type between the hyperkyphosis and the non-hyperkyphosis groups. Although cervical lordosis increased significantly after surgery, cervical kyphosis was observed in 73% of patients 2 years after surgery. We found a significant correlation between Δthoracic kyphosis (TK) and Δcervical lordosis. Preoperative cervical kyphosis, ΔT1 slope, and ΔTK were independently associated factors for postoperative cervical hyperkyphosis. The cervical hyperkyphosis group had significantly lower SRS-22r domains. In AIS corrective surgery, restoring TK leading to a gain of T1 slope may lead to an improvement of cervical sagittal alignment. Remaining cervical hyperkyphosis after AIS surgery may affect clinical outcomes.
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Affiliation(s)
- Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu 520-2192, Shiga, Japan;
| | - Jun Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Nagano, Japan; (J.T.); (H.O.); (T.M.)
| | - Hiroki Oba
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Nagano, Japan; (J.T.); (H.O.); (T.M.)
| | - Tetsuhiko Mimura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Nagano, Japan; (J.T.); (H.O.); (T.M.)
| | - Shinji Imai
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu 520-2192, Shiga, Japan;
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Fujikawa H, Kojima H, Terashima T, Katagi M, Yayama T, Kumagai K, Mori K, Saito H, Imai S. Expression of proinflammatory cytokines and proinsulin by bone marrow-derived cells for fracture healing in long-term diabetic mice. BMC Musculoskelet Disord 2023; 24:585. [PMID: 37464323 DOI: 10.1186/s12891-023-06710-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/09/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) causes bone dysfunction due to poor bone quality, leading to severe deterioration in patient of quality of life. The mechanisms of bone metabolism in DM remain unclear, although chemical and/or mechanical factors are known to disrupt the homeostasis of osteoblasts and osteoclasts. The purpose of this study was to identify the changes of osteoblasts and osteoclasts under long-term hyperglycaemic conditions, using a mouse fracture model of long-term hyperglycemia (LT-HG). METHODS C57BL/6J mice and green fluorescent protein (GFP) -positive bone marrow transplanted C57BL/6J mice with LT-HG, maintained under a state of hyperglycaemia for 2 months, were used in this study. After the experimental fracture, we examined the immunohistochemical expression of proinsulin and tumor necrosis factor (TNF) -α at the fracture site. C57BL/6J fracture model mice without hyperglycaemia were used as controls. RESULTS In the LT-HG mice, chondrocyte resorption was delayed, and osteoblasts showed an irregular arrangement at the callus site. The osteoclasts were scattered with a decrement in the number of nuclei. The expression of proinsulin was confirmed in bone marrow derived cells (BMDCs) with neovascularization 2 and 3 weeks after fracture. Immunopositivity for TNF-α was also confirmed in immature chondrocytes and BMDCs with neovascularization at 2 weeks, and the number of positive cells was not decreased at 3 weeks. Examination of GFP-grafted hyperglycaemic mice showed that the majority of cells at the fracture site were GFP-positive. Immunohistochemistry showed that the rate of double positives was 15% for GFP and proinsulin and 47% for GFP and TNF-α. CONCLUSION LT-HG induces an increase in the number of proinsulin and TNF-α positive cells derived from BMDCs. We suggest that proinsulin and TNF-α positive cells are involved in both bone formation and bone resorption after fracture under hyperglycaemic conditions, resulting in the delay of bone healing.
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Affiliation(s)
- Hitomi Fujikawa
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan.
| | - Hideto Kojima
- Department of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Otsu, 520-2192, Shiga, Japan
| | - Tomoya Terashima
- Department of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Otsu, 520-2192, Shiga, Japan
| | - Miwako Katagi
- Department of Stem Cell Biology and Regenerative Medicine, Shiga University of Medical Science, Otsu, 520-2192, Shiga, Japan
| | - Takafumi Yayama
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan
| | - Kosuke Kumagai
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan.
| | - Hideki Saito
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan
| | - Shinji Imai
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan
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Koike Y, Takahata M, Nakajima M, Otomo N, Suetsugu H, Liu X, Endo T, Imagama S, Kobayashi K, Kaito T, Kato S, Kawaguchi Y, Kanayama M, Sakai H, Tsuji T, Miyamoto T, Inose H, Yoshii T, Kashii M, Nakashima H, Ando K, Taniguchi Y, Takeuchi K, Ito S, Tomizuka K, Hikino K, Iwasaki Y, Kamatani Y, Maeda S, Nakajima H, Mori K, Seichi A, Fujibayashi S, Kanchiku T, Watanabe K, Tanaka T, Kida K, Kobayashi S, Takahashi M, Yamada K, Takuwa H, Lu HF, Niida S, Ozaki K, Momozawa Y, Yamazaki M, Okawa A, Matsumoto M, Iwasaki N, Terao C, Ikegawa S. Genetic insights into ossification of the posterior longitudinal ligament of the spine. eLife 2023; 12:e86514. [PMID: 37461309 DOI: 10.7554/elife.86514] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/22/2023] [Indexed: 07/20/2023] Open
Abstract
Ossification of the posterior longitudinal ligament of the spine (OPLL) is an intractable disease leading to severe neurological deficits. Its etiology and pathogenesis are primarily unknown. The relationship between OPLL and comorbidities, especially type 2 diabetes (T2D) and high body mass index (BMI), has been the focus of attention; however, no trait has been proven to have a causal relationship. We conducted a meta-analysis of genome-wide association studies (GWASs) using 22,016 Japanese individuals and identified 14 significant loci, 8 of which were previously unreported. We then conducted a gene-based association analysis and a transcriptome-wide Mendelian randomization approach and identified three candidate genes for each. Partitioning heritability enrichment analyses observed significant enrichment of the polygenic signals in the active enhancers of the connective/bone cell group, especially H3K27ac in chondrogenic differentiation cells, as well as the immune/hematopoietic cell group. Single-cell RNA sequencing of Achilles tendon cells from a mouse Achilles tendon ossification model confirmed the expression of genes in GWAS and post-GWAS analyses in mesenchymal and immune cells. Genetic correlations with 96 complex traits showed positive correlations with T2D and BMI and a negative correlation with cerebral aneurysm. Mendelian randomization analysis demonstrated a significant causal effect of increased BMI and high bone mineral density on OPLL. We evaluated the clinical images in detail and classified OPLL into cervical, thoracic, and the other types. GWAS subanalyses identified subtype-specific signals. A polygenic risk score for BMI demonstrated that the effect of BMI was particularly strong in thoracic OPLL. Our study provides genetic insight into the etiology and pathogenesis of OPLL and is expected to serve as a basis for future treatment development.
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Affiliation(s)
- Yoshinao Koike
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Masahiko Takahata
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Nao Otomo
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Orthopedic Surgery, Keio University School of Medicine, Nagoya, Japan
| | - Hiroyuki Suetsugu
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Xiaoxi Liu
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Tsutomu Endo
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shiro Imagama
- Department of Orthopedics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyoshi Kobayashi
- Department of Orthopedics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | | | - Masahiro Kanayama
- Department of Orthopedics, Hakodate Central General Hospital, Hakodate, Japan
| | - Hiroaki Sakai
- Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan
| | - Takashi Tsuji
- Department of Orthopedic Surgery, Keio University School of Medicine, Nagoya, Japan
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Nagoya, Japan
- Department of Orthopedic Surgery, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Inose
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masafumi Kashii
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroaki Nakashima
- Department of Orthopedics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Ando
- Department of Orthopedics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuki Taniguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Takeuchi
- Department of Orthopaedic Surgery, National Okayama Medical Center, Okayama, Japan
| | - Shuji Ito
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Orthopedic Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Kohei Tomizuka
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Keiko Hikino
- Laboratory for Pharmacogenomics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Yusuke Iwasaki
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Shingo Maeda
- Department of Bone and Joint Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Seichi
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsukasa Kanchiku
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, Nankoku, Japan
| | - Toshihiro Tanaka
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazunobu Kida
- Department of Orthopaedic Surgery, Kochi Medical School, Nankoku, Japan
| | - Sho Kobayashi
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahito Takahashi
- Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Obu, Japan
| | - Hiroshi Takuwa
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Department of Orthopedic Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Hsing-Fang Lu
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Million-Person Precision Medicine Initiative, China Medical University Hospital, Taichung, Taiwan
| | - Shumpei Niida
- Core Facility Administration, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kouichi Ozaki
- Medical Genome Center, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Nagoya, Japan
| | - Norimasa Iwasaki
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
- Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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11
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Nagoshi N, Yoshii T, Egawa S, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Sato Y, Maki S, Nishida N, Nagamoto Y, Oshima Y, Ando K, Nakashima H, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Moridaira H, Fujibayashi S, Katoh H, Kanno H, Watanabe K, Taneichi H, Imagama S, Kawaguchi Y, Takeshita K, Nakamura M, Matsumoto M, Yamazaki M. Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study. Spine (Phila Pa 1976) 2023; 48:937-943. [PMID: 36940262 DOI: 10.1097/brs.0000000000004634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/18/2023] [Accepted: 03/09/2023] [Indexed: 03/22/2023]
Abstract
STUDY DESIGN A prospective multicenter study. OBJECTIVE The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. MATERIALS AND METHODS A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. RESULTS Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. CONCLUSIONS Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.
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Affiliation(s)
- Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchishi, Saitama, Japan
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku, Japan
| | - Shunji Tsutsui
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Matsukura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Niigata, Japan
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Maki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Norihiro Nishida
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Yamaguchi, Japan
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka, Japan
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta, Otsu, Shiga, Japan
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Yoshida-gun, Fukui, Japan
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kitasato University, School of Medicine, Sagamiharashi, Kanagawa, Japan
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Tomohiro Banno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Moridaira
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi, Japan; and Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Toyama, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Hiroshi Taneichi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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12
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Miyagi M, Inoue G, Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Kimura A, Furuya T, Nagoshi N, Kanchiku T, Nagamoto Y, Oshima Y, Nakashima H, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Koda M, Takahashi H, Ikeda S, Imagama S, Kawaguchi Y, Takeshita K, Matsumoto M, Takaso M, Okawa A, Yamazaki M. Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament. Clin Spine Surg 2023; 36:E277-E282. [PMID: 36823706 DOI: 10.1097/bsd.0000000000001449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/14/2021] [Accepted: 01/25/2023] [Indexed: 02/25/2023]
Abstract
STUDY DESIGN A prospective multi-institutional observational study. OBJECTIVE To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). SUMMARY OF BACKGROUND DATA Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. METHODS Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. RESULTS The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. CONCLUSIONS The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Gen Inoue
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchishi, Saitama
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Kudanzaka Hospital, Kudanminami, Chiyadaku
| | - Yukihiro Nakagawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku hospital, Myoji, Katsuragi-cho, Itogun, Wakayama
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Zaifucho, Hirosaki, Aomori
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Asahimachidori, Chuo Ward, Niigata, Niigata
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedics, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Inohana, Chuo Ward, Chiba, Chiba
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinanomachi, Shinjuku Ward, Tokyo
| | - Tsukasa Kanchiku
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine Kogushi, Ube, Yamaguchi
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Nagasonecho, Sakaishi, Osaka
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hongo, Bunkyo-ku, Tokyo
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa Ward, Nagoya, Aichi
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa Ward, Nagoya, Aichi
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita, Nishi, Sapporo
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical University, Nishishinjuku, Shinjuku-ku, Tokyo
| | - Shunji Matsunaga
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Imakiire General Hospital, Shimotatsuocho, Kagoshimashi
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University Yamadaoka, Suita-shi, Osaka
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Kurume University School of Medicine Asahi-machi, Kurume-shi, Fukuoka
| | - Sho Kobayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Shizuoka
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, University of Yamanashi, Shimokato, Chuo Ward, Yamanashi
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Shimokasuya, Isehara, Kanagawa
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Seiryomachi, Aoba Ward, Sendai, Miyagi
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
| | - Hiroshi Takahashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
| | - Shinsuke Ikeda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Sugitani, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedics, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi
| | - Morio Matsumoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinanomachi, Shinjuku Ward, Tokyo
| | - Masashi Takaso
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Atsushi Okawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
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13
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Nakashima H, Imagama S, Yoshii T, Egawa S, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nagoshi N, Nishida N, Nagamoto Y, Oshima Y, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Moridaira H, Fujibayashi S, Katoh H, Kanno H, Taneichi H, Kawaguchi Y, Takeshita K, Nakamura M, Okawa A, Yamazaki M. Factors Associated with Loss of Cervical Lordosis after Laminoplasty for Patients with Cervical Ossification of the Posterior Longitudinal Ligament: Data from a Prospective Multicenter Study. Spine (Phila Pa 1976) 2023:00007632-990000000-00343. [PMID: 37146070 DOI: 10.1097/brs.0000000000004706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/26/2022] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
STUDY DESIGN A prospective multicenter study. OBJECTIVE To investigate the incidence of loss of cervical lordosis after laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL). We also sought to determine associated risk factors and the relationship with patient-reported outcomes. SUMMARY OF BACKGROUND DATA Loss of cervical lordosis is a sequalae often observed after laminoplasty, which may adversely impact surgical outcomes. Cervical kyphosis, especially in OPLL, is associated with reoperation, but risk factors and relationship to postoperative outcomes remain understudied at this time. METHODS This study was conducted by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. We included 165 patients who underwent laminoplasty and completed Japanese Orthopaedic Association (JOA) score or Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaires (JOACMEQ), as well as visual analog scales (VAS) for pain, with imaging. The participants were divided into two groups: those with loss of cervical lordosis of>10° or 20° after surgery and those without loss of cervical lordosis. A paired t-test was applied to evaluate the association between changes in cervical spinal angles, ROM, and cervical JOA and VAS scores before and at 2 years postoperatively. Mann-Whitney U-test was used for JOACMEQ. RESULTS Postoperative loss of cervical lordosis>10° and>20° was observed in 32 (19.4%) and 7 (4.2%), respectively. JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small extension range of motion (eROM) was significantly associated with postoperative loss of cervical lordosis, and the cutoff values of eROM were 7.4° [area under the curve (AUC): 0.76] and 8.2° (AUC: 0.92) for loss of cervical lordosis>10° and>20°, respectively. A large occupation ratio of OPLL was also associated with loss of cervical lordosis, with a cutoff value of 39.9% (AUC: 0.94). Laminoplasty resulted in functional improvement in most patient-reported outcomes; however, neck pain and bladder function tended to become worse postoperatively in cases with postoperative loss of cervical lordosis>20°. CONCLUSION JOA, JOACMEQ, and VAS scores were not significantly different between those with, and without, loss of cervical lordosis. Preoperative small eROM and large OPLL may represent factors associated with loss of cervical lordosis after laminoplasty in patients with OPLL.
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Affiliation(s)
- Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama, 332-8558, Japan
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, 102-0074, Japan
| | - Shinji Tsutsui
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-city, Wakayama, 641-8510, Japan
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Yu Matsukura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata, Niigata, 951-8520, Japan
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575 Japan
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthoaedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-8670, Japan
| | - Satoshi Maki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-8670, Japan
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Keio University school of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
| | - Norihiro Nishida
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi, Osaka, 591-8025, Japan
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Myokencho 2-9, Showa Ward, Nagoya, Aichi, 466-8650, Japan
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopedic Surgery, Kitasato University, School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamiharashi, Kanagawa, 252-0375, Japan
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan
| | - Tomohiro Banno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi, 409-3898, Japan
| | - Hiroshi Moridaira
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Taneichi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthoaedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Masaya Nakamura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Keio University school of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
| | - Atsushi Okawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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Saito H, Yayama T, Mori K, Kumagai K, Fujikawa H, Chosei Y, Imai S. Increased Cellular Expression of Interleukin-6 in Patients With Ossification of the Posterior Longitudinal Ligament. Spine (Phila Pa 1976) 2023; 48:E78-E86. [PMID: 36729990 DOI: 10.1097/brs.0000000000004557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/06/2022] [Accepted: 11/24/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN We performed histologic, immunohistochemical, immunoblot examination and suspension array analyses of cytokine expression in cultured cells derived from human cervical ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE To determine the roles of interleukin-6 (IL-6) during the maturation of osteoblasts and chondrocytes associated with the development of OPLL. SUMMARY OF BACKGROUND DATA Ectopic OPLL affects ~3% of the general population, with a higher incidence in Asian ethnic groups. Alterations in cytokine profiles may influence osteoblast differentiation, but the mechanisms and signaling pathways associated with the ossification process remain unclear. METHODS Samples were collected from 14 patients with OPLL who had undergone spinal surgery and seven with cervical spondylotic myelopathy without OPLL. Tissue sections were used for histologic and immunohistochemical studies, and primary cells from ligamentum samples were used for cytokine array and immunoblotting. A suspension array was used to measure the concentrations of 27 inflammatory cytokines or growth factors. RESULTS Suspension array and immunoblot analyses revealed significantly elevated levels of IL-6 in OPLL patients. Alterations in IL-6 concentrations were found to alter the expression of the genes Sox9 , Runx2 , and SIRT1 . In addition, immunohistochemical analysis revealed that these factors are present in mesenchymal cells within the degenerative portion of the ligament matrix that is adjacent to the ossification front. CONCLUSIONS IL-6 plays a profound role in the osteoblast differentiation process along with the induction of chondrocyte hypertrophy and cell apoptosis in the early stages of ossification in OPLL. These changes in cytokine profiles are essential factors for regulation of the ectopic ossified plaque in OPLL.
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Affiliation(s)
- Hideki Saito
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Shiga, Japan
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Hayashi K, Tanaka Y, Tsuda T, Nomura A, Fujino N, Furusho H, Sakai N, Iwata Y, Usui S, Sakata K, Kato T, Tada H, Kusayama T, Usuda K, Kawashiri MA, Passman RS, Wada T, Yamagishi M, Takamura M, Fujino N, Nohara A, Kawashiri MA, Hayashi K, Sakata K, Yoshimuta T, Konno T, Funada A, Tada H, Nakanishi C, Hodatsu A, Mori M, Tsuda T, Teramoto R, Nagata Y, Nomura A, Shimojima M, Yoshida S, Yoshida T, Hachiya S, Tamura Y, Kashihara Y, Kobayashi T, Shibayama J, Inaba S, Matsubara T, Yasuda T, Miwa K, Inoue M, Fujita T, Yakuta Y, Aburao T, Matsui T, Higashi K, Koga T, Hikishima K, Namura M, Horita Y, Ikeda M, Terai H, Gamou T, Tama N, Kimura R, Tsujimoto D, Nakahashi T, Ueda K, Ino H, Higashikata T, Kaneda T, Takata M, Yamamoto R, Yoshikawa T, Ohira M, Suematsu T, Tagawa S, Inoue T, Okada H, Kita Y, Fujita C, Ukawa N, Inoguchi Y, Ito Y, Araki T, Oe K, Minamoto M, Yokawa J, Tanaka Y, Mori K, Taguchi T, Kaku B, Katsuda S, Hirase H, Haraki T, Fujioka K, Terada K, Ichise T, Maekawa N, Higashi M, Okeie K, Kiyama M, Ota M, Todo Y, Aoyama T, Yamaguchi M, Noji Y, Mabuchi T, Yagi M, Niwa S, Takashima Y, Murai K, Nishikawa T, Mizuno S, Ohsato K, Misawa K, Kokado H, Michishita I, Iwaki T, Nozue T, Katoh H, Nakashima K, Ito S, Yamagishi M. Correction: Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry. Heart Vessels 2023; 38:412. [PMID: 36508013 DOI: 10.1007/s00380-022-02218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Yoshihiro Tanaka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Cardiology, Ishikawa Prefectural Central Hospital, 2-1, Kuratsuki-higashi, Kanazawa, Japan
| | - Norihiko Sakai
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Yasunori Iwata
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Keisuke Usuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Rod S Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Osaka University of Human Sciences, Settsu, Osaka, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Mori K, Schuettfort V, Yanagisawa T, Katayama S, Laukhtina E, Pradere B, Rajwa P, Mostafaei H, Kimura T, Shariat S. Prognostic value of angiogenesis related marker vascular endothelial growth factor and vascular cell adhesion molecule-1 in bladder carcinoma treated with radical cystectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01342-8] [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: 02/12/2023]
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von Deimling M, Laukhtina E, Pradere B, Yanagisawa T, Rajwa P, Kawada T, Quhal F, Pallauf M, Bianchi A, Majdoub M, Mostafaei H, Motlagh R, Mori K, Enikeev D, Fisch M, Moschini M, D’Andrea D, Soria F, Albisinni S, Fajkovic H, Rink M, Teoh J, Gontero P, Shariat S. Functional outcomes in female patients after traditional, organ- and nerve-sparing radical cystectomy and urinary diversion for bladder cancer: A systematic review and pooled analyses. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01045-x] [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: 02/12/2023]
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Yanagiswawa T, Rajwa P, Kawada T, Mori K, Quhal F, Laukhtina E, Von Deimling M, Bianchi A, Majdoub M, Pradere B, Kramer G, Kimura T, Shariat S. Efficacy of systemic treatment in prostate cancer patients with visceral metastasis: A systematic review, meta-analysis, and network meta-analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01234-4] [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: 02/12/2023]
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Nakatogawa H, Kawaji H, Hayashi N, Fukai J, Kijima N, Shofuda T, Yoshioka E, Kanematsu D, Katsuma A, Sumida M, Inenaga C, Mori K, Kanemura Y. MPC-15 CLINICAL FEATURE OF NON-MIDLINE GLIOMA WITH H3F3A GENE MUTATION. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.056] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Abstract
Introduction
Diffuse midline glioma (DMG), H3K27-altered, is a CNS WHO grade 4 glioma that usually occurs mainly in the brainstem region in children and also in the thalamus and spinal cord in older children and adults. On the other hand, glioma with histone H3 p. G34R/V mutations in the cerebral hemispheres are defined in a new classification of Diffuse hemispheric glioma, H3G34-mutant (DHG), in the WHO 2021 classification. However, there are some reports of H3K27-altered non-midline gliomas (NDMG) that are not located in the midline, but the differences between these hemispheric tumors with mutations in different regions of histone H3 are unknown. In this study, we report a comparative study of the clinical characteristics between two groups of glioma, H3K27-altered NDMGs and H3G34-mutant DHGs.
Methods
Among 4128 brain tumor specimens collected in the Kansai Network for Molecular Diagnosis of Central Nervous System Tumors, 25 NDMG cases, excluding 93 cases defined as DMG, were included out of 118 cases with mutations in the H3F3A gene. Both 16 H3K27-altered NDMG cases and 9 H3G34-mutant DHG cases were examined for comparison of clinical characteristics.
Results
There were no differences in gender, tumor location, or pathology between NDMG and DHG. The median age was 47.3 years in NDMG and 26.2 years in DHG, and NDMG was significantly older than DHG (p=0.003). The rate of MGMT promoter methylation is no significant difference between 4 cases (25%) in NDMG and 6 cases (66.7%) in DHG (p=0.087). The Kaplan-Meier survival curve showed no significant difference, with a median survival of 495 days for NDMG and 587 days for DHG (p=0.765).
Discussion and Conclusion
We reported on gliomas with H3F3A mutations that occur in the cerebral hemispheres. We compared the clinical characteristics of NDMG with H3K27-altered and DHG with H3G34-mutant, which have similar tumor locations of occurrence.
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Affiliation(s)
- Hirokazu Nakatogawa
- Department of Pediatric Neurosurgery, Seirei Hamamatsu General Hospital , Shizuoka , Japan
- Department of Neurosurgery, Seirei Hamamatsu General Hospital , Shizuoka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Hiroshi Kawaji
- Department of Neurosurgery, Seirei Hamamatsu General Hospital , Shizuoka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Nobuhide Hayashi
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Neurosurgery, Wakayama Rosai Hospital , Wakayama , Japan
| | - Junya Fukai
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Neurological Surgery, Wakayama Medical University , Wakayama , Japan
| | - Noriyuki Kijima
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Neurosurgery, Graduate School of Medicine, Osaka University , Osaka , Japan
| | - Tomoko Shofuda
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
| | - Ema Yoshioka
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
| | - Daisuke Kanematsu
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
| | - Asako Katsuma
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
| | - Miho Sumida
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
| | - Chikanori Inenaga
- Department of Neurosurgery, Seirei Hamamatsu General Hospital , Shizuoka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Kanji Mori
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Neurosurgery, Yao Municipal Hospital , Osaka , Japan
| | - Yonehiro Kanemura
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Biomedical Research and Innovation Research, National Hospital Organization Osaka National Hospital Institute for Clinical Research , Osaka , Japan
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital , Osaka , Japan
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Hayashi N, Fukai J, Nakatogawa H, Kawaji H, Okita Y, Kijima N, Shofuda T, Yoshioka E, Kanemastu D, Katsuma A, Sumida M, Nakao N, Mori K, Kanemura Y. MPC-8 CLINICAL CHARACTERISTICS OF H3 K27-MUTATED GLIOMAS AT MIDLINE AND NEAR MIDLINE. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.054] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Abstract
Background and Purpose
Diffuse midline glioma(DMG),H3K27 alterd (WHO 2021, CNS grade 4) is a type of tumor that mainly develops in the CNS's median. However, owing to its rarity, few comprehensive reports have been published. This report conducted a retrospective study on H3p.K27M mutation cases via the Kansai Molecular Diagnosis Network for CNS tumors.
Materials and Methods
H3p.K27M mutation cases were analyzed out of 4128 total gene analysis specimens submitted for suspected glioma during the case accumulation period from May 2007 to July 2022.
Results
There were 109 cases with the H3p.K27M mutation, of which 107 had the H3F3A mutation, and 2 had the HIST1H3B mutation. Of the 93cases that developed a tumor on or around the lateral ventricles of the brain along the midline of the CNS, affected sites included the thalamus (37 cases), brainstem (19 cases), spinal cord (11 cases), and other areas (15 cases), while 7 cases were of multifocal origin and 4 cases were unclassifiable. The patients' ages ranged from 4 to 76 years, with a mean and median age of 32.8 and 30 years, respectively (n = 88). The male to female ratio was 52:36. All cases had IDH-wild type with pMGMT methylation (9.6%), pTERT mutation (3.2%), TP53 mutation (56.5%), BRAF V600E mutation (1.1%), FGFR1 mutation (14.3%), or EGFR mutation (3.3%). Histopathological examination revealed the existence of WHO CNS grade 2, 3, and 4 tumors. Overall survival (OS) was confirmed in 38 cases, with a mean and median age of 15.0 and 11.9 months, respectively. The results of 51 cases in which prognosis was followed up on, suggested that the factors that contributed to the prolongation of OS were female sex (p = 0.0335), thalamus location (p = 0.0366), and irradiation of 50 Gy or more (p = 0.0237).
Discussion/Conclusion
Based on a literature review, we report on the clinical characteristics of DMG in our cases, including the category of midline in DMG.
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Affiliation(s)
- Nobuhide Hayashi
- Department of Neurosurgery, Wakayama Rosai Hospital , Wakayama , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University , Wakayama , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Hirokazu Nakatogawa
- Department of Pediatric Neurosurgery, Seirei Hamamatsu General Hospital , Sizuoka , Japan
- Department of Neurosurgery, Seirei Hamamatsu General Hospital , Sizuoka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Hiroshi Kawaji
- Department of Neurosurgery, Seirei Hamamatsu General Hospital , Sizuoka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Yoshiko Okita
- Department of Neurosurgery, Graduate School of Medicine, Osaka University , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Noriyuki Kijima
- Department of Neurosurgery, Graduate School of Medicine, Osaka University , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Tomoko Shofuda
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Ema Yoshioka
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Daisuke Kanemastu
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Asako Katsuma
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Miho Sumida
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Naoyuki Nakao
- Department of Neurological Surgery, Wakayama Medical University , Wakayama , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Kanji Mori
- Department of Neurosurgery, Yao Municipal Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Yonehiro Kanemura
- Department of Biomedical Research and Innovation Research, Institute for Clinical Research, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital , Osaka , Japan
- Kansai Molecular Diagnosis Network for CNS Tumors
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Mori K, Sasaki H, Urabe F, Honda M, Yanagisawa T, Aoki M, Miki K, Shariat S, Kimura T. Radical prostatectomy versus high-dose-rate brachytherapy and hypo-fractionated external beam radiation combined with long-term androgen deprivation for high-risk prostate cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02507-1] [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: 11/11/2022] Open
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22
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Obama K, Fujimori M, Boku N, Matsuoka A, Mori K, Okizaki A, Miyaji T, Kadowaki M, Okamura M, Majima Y, Shimazu T, Uchitomi Y. Shared Decision-Making Support Program for Elderly Patients with Advanced Cancer Using Question Prompts and Geriatric Assessments: Phase II Randomized Controlled Trial. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00301-0] [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: 11/06/2022]
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Nagoshi N, Yoshii T, Egawa S, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nishida N, Nagamoto Y, Oshima Y, Ando K, Nakashima H, Takahata M, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Watanabe K, Taneichi H, Imagama S, Kawaguchi Y, Takeshita K, Nakamura M, Matsumoto M, Yamazaki M, Okawa A. Clinical Indicators of Surgical Outcomes After Laminoplasty for Patients With Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study. Spine (Phila Pa 1976) 2022; 47:1077-1083. [PMID: 35867608 DOI: 10.1097/brs.0000000000004359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/16/2021] [Accepted: 03/13/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective multicenter study. OBJECTIVE This study aims to evaluate patient-reported outcomes using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and clarify clinical factors that affect the therapeutic effects for patients with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA Although previous studies identified factors that affected the surgical outcomes, their assessment was mainly based on the Japanese Orthopedic Association score, which only includes neurological function. Investigating this pathology through multiple functions and quality of life (QOL) is pivotal to understanding the comprehensive clinical pictures of the cervical OPLL and its therapeutic outcomes. MATERIALS AND METHODS This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of the patients, 168 received laminoplasties and fully completed questionnaires. Demographic information, imaging findings, and clinical outcomes were collected. Patients were grouped according to effective or ineffective surgical outcomes as defined by the JOACMEQ using logistic regression analyses. RESULTS Laminoplasty resulted in functional improvement in the cervical spine and upper extremity around 40% of the patients, while QOL showed only 21.4% ( P <0.01). Multivariable analyses revealed that younger age and a postoperative decrease in arm or hand pain were correlated with significantly improved function of the upper extremities. A reduction in lower limb pain favorably affected the postoperative lower extremity function. A postoperative reduction in upper extremity pain enhanced the QOL recovery. CONCLUSIONS Surgeons should recognize the diversity of surgical outcomes after laminoplasty and understand the necessity of pain management even after the surgery to enhance bodily functions and QOL in patients with cervical OPLL.
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Affiliation(s)
- Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku, Japan
| | - Shunji Tsutsui
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Matsukura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedics, Jichi Medical University, Tochigi, Japan
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoshi Maki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Norihiro Nishida
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Osaka, Japan
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Shiga, Japan
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Fukui, Japan
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Kitasato Universiy Hospital, Kanagawa, Japan
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka UniversityOsaka, Japan
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomohiro Banno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Hiroshi Taneichi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedics, Jichi Medical University, Tochigi, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Okawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Mori K, Yoshii T, Hirai T, Maki S, Katsumi K, Nagoshi N, Nishimura S, Takeuchi K, Ushio S, Furuya T, Watanabe K, Nishida N, Watanabe K, Kaito T, Kato S, Nagashima K, Koda M, Ito K, Imagama S, Matsuoka Y, Wada K, Kimura A, Ohba T, Katoh H, Matsuyama Y, Ozawa H, Haro H, Takeshita K, Watanabe M, Matsumoto M, Nakamura M, Yamazaki M, Okawa A, Kawaguchi Y. The characteristics of the young patients with cervical ossification of the posterior longitudinal ligament of the spine: A multicenter cross-sectional study. J Orthop Sci 2022; 27:760-766. [PMID: 34092477 DOI: 10.1016/j.jos.2021.04.010] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by heterotopic bone formation in the posterior longitudinal ligament of the spine. Although the patients with OPLL are more common in the 60s and 70s, we know that there are markedly young patients (e.g., early 40s). However, to the best of our knowledge, there is few reports characterize young patients with cervical OPLL in terms of the imaging features, subjective symptoms, and ADL problems. METHODS This is the multicenter cross-sectional study. Two hundred and thirty-seven Japanese symptomatic patients with cervical OPLL confirmed by standard X-rays collected from 16 institutions belonging to the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament formed by the Japanese Ministry of Health, Labor and Welfare were recruited. Whole spine CT data as well as demographic data such as age, gender, patients-based evaluations, and the 36-item Short Form Health Survey (SF-36) were evaluated. RESULTS Young group (≦ 45 years old) consisted of 23 patients (8 females and 15 males), accounting for 9.7% of the total. Their characteristics were high body mass index (BMI), significant involvement of trauma in the onset and deterioration of symptoms, and the predominance of thoracic OPLL. The patient-based evaluations did not show a significant difference between the young and non-young groups, or between the genders in the young group except for bodily pain (BP) of SF-36. Female patients in young group had significantly lower BP score of SF-36 than that of male in young group. CONCLUSIONS Characteristics of young patients with cervical OPLL were high BMI, significant involvement of trauma in the onset and deterioration of symptoms, lower BP score of SF-36 in female, and the predominance of thoracic OPLL.
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Affiliation(s)
- Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan.
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Satoshi Maki
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Keiichi Katsumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Soraya Nishimura
- Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kazuhiro Takeuchi
- Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Shuta Ushio
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takeo Furuya
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Norihiro Nishida
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Satoshi Kato
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Katsuya Nagashima
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masao Koda
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kenyu Ito
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yuji Matsuoka
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kanichiro Wada
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Atsushi Kimura
- Department of Orthopedics, Jichi Medical University, Jichi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Tetsuro Ohba
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hiroyuki Katoh
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Tokai, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yukihiro Matsuyama
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hiroshi Ozawa
- Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, Tohoku, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hirotaka Haro
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Katsushi Takeshita
- Department of Orthopedics, Jichi Medical University, Jichi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masahiko Watanabe
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Tokai, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
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Yamazaki K, Taniguchi H, Masuishi T, Kawakami T, Onozawa Y, Honda K, Tsushima T, Hamauchi S, Mori K, Yasui H, Muro K. P-95 Bevacizumab, irinotecan and biweekly trifluridine/tipiracil for pretreated metastatic colorectal cancer: MODURATE, a phase Ib study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.185] [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: 11/01/2022] Open
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Katayama K, Pan D, Oda M, Okubo T, Mori K. AB1335 BONE MARROW EDEMA SCORE IN HAND X-RAY FILM BY AI DEEP LEARNING ASSOCIATE WITH MRI BONE EDEMA IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRapid radiographic progression (RRP) was reported to be one of clinical symptom in difficult to treat RA(D2T RA) (1). Eular recommendation for imaging showed BME is strong and independent prognostic factor for bone destruction(2). We reported bone marrow edema (BME) in MRI image was most associated with RRP compared with bone erosion, synovitis in Adalimumab add-on therapy in MTX-IR RA patients(3). To rescue RRP, early detection of BME is important although cost of MRI is expensive and hard to repeat.ObjectivesTo investigate the score of BME in hand X ray film by deep learning between X ray film and MRI BME information can discriminate the differences between BME and non-BME images.MethodsIn this work, we use a neural network consisted of convolutional layers and fully connected layers to classify X-ray images (Figure 1) In this paper, the output is the socre of BME which ranges from 0 to1(threshold = 0.4). We also used an interpretation technique called the Grad-CAM for visual explanations. Hand MRI (1.5T) were used.Figure 1.The convolutional neural network design. A red block “Conv” means a convolutional block. It contains a 2D convolution layer, a leaky relu activation function, a maxpooling layer and a batch normalization layer. The numbers above each “Conv” block are (kernal size, kernal size, kernal number). A green block “FC” is a fully connection layer. The number above it is (neuron number). After the last Softmax layer, the output becomes the probability of BME which ranges from 0 to 1.ResultsRegarding data split, 104 images including 79 non-BME images and 25 BME images are used as a hold-out test set. The rest of the images (473 images) are used as training data and validation data. Five fold cross-validation is used for these 473images. For each fold, there are about 378 images including 297 non-BME images and 81 BME images in the training set. There are about 95 images including 74 non-BME images and 21 BME images in the validation set. In order to fully utilize every image and unify the distribution of the training set and the validation set, the ratio of non-BME and BME is controlled to be the same which is about 3.66:1. The five folds showed similar performance on the hold-out test set. AUC is the area under the ROC curve. As the result, AUC which indicates the general performance of this model, ranged from 0.88 to 0.91. The average precision was 63% and the average recall rate was 87%. In this experiment, the initialization seed will greatly influence the final result. For example, AUC can be reduced to 0.73 from 0.89 because of a different initialization seed. It perhaps results from the shortage of data, which can easily make the neural network drop into a local minimum.We also utilized Grad-cam to visualize the result. The result of Grad-cam shows the importance of each part to the final prediction(Figure 2).Figure 2.Result of Grad-cam. Numbers in the parenthesises are the possibilities of BME. The middle case is unexpected because red region is the surrounding of the hand. The left and right cases may indicate the evidence for prediction.ConclusionThe preliminary result is much better than a random guess. According to this result, there should be a certain difference between BME and non-BME images. If it’s the characteristic of BME that domains this difference, our classification algorithm will be feasible for BME. Our future work is to justify the evidence of the predictions and improve performance.References[1]Nagy G et al. Eular definition of difficult- to - treat to rheumatoid arthritis. Ann Rheum Dis 2021;80:31-35[2]Colebatch AN et al. Eular recommendation for the use of imaging of joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013;72: 804-814[3]Katayama K et al. Bone marrow OEDEMA is more associated with rapid radiographic progression than in synovitis or bone erosion by using low field MRI in bio-naiive rheumatoid arthritis patients treated with adalimumab and methotrexate combination therapy. Ann Rheum Dis 2014, eular meeting SAT0100.Disclosure of InterestsNone declared
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Mori K, Yoshii T, Egawa S, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nagoshi N, Nishida N, Nagamoto Y, Oshima Y, Ando K, Nakashima H, Takahata M, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Taneichi H, Imagama S, Kawaguchi Y, Takeshita K, Matsumoto M, Yamazaki M, Okawa A. Impact of obesity on cervical ossification of the posterior longitudinal ligament: a nationwide prospective study. Sci Rep 2022; 12:8884. [PMID: 35614091 PMCID: PMC9133031 DOI: 10.1038/s41598-022-12625-3] [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: 11/11/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Positive association between ossification of the posterior longitudinal ligament of the spine (OPLL) and obesity is widely recognized; however, few studies focused on the effects of obesity on treatment of cervical OPLL. The effects of obesity on surgical treatment of cervical OPLL were investigated by a Japanese nationwide, prospective study. Overall, 478 patients with cervical myelopathy due to OPLL were prospectively enrolled. To clarify the effects of obesity on the surgical treatment for cervical OPLL, patients were stratified into two groups, non-obese (< BMI 30.0 kg/m2) and obese (≥ BMI 30.0 kg/m2) groups. The mean age of the obese group was significantly younger than that of non-obese group. There were no significant differences between the two groups in other demographic information, medical history, and clinical and radiographical findings. Alternatively, the obese group had a significantly higher rate of surgical site infection (SSI) than that of non-obese group. Approach-specific analyses revealed that the SSI was significantly higher in the obese group than in the non-obese group. A logistic regression analysis revealed that age, BMI, and duration of symptoms were significant factors affecting the postoperative minimum clinically important difference success. The result of this study provides useful information for future cervical OPLL treatment.
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Affiliation(s)
- Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan. .,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan.
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoru Egawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama, 332-8558, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kazuo Kusano
- Department of Orthopedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, 102-0074, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shunji Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yu Matsukura
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kanichiro Wada
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Keiichi Katsumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata, Niigata, 951-8520, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masao Koda
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Atsushi Kimura
- Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takeo Furuya
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-0856, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Maki
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-0856, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Norihiro Nishida
- Department of Orthopedic Surgery, Yamaguchi University Graduate School, of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yukitaka Nagamoto
- Department of Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi, Osaka, 591-8025, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kei Ando
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kazuma Murata
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masayuki Miyagi
- Department of Orthopedic Surgery, Kitasato University, School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamiharashi, Kanagawa, 252-0375, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Tomohiro Banno
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Tetsuro Ohba
- Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi, 409-3898, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Satoshi Inami
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hiroyuki Katoh
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Haruo Kanno
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Katsushi Takeshita
- Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan.,Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo, Japan
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Yamamoto T, Okada E, Michikawa T, Yoshii T, Yamada T, Watanabe K, Katsumi K, Hiyama A, Watanabe M, Nakagawa Y, Okada M, Endo T, Shiraishi Y, Takeuchi K, Matsunaga S, Maruo K, Sakai K, Kobayashi S, Ohba T, Wada K, Ohya J, Mori K, Tsushima M, Nishimura H, Tsuji T, Koda M, Okawa A, Yamazaki M, Matsumoto M, Watanabe K. The impact of diabetes mellitus on spinal fracture with diffuse idiopathic skeletal hyperostosis: A multicenter retrospective study. J Orthop Sci 2022; 27:582-587. [PMID: 34162513 DOI: 10.1016/j.jos.2021.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/26/2020] [Revised: 02/09/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Patients with diffuse idiopathic skeletal hyperostosis (DISH) are susceptible to spinal column injuries with neurological deterioration. Previous studies indicated that the prevalence of diabetes mellitus (DM) in patients with DISH was higher than that in patients without DISH. This study investigates the impact of DM on surgical outcomes for spinal fractures in patients with DISH. METHODS We retrospectively evaluated 177 spinal fractures in patients with DISH (132 men and 45 women; mean age, 75 ± 10 years) who underwent surgery from a multicenter database. The subjects were classified into two groups according to the presence of DM. Perioperative complications, neurological status by Frankel grade, mortality rate, and status of surgical site infection (SSI) were compared between the two groups. RESULTS DM was present in 28.2% (50/177) of the patients. The proportion of men was significantly higher in the DM group (DM group: 86.0% vs. non-DM group: 70.1%) (p = 0.03). The overall complication rate was 22.0% in the DM group and 19.7% in the non-DM group (p = 0.60). Poisson regression model revealed that SSI was significantly associated with DM (DM group: 10.0% vs. non-DM group: 2.4%, Relative risk: 4.5) (p = 0.048). Change in neurological status, mortality rate, instrumentation failure, and nonunion were similar between both groups. HbA1c and fasting blood glucose level (SSI group: 7.2% ± 1.2%, 201 ± 67 mg/dL vs. non-SSI group: 6.6% ± 1.1%, 167 ± 47 mg/dL) tended to be higher in patients with SSI; however, there was no significant difference. CONCLUSIONS In spinal fracture in patients with DISH, although DM was an associated factor for SSI with a relative risk of 4.5, DM did not negatively impact neurological recovery. Perioperative glycemic control may be useful for preventing SSI because fasting blood glucose level was high in patients with SSI.
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Affiliation(s)
- Tatsuya Yamamoto
- Dept. of Orthopaedic Surgery, Keio University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Eijiro Okada
- Dept. of Orthopaedic Surgery, Keio University, Tokyo, Japan; Dept. of Orthopaedic Surgery, Saiseikai Central Hospital, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | | | - Toshitaka Yoshii
- Dept. of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Tsuyoshi Yamada
- Dept. of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kei Watanabe
- Dept. of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Keiichi Katsumi
- Dept. of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Akihiko Hiyama
- Dept. of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masahiko Watanabe
- Dept. of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yukihiro Nakagawa
- Dept. of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Motohiro Okada
- Dept. of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Teruaki Endo
- Dept. of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Yasuyuki Shiraishi
- Dept. of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kazuhiro Takeuchi
- Dept. of Orthopaedic Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Shunji Matsunaga
- Dept. of Orthopaedic Surgery, Imakiire General Hospital, Kagoshima, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Keishi Maruo
- Dept. of Orthopaedic Surgery, Hyogo College of Medicine, Hyogo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kenichiro Sakai
- Dept. of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Sho Kobayashi
- Dept. of Orthopaedic Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Tetsuro Ohba
- Dept. of Orthopaedic Surgery, University of Yamanashi, Yamanashi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kanichiro Wada
- Dept. of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Junichi Ohya
- Dept. of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kanji Mori
- Dept. of Orthopaedic Surgery, Shiga University of Medical Science, Shiga, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Mikito Tsushima
- Dept. of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Hirosuke Nishimura
- Dept. of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Takashi Tsuji
- Dept. of Orthopaedic Surgery, Fujita Health University, Aichi, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masao Koda
- Dept. of Orthopaedic Surgery, University of Tsukuba, Ibaraki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Atsushi Okawa
- Dept. of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Masashi Yamazaki
- Dept. of Orthopaedic Surgery, University of Tsukuba, Ibaraki, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Morio Matsumoto
- Dept. of Orthopaedic Surgery, Keio University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan
| | - Kota Watanabe
- Dept. of Orthopaedic Surgery, Keio University, Tokyo, Japan; Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan.
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Inose H, Hirai T, Yoshii T, Kimura A, Takeshita K, Inoue H, Maekawa A, Endo K, Miyamoto T, Furuya T, Nakamura A, Mori K, Kanbara S, Imagama S, Seki S, Matsunaga S, Takahashi K, Okawa A. Factors contributing to neck pain in patients with degenerative cervical myelopathy: A prospective multicenter study. J Orthop Surg (Hong Kong) 2022; 30:10225536221091848. [PMID: 35426758 DOI: 10.1177/10225536221091848] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Although the understanding of the mechanisms of low back pain due to spinopelvic sagittal imbalance has strengthened, the understanding of the mechanisms of neck pain remains insufficient. Thus, this study aimed to identify the factors associated with preoperative and postoperative neck pain in patients with degenerative cervical myelopathy who underwent laminoplasty. METHODS In this prospective multicenter study, we prospectively enrolled patients who were scheduled for laminoplasty for degenerative cervical myelopathy. The associations between different variables and the Numerical Pain Rating Scale (NRS) scores for neck pain were investigated using univariate and multiple linear regression models. RESULTS In total, 92 patients were included in the current study. The univariate analysis showed that age, sex, cervical lordosis in neutral and extension, and thoracic kyphosis were significantly associated with the preoperative NRS score for neck pain; moreover, preoperative cervical lordosis in extension and range of motion and postoperative cervical lordosis in neutral, flexion, and extension were significantly associated with the postoperative NRS Scale score for neck pain. Stepwise multiple regression analysis showed that the independent factors contributing to preoperative neck pain were preoperative cervical lordosis in extension, sex, and age. The independent preoperative predictor and contributor to postoperative neck pain were preoperative cervical lordosis in extension and postoperative cervical lordosis in extension, respectively. CONCLUSIONS Cervical lordosis in extension showed significant association with neck pain in patients with degenerative cervical myelopathy. Therefore, when performing laminoplasty for patients with a low cervical lordosis in extension, attention should be paid to residual postoperative neck pain.
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Affiliation(s)
- Hiroyuki Inose
- Department of Orthopaedic and Trauma Research, 13100Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takashi Hirai
- Department of Orthopaedic Surgery, 13100Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, 13100Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Atsushi Kimura
- Department of Orthopaedics, 12838Jichi Medical University, Shimotsuke, Japan
| | - Katsushi Takeshita
- Department of Orthopaedics, 12838Jichi Medical University, Shimotsuke, Japan
| | - Hirokazu Inoue
- Department of Orthopaedics, 12838Jichi Medical University, Shimotsuke, Japan
| | - Asato Maekawa
- Department of Orthopaedic Surgery, 13112Tokyo Medical University, Shinjuku-ku, Japan
| | - Kenji Endo
- Department of Orthopaedic Surgery, 13112Tokyo Medical University, Shinjuku-ku, Japan
| | - Takuya Miyamoto
- Department of Orthopaedic Surgery, 12737Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, 12737Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Nakamura
- Department of Orthopaedic Surgery, 13051Shiga University of Medical Science, Otsu, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, 13051Shiga University of Medical Science, Otsu, Japan
| | - Shunsuke Kanbara
- Department of Orthopaedic Surgery, 12965Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, 12965Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, Faculty of Medicine, 34823University of Toyama, Toyama, Japan
| | - Shunji Matsunaga
- Department of Orthopaedic Surgery, 73599Imakiire General Hospital, Kagoshima, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, 13100Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, 13100Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Matsumura Y, Tabusadani M, Yamane K, Takao S, Kuroyama Y, Mori K, Ono K, Kawahara K, Omatsu S, Furuuchi K, Fujiwara K, Morimoto K, Kimura H, Senjyu H. Prevalence of and risk factors for depressive symptoms in non-tuberculous mycobacterial pulmonary disease. Int J Tuberc Lung Dis 2022; 26:310-316. [PMID: 35351235 DOI: 10.5588/ijtld.21.0527] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: The presence of depressive symptoms in patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD) is an important research topic; however, the prevalence of depressive symptoms and the factors that influence their development are unclear.OBJECTIVE: To analyse the association between CES-D (Center for Epidemiological Studies Depression Scale) scores and clinical parameters such as age, disease duration, pulmonary function, imaging findings, blood data, physical functions, sleep disturbances, respiratory symptoms and health-related quality of life (HRQOL).METHODS: We conducted a cross-sectional retrospective study of 114 patients with NTM-PD at a single centre from March 2016 to January 2021 to evaluate the relationship between CES-D scores and clinical parameters.RESULTS: Participants had a median age of 64 years; 32.5% of them had depressive symptoms. Disease duration, albumin, C-reactive protein, pulmonary function, dyspnoea, exercise capacity, respiratory symptoms, cough-related HRQOL and sleep disturbances were associated with depressive symptoms. Binomial logistic regression analyses indicated that the CES-D score was significantly associated with cough-related HRQOL and sleep disturbances.CONCLUSION: A high percentage of NTM-PD patients in this study experienced depressive symptoms, and these patients had abnormalities of various clinical parameters. Cough-related HRQOL and sleep disturbance had a strong influence on the development of depressive symptoms.
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Affiliation(s)
- Y Matsumura
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - M Tabusadani
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - K Yamane
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, Chiba, Japan
| | - S Takao
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Y Kuroyama
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Department of Rehabilitation, Showa General Hospital, Kodaira, Tokyo, Japan
| | - K Mori
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - K Ono
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - K Kawahara
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - S Omatsu
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - K Furuuchi
- Respiratory Diseases Center, Fukujuji Hospital, JATA, Tokyo, Japan, Department of Basic Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Fujiwara
- Respiratory Diseases Center, Fukujuji Hospital, JATA, Tokyo, Japan, Department of Basic Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Morimoto
- Respiratory Diseases Center, Fukujuji Hospital, JATA, Tokyo, Japan, Division of Clinical Research, Fukujuji Hospital, JATA, Tokyo, Japan
| | - H Kimura
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan, Respiratory Diseases Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - H Senjyu
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
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Mori K. Axion-like Particles from Nearby Type Ia Supernovae. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226006003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Axion-like particles (ALPs) are a class of hypothetical pseudo-scalar particles and can be created in hot astrophysical plasma through the interaction between photons. I calculate the production of ALPs in type Ia supernovae. It is found that many ALPs lighter than a few MeV can be produced in type Ia supernovae. Once produced, heavy ALPs decay into photons during propagation in the interstellar space. I calculate the flux of the decay photons and find that it may be detected by future MeV γ-ray telescopes if a type Ia supernova explodes near the Solar System.
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Suzuki T, Mori K, Honma M, Famiano MA, Kajino T, Kusakabe M, Balantekin AB. Screening Effects on Electron-Capture Rates and Type Ia Supernova Nucleosynthesis. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226006004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Nucleosynthesis of iron-group elements in Type Ia supernovae is studied for single-degenerate models with the use of electron-capture rates updated with the new shell-model Hamiltonian in pf -shell. An over-production problem of neutron-rich iron-group isotopes compared with the solar abundances is now found to be suppressed within a factor of about twice for the updated weak rates. Effects of screening on nucleosynthesis are investigated for explosion models of fast deflagration and slow deflagration with delayed detonation. The e-capture rates are reduced by the screening, especially by the screening effects on the ions. The production yields of most neutron-rich isotopes such as 50Ti, 54Cr and 58Fe are found to be suppressed most by the screening. The inclusion of the screening is desirable for precise evaluation of abundances of neutron-rich nuclides.
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Mori K, Kusakabe M, Balantekin AB, Kajino T, Famiano MA. Enhancement of Lithium in Red Clump Stars by Neutrino Magnetic Moments. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226011016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A recent spectroscopic survey has shown that the lithium abundances in low-mass red-clump stars are higher than theoretical prediction. Motivated by their finding, we implemented effects of additional energy losses induced by neutrino magnetic moments on stellar evolution models. It is found that the lithium abundances in red giants increase because the finite magnetic moments of neutrinos enhance the efficiency of deep mixing and 7Be is conveyed from the hydrogen burning shell to the convective envelope. The results motivate further studies on the effects of non-standard energy losses on the surface compositions of low-mass red giants and red-clump stars.
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Sari Motlagh R, Schuettfort V, Mori K, Katayama S, Rajwa P, Aydh A, Grossmann N, Laukhtina E, Pradere B, Mostafai H, Quhal F, Abufaraj M, Lee R, Karakiewicz P, Lotan Y, Comprate E, Moschini M, Gontero P, Shariat S. Prognostic impact of perioperative circulating levels of Insulin-like growth factor-I (IGF-I) and its binding proteins, IGFBP-2 and IGFBP-3, on disease outcomes after radical cystectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01159-9] [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: 11/28/2022]
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Laukhtina E, Quhal F, Mori K, Sari Motlagh R, Katayama S, Rajwa P, Yanagisawa T, Grossmann N, Mostafaei H, König F, Aydh A, Pradere B, Teoh J, Enikeev D, Karakiewicz P, Schmidinger M, Shariat S. Pembrolizumab outperforms tyrosine kinase inhibitors in the adjuvant therapy of patients with high-risk renal cell carcinoma: A systematic review and network meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01083-1] [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: 11/29/2022]
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36
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Mizoguchi S, Mori K, Shin T, Mimata H. The effect of GPER inhibition on prostatic enlargement and chronic inflammation in high fat diet induced obesity rat model. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00675-3] [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: 11/27/2022]
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Laukhtina E, Moschini M, Krajewski W, Teoh J, Ploussard G, Soria F, Roghmann F, Muenker M, Roumiguie M, Alvarez-Maestro M, Misrai V, Antonelli A, Tafuri A, Simone G, Mastroianni R, Zhao H, Rahota RG, Scuderi S, Petov V, D`andrea D, Mori K, Montorsi F, Enikeev D, Shariat S, Pradere B. Oncological and safety profiles in patients undergoing simultaneous transurethral resection of bladder tumor and prostate: Results from a large multicenter international collaboration. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00331-1] [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: 11/04/2022]
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Yanagiswawa T, Mori K, Kawada T, Sari Motlagh R, Mostafaei H, Quhal F, Laukhtina E, Rajwa P, König F, Pallauf M, Pradere B, Miki J, Kimura T, Egawa S, Shariat S. Can ablation therapy be an alternative treatment to partial nephrectomy for clinical T1b renal tumors?: A systematic review and meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00300-1] [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: 11/30/2022]
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Yayama T, Mori K, Saito H, Fujikawa H, Kitagawa M, Okumura N, Nishizawa K, Nakamura A, Kumagai K, Mimura T, Imai S. Cytokine Profile From the Ligamentum Flavum in Patients with Ossification of the Posterior Longitudinal Ligament in the Cervical Spine. Spine (Phila Pa 1976) 2022; 47:277-285. [PMID: 34919077 DOI: 10.1097/brs.0000000000004302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Histological, immunohistochemical, and suspension array analyses of cytokine expression in human cervical ossification of the posterior longitudinal ligament (OPLL). OBJECTIVES The aim of this study was to determine whether changes in the cytokine profile reflect the maturation of chondrocytes and osteoblasts are associated with OPLL development. SUMMARY OF BACKGROUND DATA OPLL progresses gradually over a prolonged period and may lead to serious spinal cord complications. However, treatment methods only include conservative therapy for neurological symptoms or surgical decompression, whereas preventive therapy for OPLL remains nonexistent. METHODS Ligamentous samples were harvested from 24 patients with OPLL who underwent spinal surgery, and five control samples from cervical spondylotic myelo/radiculopathy patients without OPLL. Tissue sections were used for immunohistochemical studies and primary cells were cultured from the ligamentous samples for cytokine profiling. Using a suspension array system, concentrations of 27 inflammatory cytokines or growth factors were measured to generate the cytokine profiles. RESULTS Suspension array and immunoblot analysis revealed significant increments in the levels of interleukin (IL)-6, IL-1α, basic fibroblast growth factor, and RANTES in patients with OPLL. Immunohistochemical analysis further revealed that these factors were present in mesenchymal cells within the degenerative portion of the ligamentous matrix. CONCLUSION Our findings suggest that specific changes in the cytokine profile during ossification promote osteoblast differentiation, thereby providing new insights into OPLL pathogenesis. Moreover, this work supports the development of a new therapeutic method for preventing OPLL progression by regulating the cytokine profiles.Level of Evidence: 3.
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Affiliation(s)
- Takafumi Yayama
- Department of Orthopedic Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
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Mostafaei H, Mori K, Pradere B, Kawada T, Sari Motlagh R, Yanagisawa T, Quhal F, Laukhtina E, Rajwa P, Aydh A, König F, Pallauf M, Salehi-Pourmehr H, Hajebrahimi S, Shariat S. Desmopressin is twice effective in females: A systematic review and meta-analysis on medical treatment of nocturia. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00259-7] [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: 11/04/2022]
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41
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Quhal F, Mori K, Laukhtina E, Rajwa P, Mostafaei H, Pradere B, Shariat S, Schmidinger M. Immunotherapy-based combinations in the first-line treatment of metastatic renal cell carcinoma with sarcomatoid features: A systematic review and network meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00467-5] [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: 11/25/2022]
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42
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Yanagiswawa T, Mori K, Kawada T, Mostafaei H, Quhal F, Laukhtina E, Rajwa P, Sari Motlagh R, Frederik K, Pallauf M, Pradere B, Miki J, Kimura T, Egawa S, Shariat S. Prevention and detection of iatrogenic ureteral injury during abdominal or pelvic surgery: A systematic review and meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00268-8] [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: 11/16/2022]
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43
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Mostafaei H, Naseri A, Pradere B, Mori K, Kawada T, Sari Motlagh R, Yanagisawa T, Quhal F, Laukhtina E, Rajwa P, Aydh A, König F, Pallauf M, Salehi-Pourmehr H, Kabiri N, Hajebrahimi S, Shariat S. Placebo response is up to four times more in conventional drugs compared to herbal medicine in male LUTS: A systematic review and meta-analysis. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00258-5] [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: 11/15/2022]
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Hirai T, Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Wada K, Katsumi K, Fujii K, Kimura A, Furuya T, Nagoshi N, Kanchiku T, Nagamoto Y, Oshima Y, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Imagama S, Koda M, Kawaguchi Y, Takeshita K, Matsumoto M, Yamazaki M, Okawa A. Severity of Myelopathy is Closely Associated With Advanced Age and Signal Intensity Change in Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Nationwide Investigation. Clin Spine Surg 2022; 35:E155-E161. [PMID: 33769979 DOI: 10.1097/bsd.0000000000001164] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Prospective, nationwide case series. OBJECTIVE To identify preoperative factors associated with myelopathy and neurological impairment in patients with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA Various studies have reported clinical outcomes following the surgical treatment of OPLL. However, there has been no large-scale study of preoperative clinical features in patients with cervical OPLL. MATERIALS AND METHODS Data were prospectively collected from 28 institutions nationwide in Japan. In total, 512 patients with neurological impairment caused by cervical OPLL requiring surgery were enrolled. Basic demographic and clinical data, including age, sex, diabetes status, body mass index, smoking history, and disease duration were collected. C2-7 lordotic angle, canal narrowing ratio, range of motion in flexion-extension at C2-7, and type of OPLL were evaluated on lateral radiographs to identify factors influencing the clinical features of patients with OPLL in whom surgery was planned. RESULTS Complete documentation was available for 490 patients (362 male, 128 female). In total, 34 patients had the localized type, 181 had the segmental type, 64 had the continuous type, and 211 had the mixed type. Although there were no significant differences in age, body mass index, disease duration, Japanese Orthopedic Association (JOA) score, and lordotic angle at C2-7 according to the type of OPLL, significant differences were observed in a range of motion at C2-7 and the canal narrowing ratio among the 4 types. Multiple regression analysis revealed that the JOA score was significantly associated with age and signal intensity change on magnetic resonance imaging. CONCLUSIONS This is the first large-scale, prospective, multicenter case series study to investigate factors influencing preoperative neurological status in patients with OPLL. Age and signal intensity change on magnetic resonance images were significantly associated with JOA score in patients requiring surgery. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
| | - Satoru Egawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Saitama
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku
| | - Yukihiro Nakagawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, Wakayama
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Aomori
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Niigata
| | - Kengo Fujii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedics, Jichi Medical University, Tochigi
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo
| | - Tsukasa Kanchiku
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Osaka
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Shiga
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo
| | - Shunji Matsunaga
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshimashi
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka
| | - Sho Kobayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Shizuoka
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedics, Jichi Medical University, Tochigi
| | - Morio Matsumoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Tokyo
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Inose H, Yoshii T, Kimura A, Takeshita K, Inoue H, Maekawa A, Endo K, Furuya T, Nakamura A, Mori K, Kanbara S, Imagama S, Seki S, Matsunaga S, Okawa A. Factors Negatively Influencing Postoperative Improvement After Laminoplasty in Degenerative Cervical Myelopathy. Clin Spine Surg 2022; 35:E230-E235. [PMID: 34039892 DOI: 10.1097/bsd.0000000000001207] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/28/2020] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN This was a retrospective study of prospectively collected data. OBJECTIVE In this study, we aimed to characterize a population of patients with degenerative cervical myelopathy (DCM) and a history of poor postoperative neurological recovery and to identify risk factors associated with poor neurological recovery after laminoplasty. SUMMARY OF BACKGROUND DATA Kyphotic cervical alignment has been considered a relative contraindication to laminoplasty in recent years; hence, laminoplasty has been decreasingly performed for the treatment of DCM in patients with cervical kyphosis. However, the effect of global spinal alignment on postoperative outcomes has not been extensively investigated. MATERIALS AND METHODS We prospectively enrolled patients who were scheduled for laminoplasty for DCM. Outcome (at enrollment and 1 y after surgery) and risk factor analyses were performed by comparing the good recovery and poor recovery groups. The Spearman correlation coefficient was used to evaluate the relationships between the recovery rate and the preoperative radiographic factors. RESULTS In total, 101 patients completed the 1-year follow-up. Regarding clinical outcomes, the Japanese Orthopedic Association score for the assessment of cervical myelopathy, European Quality of Life-5 Dimensions, and Neck Disability Index scores improved postoperatively. The recovery rate was significantly correlated with the preoperative sagittal vertical axis (SVA). The patients in the poor recovery group were older than those in the good recovery group. Univariate analyses showed that the SVA and T1 pelvic angle were significantly higher in the poor recovery group. Lastly, stepwise logistic regression analysis showed that a higher SVA was an independent predictor of poor recovery after laminoplasty. CONCLUSIONS The SVA and T1 pelvic angle were significantly higher in the poor recovery group. A high preoperative SVA is an independent predictor for poor recovery after laminoplasty. Therefore, indications for laminoplasty in elderly DCM patients with a high preoperative SVA should be carefully considered. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Hiroyuki Inose
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo
| | - Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo
| | - Atsushi Kimura
- Department of Orthopaedics, Jichi Medical University, Tochigi
| | | | - Hirokazu Inoue
- Department of Orthopaedics, Jichi Medical University, Tochigi
| | - Asato Maekawa
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo
| | - Kenji Endo
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo
| | - Takeo Furuya
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba
| | - Akira Nakamura
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu
| | - Shunsuke Kanbara
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Shoji Seki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama
| | - Shunji Matsunaga
- Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshima, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo
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Nakashima H, Imagama S, Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Fujii K, Kimura A, Furuya T, Kanchiku T, Nagamoto Y, Oshima Y, Nagoshi N, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Li Y, Yatsuya H, Koda M, Kawaguchi Y, Takeshita K, Matsumoto M, Yamazaki M, Okawa A. Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament. Sci Rep 2022; 12:748. [PMID: 35031694 PMCID: PMC8760337 DOI: 10.1038/s41598-021-04727-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 04/29/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022] Open
Abstract
This prospective multicenter study, established by the Japanese Ministry of Health, Labour and Welfare and involving 27 institutions, aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL), in order to address the controversy surrounding the role of instrumented fusion in cases of posterior surgical decompression for OPLL. 478 patients were considered for participation in the study; from among them, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, there were no significant differences among the participants in terms of patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments. The overall risk of perioperative complications was found to be lower with LM (odds ratio [OR] 0.40, p = 0.006), and the rate of C5 palsy occurrence was significantly lower with LM (OR 0.11, p = 0.0002) than with PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients who had PF was significantly smaller than in those who had LM. However, multivariable logistic regression analysis showed no significant difference among the participants in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in the LM group than in the PF group (OR 2.73, p = 0.0002). Both LM and PF for cervical myelopathy due to OPLL had resulted in comparable postoperative outcomes at 2 years after surgery.
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Affiliation(s)
- Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan.
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Satoru Egawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Kenichiro Sakai
- Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama, 332-8558, Japan
| | - Kazuo Kusano
- Department of Orthopaedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, 102-0074, Japan
| | - Yukihiro Nakagawa
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Itogun, Wakayama, 649-7113, Japan
| | - Takashi Hirai
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori, 036-8562, Japan
| | - Keiichi Katsumi
- Department of Orthopaedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata, Niigata, 951-8520, Japan
| | - Kengo Fujii
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Atsushi Kimura
- Department of Orthoaedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba, Chiba, 260-8670, Japan
| | - Tsukasa Kanchiku
- Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, 111 Minami Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi, Osaka, 591-8025, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi, 466-8550, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, 060-8638, Japan
| | - Kanji Mori
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan
| | - Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Kazuma Murata
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Shunji Matsunaga
- Department of Orthopaedic Surgery, Imakiire General Hospital, 4-16 Shimotatsuocho, Kagoshimashi, 892-8502, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan
| | - Sho Kobayashi
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Tetsuro Ohba
- Department of Orthopaedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi, 409-3898, Japan
| | - Satoshi Inami
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroyuki Katoh
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Haruo Kanno
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan
| | - Yuanying Li
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan.,Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Katsushi Takeshita
- Department of Orthoaedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo, 160-8582, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8519, Japan
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47
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Inoue T, Maki S, Yoshii T, Furuya T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Fujii K, Kimura A, Nagoshi N, Kanchiku T, Nagamoto Y, Oshima Y, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Imagama S, Koda M, Kawaguchi Y, Takeshita K, Matsumoto M, Ohtori S, Yamazaki M, Okawa A. Is anterior decompression and fusion more beneficial than laminoplasty for K-line (+) cervical ossification of the posterior longitudinal ligament? An analysis using propensity score matching. J Neurosurg Spine 2022; 37:1-8. [PMID: 35171838 DOI: 10.3171/2021.11.spine211205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/04/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE It is unclear whether anterior cervical decompression and fusion (ADF) or laminoplasty (LMP) results in better outcomes for patients with K-line-positive (+) cervical ossification of the posterior longitudinal ligament (OPLL). The purpose of the study is to compare surgical outcomes and complications of ADF versus LMP in patients with K-line (+) OPLL. METHODS The study included 478 patients enrolled in the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament and who underwent surgical treatment for cervical OPLL. The patients who underwent anterior-posterior combined surgery or posterior decompression with instrumented fusion were excluded. The patients with a follow-up period of fewer than 2 years were also excluded, leaving 198 patients with K-line (+) OPLL. Propensity score matching was performed on 198 patients with K-line (+) OPLL who underwent ADF (44 patients) or LMP (154 patients), resulting in 39 pairs of patients based on the following predictors for surgical outcomes: age, preoperative Japanese Orthopaedic Association (JOA) score, C2-7 angle, and the occupying ratio of OPLL. Clinical outcomes were assessed 1 and 2 years after surgery using the recovery rate of the JOA score. Complications and reoperation rates were also investigated. RESULTS The mean recovery rate of the JOA score 1 year after surgery was 55.3% for patients who underwent ADF and 42.3% (p = 0.06) for patients who underwent LMP. Two years after surgery, the recovery rate was 53.4% for those who underwent ADF and 38.7% for LMP (p = 0.07). Although both surgical procedures yielded good results, the mean recovery rate of JOA scores tended to be higher in the ADF group. The incidence of surgical complications, however, was higher following ADF (33%) than LMP (15%; p = 0.06). The reoperation rate was also higher in the ADF group (15%) than in the LMP group (0%; p = 0.01). CONCLUSIONS Clinical outcomes were good for both ADF and LMP, indicating that ADF and LMP are appropriate procedures for patients with K-line (+) OPLL. Clinical outcomes of ADF 1 and 2 years after surgery tended to be better than LMP, but the analysis did not detect any significant difference in clinical outcomes between the groups. Conversely, patients who underwent ADF had a higher incidence of surgery-related complications. When considering indications for ADF or LMP, benefits and risks of the surgical procedures should be carefully weighed.
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Affiliation(s)
- Takaki Inoue
- 1Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba
| | - Satoshi Maki
- 1Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba
| | - Toshitaka Yoshii
- 2Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
| | - Takeo Furuya
- 1Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba
| | - Satoru Egawa
- 2Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
| | - Kenichiro Sakai
- 3Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama
| | - Kazuo Kusano
- 4Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyoda-yu, Tokyo
| | - Yukihiro Nakagawa
- 5Department of Orthopedic Surgery, Wakayama Medical University Kihoku Hospital, Ito-gun, Wakayama
| | - Takashi Hirai
- 2Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
| | - Kanichiro Wada
- 6Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori
| | - Keiichi Katsumi
- 7Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata
| | - Kengo Fujii
- 8Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Atsushi Kimura
- 9Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi
| | - Narihito Nagoshi
- 10Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - Tsukasa Kanchiku
- 11Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi
| | - Yukitaka Nagamoto
- 12Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakai, Osaka
| | - Yasushi Oshima
- 13Department of Orthopedic Surgery, The University of Tokyo Hospital, Bunkyo-ku, Tokyo
| | - Kei Ando
- 14Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi
| | - Masahiko Takahata
- 15Department of Orthopedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido
| | - Kanji Mori
- 16Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga
| | - Hideaki Nakajima
- 17Department of Orthopedics and Rehabilitation Medicine, University of Fukui Faculty of Medical Sciences, Yoshida-gun, Fukui
| | - Kazuma Murata
- 18Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo
| | - Shunji Matsunaga
- 19Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshima
| | - Takashi Kaito
- 20Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka
| | - Kei Yamada
- 21Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Fukuoka
| | - Sho Kobayashi
- 22Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka
| | - Satoshi Kato
- 23Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa
| | - Tetsuro Ohba
- 24Department of Orthopedic Surgery, University of Yamanashi, Chuo, Yamanashi
| | - Satoshi Inami
- 25Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi
| | - Shunsuke Fujibayashi
- 26Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto
| | - Hiroyuki Katoh
- 27Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa
| | - Haruo Kanno
- 28Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Miyagi; and
| | - Shiro Imagama
- 14Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi
| | - Masao Koda
- 8Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Yoshiharu Kawaguchi
- 29Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Katsushi Takeshita
- 9Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi
| | - Morio Matsumoto
- 10Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo
| | - Seiji Ohtori
- 1Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba
| | - Masashi Yamazaki
- 8Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki
| | - Atsushi Okawa
- 2Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
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Fukai J, Sasaki T, Yamoto T, Nakai Y, Ishii M, Kitayama M, Nishibayashi H, Mori K, Kanemura Y, Nakao N. COT-1 Clinical Questions and Answers about Glioma-Related Epilepsy (GRE): Real-world data in Wakayama Medical University Hospital. Neurooncol Adv 2021. [PMCID: PMC8648227 DOI: 10.1093/noajnl/vdab159.110] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: In glioma patients, epilepsy not infrequently occurred and anti-epileptic drugs (AEDs) are commonly used. In this study, we revealed the real-world data on clinical practice of glioma-related epilepsy in Wakayama Medical University Hospital (WMUH). Methods. We collected clinical and molecular data of glioma patients operated at WMUH from January 1996 to December 2020 and analyzed the data to answer clinical questions as follows: 1) location/histology related GRE, 2) molecular features related GRE, 3) prophylactic AEDs and postoperative seizure, 4) tumor progression and convulsion, 5) GRE and survival. Results. Fifty-five of 113 glioma patients (49%) presented with seizure. CQ1. In tumors located at frontal, temporal and parietal lobe, the occurrence rate of GRE was 27/39 (69%), 13/19 (69%) and 9/14 (64%), respectively. Patients with glioblastoma, astrocytic tumors and oligodendroglial tumors presented with GRE at the rate of 26/54 (48%), 14/30 (47%) and 12/13 (92%), respectively. CQ2. GRE occurred in tumors with IDH mutated (16 cases, 29%), TERT mutated (32 cases, 58%) and MGMT methylated (32 cases, 58%). CQ3. Seizure in peri- or postoperative period occurred in 14 cases (12%); 4 cases in AED(+) group (4/29, 14%) and 10 cases in AED(-) group (10/84, 12%). CQ4. Tumor progression became apparent at the time of seizure in 12 cases (12/55, 22%). CQ5. According to the prognostic IDH/TERT classification of diffuse glioma cases (n = 94), overall survival (OS) times of GRE(+) cases tended to be longer than that of GRE(-) ones, especially in IDH wildtype/TERT mutated group (22.7 months vs. 8.3 months, p = 0.0397). Conclusion. GRE is likely associated with specific clinical and molecular features. Seizure in glioma patients can occur in specific situation regardless of the use of AEDs. Possible better prognosis of GRE(+) cases requires further investigation.
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Affiliation(s)
- Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Takahiro Sasaki
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
- Kansai Molecular Diagnosis Network for CNS Tumors
| | - Toshikazu Yamoto
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
| | - Yasuo Nakai
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
| | - Masamichi Ishii
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
| | - Mari Kitayama
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
| | - Hiroki Nishibayashi
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
| | - Kanji Mori
- Kansai Molecular Diagnosis Network for CNS Tumors
- Department of Neurosurgery, Yao Municipal Hospital
| | - Yonehiro Kanemura
- Kansai Molecular Diagnosis Network for CNS Tumors
- Division of Regenerative Medicine, Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital
| | - Naoyuki Nakao
- Department of Neurological Surgery, Wakayama Medical University School of Medicine
- Kansai Molecular Diagnosis Network for CNS Tumors
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49
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Nagoshi N, Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Fujii K, Kimura A, Furuya T, Kanchiku T, Nagamoto Y, Oshima Y, Nakashima H, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Watanabe K, Imagama S, Koda M, Kawaguchi Y, Takeshita K, Nakamura M, Matsumoto M, Yamazaki M, Okawa A. Comparison of Surgical Outcomes After Open- and Double-Door Laminoplasties for Patients with Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study. Spine (Phila Pa 1976) 2021; 46:E1238-E1245. [PMID: 33958538 DOI: 10.1097/brs.0000000000004094] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective multicenter study. OBJECTIVE To evaluate and compare the surgical outcomes after open-door (OD) and double-door (DD) laminoplasties in subjects with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA Although previous studies compared clinical results after OD and DD laminoplasties, they were performed at a single institution with a relatively small sample size targeting mixed pathologies, including cervical spondylotic myelopathy. METHODS This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of these, 41 and 164 patients received OD and DD laminoplasties, respectively. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, and visual analog scale scores. RESULTS Age, sex, symptom duration, and comorbidities were not significantly different between the groups. Segmental ossification was the most frequent in both the groups. No significant differences in K-line type, canal occupying ratio, C2 to C7 angles, and range of motion were found. Both the procedures reduced the cervical range of motion postoperatively. A comparable frequency of perioperative complications was observed between the groups. The cervical Japanese Orthopaedic Association scores showed a similar improvement at 2 years postopera- tively. The reduction in visual analog scale score for neck pain was favorable in the OD group (P = 0.02), while other pain assessments did not show any significant differences between the groups. The functional outcomes assessed using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire presented equivalent effective rates. CONCLUSION The results demonstrated almost comparable surgical outcomes between OD and DD laminoplasties. Lamino- plasty is a valuable technique as a therapeutic option for cervical OPLL.Level of Evidence: 2.
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Affiliation(s)
- Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku Ward, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo Ward, Tokyo, Japan
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo Ward, Tokyo, Japan
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchishi, Saitama, Japan
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyodaku, Japan
| | - Yukihiro Nakagawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, Katsuragi-cho, Itogun, Wakayama, Japan
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo Ward, Tokyo, Japan
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Chuo Ward, Niigata, Niigata, Japan
| | - Kengo Fujii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chuo Ward, Chiba, Japan
| | - Tsukasa Kanchiku
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka, Japan
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shunji Matsunaga
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshimashi, Japan
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Sho Kobayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, University of Yamanashi, Chuo Ward, Yamanashi, Japan
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Aoba Ward, Sendai, Miyagi, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku Ward, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Showa Ward, Nagoya, Aichi, Japan
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku Ward, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku Ward, Tokyo, Japan
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsushi Okawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Japan
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo Ward, Tokyo, Japan
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Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Fujii K, Kimura A, Furuya T, Nagoshi N, Kanchiku T, Nagamoto Y, Oshima Y, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Imagama S, Koda M, Kawaguchi Y, Takeshita K, Matsumoto M, Yamazaki M, Okawa A. Perioperative Complications in Posterior Surgeries for Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Nationwide Investigation. Clin Spine Surg 2021; 34:E594-E600. [PMID: 34347632 DOI: 10.1097/bsd.0000000000001243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/31/2020] [Accepted: 06/23/2021] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN This was a prospective multicenter study. OBJECTIVE The aim of this study was to investigate the perioperative complications of posterior surgeries for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA Surgical treatment for cervical OPLL has a high risk of various complications. Laminoplasty (LAMP) and posterior decompression and instrumented fusion (PDF) are effective for multilevel cervical OPLL; however, few studies have focused on the surgical complications of these 2 procedures. MATERIALS AND METHODS We prospectively included 380 patients undergoing posterior surgeries for cervical OPLL (LAMP: 270 patients, PDF: 110 patients), and investigated the systemic and local complications, including neurological complications. We further evaluated risk factors related to the neurological complications. RESULTS Motor palsy was found in 40 patients (10.5%), and motor palsy in the upper extremity was most frequent (8.9%), especially in patients who received PDF (14.5%). Motor palsies involving the lower extremities was found in 6 patients (1.6%). Regarding local complications, dural tears (3.9%) and surgical site infections (2.6%) were common. In the univariate analysis, body mass index, preoperative cervical alignment, fusion surgery, and the number of operated segments were the factors related to motor palsy. Multivariate analysis revealed that fusion surgery and a small preoperative C2-C7 angle were the independent factors related to motor palsy. Motor palsy involving the lower extremities tended to be found at early time points after the surgery, and all the patients fully recovered. Motor palsy in the upper extremities occurred in a delayed manner, and 68.8% of patients with PDF showed good recovery, whereas 81.3% of patients with LAMP showed good recovery. CONCLUSIONS In posterior surgeries for cervical OPLL, segmental motor palsy in the upper extremity was most frequently observed, especially in patients who received PDF. Fusion and a small preoperative C2-C7 angle were the independent risk factors for motor palsy. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Toshitaka Yoshii
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
| | - Satoru Egawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchishi
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku
| | - Yukihiro Nakagawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, Wakayama
| | - Takashi Hirai
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Niigata
| | - Kengo Fujii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedics, Jichi Medical University, Shimotsuke
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo
| | - Tsukasa Kanchiku
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Osaka
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Fukui
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo
| | - Shunji Matsunaga
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshimashi
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka
| | - Sho Kobayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, University of Yamanashi, Yamanashi
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedics, Jichi Medical University, Shimotsuke
| | - Morio Matsumoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Bunkyo-ku, Tokyo
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