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Takahashi S, Hoshino M, Takayama K, Sasaoka R, Tsujio T, Yasuda H, Kanematsu F, Kono H, Toyoda H, Ohyama S, Hori Y, Nakamura H. The natural course of the paravertebral muscles after the onset of osteoporotic vertebral fracture. Osteoporos Int 2020; 31:1089-1095. [PMID: 32060561 DOI: 10.1007/s00198-020-05338-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
UNLABELLED This study revealed the change in the paravertebral muscles in patients with osteoporotic vertebral fracture. Increased pain is likely to be the driver for reduced activity, reduced activities of daily living, and consequent increase in fat infiltration of the paravertebral muscles, assumed to be secondary to reduced activity level or, conversely, partial immobilization. INTRODUCTION To reveal the time courses and impact of the paravertebral muscles (PVMs) on the healing process of osteoporotic vertebral fractures and risk factors for PVM decrease. METHODS Consecutive patients with symptomatic osteoporotic vertebral fractures were enrolled in 11 hospitals. At enrollment and 3- and 6-month follow-up, PVMs, including the multifidus and erector spinae, were examined using magnetic resonance imaging (MRI). The PVM cross-sectional area (CSA) and fat signal fraction (FSF) were measured at L3. Low back pain (LBP), activities of daily living (ADLs), and risk factors for PVM decrease at the 6-month follow-up were investigated. PVM decrease was defined as > 1 standard deviation decrease of the CSA or > 1 standard deviation increase of the FSF. RESULTS Among 153 patients who completed the 6-month follow-up, 117 (92 women, 79%) had MRI of L3 at enrollment and 3- and 6-month follow-up (mean age at enrollment, 78.5 years). The CSA did not change 6 months from onset (p for trend = 0.634), whereas the FSF significantly increased (p for trend = 0.033). PVM decrease was observed in 30 patients (26%). LBP was more severe, and delayed union was more frequent in patients with PVM decrease (p = 0.021 mixed-effect model and p = 0.029 chi-square test, respectively). The risk factors for PVM decrease were ADL decline at the 3-month follow-up (adjusted odds ratio = 5.35, p = 0.026). CONCLUSION PVM decrease was significantly related to LBP and delayed union after osteoporotic vertebral fracture onset. ADL decline at the 3-month follow-up was a risk factor for PVM decrease. Therefore, restoring ADLs within 3 months after onset is important.
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Affiliation(s)
- S Takahashi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - M Hoshino
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - K Takayama
- Department of Orthopaedic Surgery, Seikeikai Hospital, Osaka, Japan
| | - R Sasaoka
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - T Tsujio
- Department of Orthopaedic Surgery, Shiraniwa Hospital, Nara, Japan
| | - H Yasuda
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - F Kanematsu
- Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, Osaka, Japan
| | - H Kono
- Department of Orthopaedic Surgery, Ishikiri Seiki Hospital, Osaka, Japan
| | - H Toyoda
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - S Ohyama
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Y Hori
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - H Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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Takahashi S, Hoshino M, Takayama K, Iseki K, Sasaoka R, Tsujio T, Yasuda H, Sasaki T, Kanematsu F, Kono H, Toyoda H, Nakamura H. Time course of osteoporotic vertebral fractures by magnetic resonance imaging using a simple classification: a multicenter prospective cohort study. Osteoporos Int 2017; 28:473-482. [PMID: 27577726 DOI: 10.1007/s00198-016-3737-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 08/10/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED This study revealed the time course of osteoporotic vertebral fracture by magnetic resonance imaging using a simple classification. Signal changes were associated with the compression degree and mobility of the fractured vertebral body. This classification showed sufficient reliability in categorizing magnetic resonance imaging findings of osteoporotic vertebral fractures. INTRODUCTION Magnetic resonance imaging (MRI) is useful in diagnosing osteoporotic vertebral fractures (OVFs). This study investigated the time course of OVFs by MRI using a simple classification. METHODS This multicenter cohort study was performed from 2012 to 2015. Consecutive patients with ≤2-week-old OVFs were enrolled in 11 institutions. MRI was performed at enrollment and at 1-, 3-, 6-, and 12-month follow-up. Signal changes on T1-weighted imaging (T1WI), T2WI, and short τ inversion recovery (STIR) were classified according to signal intensity. Height and angular motion of vertebral bodies were also measured. RESULTS The 6-month follow-up was completed by 153 patients. At enrollment, fractured vertebrae signal changes were 43 % diffuse and 57 % confined low on T1WI; on T2WI, 56, 24, and 5 % were confined low, high, and diffuse low, respectively; on STIR, 100 % were high. On T1WI, diffuse low remained most common (90 % at 1 month and 60 % at 3 months) until 6 and 12 months, when most were confined low (54 and 52 %, respectively). On T2WI, confined low remained most common (decreasing to 41 % at 12 months). On STIR, high signal change was shown in 98, 87, and 64 % at 3, 6, and 12 months, respectively. At 3, 6, and 12 months, diffuse low signal change was associated with significantly lower vertebral height, and high signal change was associated with significantly greater angular motion. CONCLUSIONS MRI signal changes were associated with the compression degree and angular motion of fractured vertebrae. This classification showed sufficient reliability in categorizing MRI findings of OVFs.
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Affiliation(s)
- S Takahashi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - M Hoshino
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Takayama
- Department of Orthopaedic Surgery, Seikeikai Hospital, Sakai, Osaka, Japan
| | - K Iseki
- Department of Orthopaedic Surgery, Sato Hospital, Osaka, Japan
| | - R Sasaoka
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - T Tsujio
- Department of Orthopaedic Surgery, Shiraniwa Hospital, Ikoma, Nara, Japan
| | - H Yasuda
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - T Sasaki
- Department of Orthopaedic Surgery, Nishinomiya Watanabe Hospital, Nishinomiya, Hyogo, Japan
| | - F Kanematsu
- Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, Osaka, Japan
| | - H Kono
- Department of Orthopaedic Surgery, Ishikiri Seiki Hospital, Higashi Osaka, Osaka, Japan
| | - H Toyoda
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Takahashi S, Hoshino M, Takayama K, Iseki K, Sasaoka R, Tsujio T, Yasuda H, Sasaki T, Kanematsu F, Kono H, Toyoda H, Nakamura H. Predicting delayed union in osteoporotic vertebral fractures with consecutive magnetic resonance imaging in the acute phase: a multicenter cohort study. Osteoporos Int 2016; 27:3567-3575. [PMID: 27344644 DOI: 10.1007/s00198-016-3687-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED This study demonstrated the predictive values of radiological findings for delayed union after osteoporotic vertebral fractures (OVFs). High-signal changes on T2WI were useful findings. INTRODUCTION The purpose of the present study is to determine predictive radiological findings for delayed union by magnetic resonance imaging (MRI) and plain X-rays at two time points in the acute phase of OVFs. METHODS This multicenter cohort study was performed from 2012 to 2015. A total of 218 consecutive patients with OVFs ≤2 weeks old were enrolled. MRIs and plain X-rays were performed at the time of enrollment and at 1- and 6-month follow-ups. Signal changes on T1-weighted imaging (T1WI) were classified as diffuse low-, confined low-, or no-signal change; those on T2WI were classified as high (similar to the intensity of cerebrospinal fluid), confined low-, diffuse low-, or no-signal change. The angular motion of the fractured vertebral body was measured with X-rays. RESULTS A total of 153 patients completed the 6-month follow-up. A high-signal change on T2WI was most useful in predicting delayed union. Sensitivity, specificity, and positive predictive values were 53.3, 87.8, and 51.6 % at enrollment and 65.5, 84.8, and 51.4 % at the 1-month follow-up, respectively. The positive predictive value increased to 62.5 % with observation of high- or diffuse low-signal changes at both enrollment and the 1-month follow-up. The cutoff value of vertebral motion was 5 degrees. Sensitivity and specificity at enrollment were 52.4 and 74.1 %, respectively. CONCLUSIONS This study demonstrated the radiological factors predicting delayed union after an OVF. T2 high-signal changes showed the strongest association with delayed union. Consecutive MRIs were particularly useful as a differential tool to predict delayed union following OVFs.
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Affiliation(s)
- S Takahashi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - M Hoshino
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - K Takayama
- Department of Orthopaedic Surgery, Seikeikai Hospital, Saitama, Japan
| | - K Iseki
- Department of Orthopaedic Surgery, Sato Hospital, Konan, Japan
| | - R Sasaoka
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - T Tsujio
- Department of Orthopaedic Surgery, Shiraniwa Hospital, Osaka, Japan
| | - H Yasuda
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - T Sasaki
- Department of Orthopaedic Surgery, Nishinomiya Watanabe Hospital, Nishinomiya, Japan
| | - F Kanematsu
- Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, Osaka, Japan
| | - H Kono
- Department of Orthopaedic Surgery, Ishikiri Seiki Hospital, Osaka, Japan
| | - H Toyoda
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - H Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
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Miyamoto T, Sasaoka R, Kawaguchi M, Ishioka S, Inoue T, Yamada N, Mihara M. Scedosporium apiospermum skin infection: a case report and review of the literature. J Am Acad Dermatol 1998; 39:498-500. [PMID: 9738792 DOI: 10.1016/s0190-9622(98)70335-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- T Miyamoto
- Department of Dermatology, Tsuyama Central Hospital, Nikaimachi, Japan
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Sasaoka R, Morimura T, Mihara M, Hagari Y, Aki T, Miyamoto T. Detection of human papillomavirus type 16 DNA in two cases of verrucous carcinoma of the foot. Br J Dermatol 1996; 134:983-4. [PMID: 8736356 DOI: 10.1111/j.1365-2133.1996.tb06346.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Abstract
We report a Japanese boy with centrifugal lipodystrophy. The initial lesion developed on the forehead as an area of erythema which showed centrifugal spread and central fading to leave a residual depression. Three years later, similar erythematous lesions appeared on the cheeks, and he developed a cadaverous appearance. A central depression on the upper trunk was surrounded by an erythematous border and there was right cervical lymphadenopathy. Histological examination revealed inflammatory changes in the subcutaneous fat. Although this patient showed the characteristics of both centrifugal and progressive lipodystrophy (partial lipodystrophy), we consider that he has centrifugal lipodystrophy of the face because of the overall features of the lesions.
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Affiliation(s)
- Y Hagari
- Department of Dermatology, Faculty of Medicine, Tottori University, Yonago, Japan
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Inoue M, Nasu T, Sasaoka R, Igarashi T, Enomoto T. [A case of Salmonella typhimurium peritonitis followed by pleurisy and pericarditis]. Nihon Naika Gakkai Zasshi 1982; 71:673-8. [PMID: 6752310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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