1
|
Takahashi R, Nojiri H, Ohara Y, Fujiwara T, Ishijima M. Decreased grip strength is associated with paraspinal muscular oxidative stress in female lumbar degenerative disease patients. J Orthop Res 2024. [PMID: 38650087 DOI: 10.1002/jor.25863] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
We aimed to investigate the relationship between superoxide dismutase 2-related oxidative stress in the paraspinal muscles and spinal alignment, clinical skeletal muscle parameters, and mitochondrial function. Multifidus muscle samples from patients who underwent posterior lumbar surgery were analyzed. Patients with diseases affecting oxidative stress and spinal alignment were excluded. The superoxide dismutase 2 redox index was defined as the ratio of reactive oxygen species (superoxide) to antioxidant enzymes (superoxide dismutase 2) and was used as an index of oxidative stress. Patients were divided into two groups based on the superoxide dismutase 2 redox index. Spinal alignment, clinical skeletal muscle parameters, and succinic dehydrogenase (SDH) mean grayscale value were compared between the groups, with analyzes for both sexes. Multiple regression analyzes were used to adjust for the confounding effect of age on variables showing a significant difference between the two groups. Thirty-five patients with lumbar degenerative diseases were included. No significant differences were observed between the two groups for any of the parameters in males; however, females with a higher superoxide dismutase 2 redox index had greater lumbar lordosis, lower grip strength, and higher SDH mean grayscale value than those with a lower index. Multiple regression analyzes revealed that the superoxide dismutase 2 redox index was an independent explanatory variable for lumbar lordosis, grip strength, and SDH mean grayscale value in female patients. In conclusion, superoxide dismutase 2-related oxidative stress in the paraspinal muscles was associated with mitochondrial dysfunction and decreased grip strength in female lumbar degenerative disease patients.
Collapse
Affiliation(s)
- Ryosuke Takahashi
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo, Japan
| | - Yukoh Ohara
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo, Japan
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Abe E, Suzuki M, Ichimura K, Arakawa A, Satomi K, Ogino I, Hara T, Iwamuro H, Ohara Y, Kondo A. Implications of DNA Methylation Classification in Diagnosing Ependymoma. World Neurosurg 2024:S1878-8750(24)00388-7. [PMID: 38479644 DOI: 10.1016/j.wneu.2024.03.013] [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: 01/18/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Ependymoma is a central nervous system (CNS) tumor that arises from the ependymal cells of the brain's ventricles and spinal cord. The histopathology of ependymomas is indistinguishable regardless of the site of origin, and the prognosis varies. Recent studies have revealed that the development site and prognosis reflect the genetic background. In this study, we used genome-wide DNA methylation array analysis to investigate the epigenetic background of ependymomas from different locations treated at our hospital. METHODS Four cases of posterior fossa ependymomas and 11 cases of spinal ependymomas were analyzed. RESULTS DNA methylation profiling using the DKFZ methylation classifier showed that the methylation diagnoses of the 2 cases differed from the histopathological diagnoses, and 2 cases could not be classified. Tumor that spread from the brain to the spinal cord was molecularly distinguishable from other primary spinal tumors. CONCLUSIONS Although adding DNA methylation classification to conventional diagnostic methods may be helpful, the diagnosis in some cases remains undetermined. This may affect decision-making regarding treatment strategies and follow-up. Further investigations are required to improve the diagnostic accuracy of these tumors.
Collapse
Affiliation(s)
- Eiji Abe
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Mario Suzuki
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koichi Ichimura
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Brain Disease Translational Research, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Arakawa
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaishi Satomi
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Ikuko Ogino
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takeshi Hara
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirokazu Iwamuro
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Kitahama Y, Shizuka H, Nakano Y, Ohara Y, Muto J, Tsuchida S, Motoyama D, Miyake H, Sakai K. Advancements and Challenges in Robot-Assisted Bone Processing in Neurosurgical Procedures. Neurospine 2024; 21:97-103. [PMID: 38569635 PMCID: PMC10992635 DOI: 10.14245/ns.2347164.582] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE Practical applications of nerve decompression using neurosurgical robots remain unexplored. Our ongoing research and development initiatives, utilizing industrial robots, aim to establish a secure and efficient neurosurgical robotic system. The principal objective of this study was to automate bone grinding, which is a pivotal component of neurosurgical procedures. METHODS To achieve this goal, we integrated an endoscope system into a manipulator and conducted precision bone machining using a neurosurgical drill, recording the grinding resistance values across 3 axes. Our study encompassed 2 core tasks: linear grinding, such as laminectomy, and cylindrical grinding, such as foraminotomy, with each task yielding unique measurement data. RESULTS In linear grinding, we observed a proportional increase in grinding resistance values in the machining direction with acceleration. This observation suggests that 3-axis resistance measurements are a valuable tool for gauging and predicting deep cortical penetration. However, problems occurred in cylindrical grinding, and a significant error of 10% was detected. The analysis revealed that multiple factors, including the tool tip efficiency, machining speed, teaching methods, and deflection in the robot arm and jig joints, contributed to this error. CONCLUSION We successfully measured the resistance exerted on the tool tip during bone machining with a robotic arm across 3 axes. The resistance ranged from 3 to 8 Nm, with the measurement conducted at a processing speed approximately twice that of manual surgery performed by a surgeon. During the simulation of foraminotomy under endoscopic grinding conditions, we encountered a -10% error margin.
Collapse
Affiliation(s)
- Yoshihiro Kitahama
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Mechanical Engineering, Shizuoka University, Hamamatsu, Japan
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Hiroo Shizuka
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Yuto Nakano
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Yukoh Ohara
- Department of Mechanical Engineering, Shizuoka University, Hamamatsu, Japan
| | - Jun Muto
- Spine Center, Fuji Toranomon Orthopedic Surgery Hospital, Gotenba, Japan
| | - Shuntaro Tsuchida
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Daisuke Motoyama
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideaki Miyake
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Katsuhiko Sakai
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| |
Collapse
|
4
|
Ohara Y. Full Endoscopic Spine Surgery with Image-Guided Navigation System as "Hybrid Endoscopic Spine Surgery": A Narrative Review. World Neurosurg 2023; 179:45-48. [PMID: 37543200 DOI: 10.1016/j.wneu.2023.07.135] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
Endoscopic surgery is adopted as a minimally invasive technique in several surgical fields. Endoscopic spine surgery (ESS) was performed initially for lumbar discectomy but is currently widely utilized for various pathologies. Similar to other endoscopic techniques, ESS has a steep learning curve that has recently been a topic of discussion. Image-guided navigation systems have been developed for spine surgery. Intraoperative computed tomography enables the use of an image-guided navigation system in ESS, which is a suitable approach for managing complex lesions. Full-ESS is currently being adopted for certain cervical pathologies, and the incorporation of an image-guided navigation system will soon enable surgery for other cervical pathologies.
Collapse
Affiliation(s)
- Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.
| |
Collapse
|
5
|
Hara T, Mizuno M, Hida K, Sasamori T, Miyoshi Y, Uchikado H, Ohashi H, Sugawara T, Takeshima Y, Ohara Y, Kondo A, Endo T. Intramedullary Schwannoma of the Spinal Cord: A Nationwide Analysis by the Neurospinal Society of Japan. Neurospine 2023; 20:747-755. [PMID: 37350168 PMCID: PMC10562212 DOI: 10.14245/ns.2346376.188] [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: 03/30/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVE This study was aimed to report the clinical characteristics of intramedullary schwannomas and discuss imaging findings and treatment strategies. METHODS The inclusion criterion was consecutive patients with intramedullary schwannomas who were surgically treated at 8 centers between 2009 and 2020. Clinical characteristics included age, sex, clinical presentation, disease duration, and follow-up period. The modified McCormick scale was used to compare the preoperative and postoperative conditions. Pre- and postoperative magnetic resonance images (MRI) of each case were analyzed. RESULTS The mean age of the total 11 patients at the operation was 50.2 years. The mean duration of the symptoms was 23 months, with limb paresthesia being the most common clinical presentation. The cervical spine was the most common localization level of the tumor in 6 cases. The mean follow-up duration was 49.4 months. Gross total resection (GTR) and subtotal resection (STR) was achieved in 9 and 2 cases, respectively. According to the modified McCormick scale at 6 months postoperatively, 7 cases (63.6%) had improved and 4 cases (36.3%) had unchanged grades. Typical MRI findings of the intramedullary schwannoma included ring-like enhancement, syringomyelia, cystic formation, intramedullary edema, and hemosiderin deposition. Gadolinium enhancement was homogenous in 8 cases (72.7%). The tumor margins were well demarcated in all cases. CONCLUSION Intramedullary schwannoma should be considered when sharp margins and well-enhanced tumors are present at the cervical spine level and the initial symptoms are relatively mild, such as dysesthesia. When GTR cannot be achieved, STR for tumor decompression is recommended.
Collapse
Affiliation(s)
- Takeshi Hara
- Spine and Spinal Cord center, Juntendo University, Tokyo, Japan
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Masaki Mizuno
- Department of Minimum-Invasive Neurospinal Surgery, Mie University, Mie, Japan
| | | | - Toru Sasamori
- Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
| | - Yasuyuki Miyoshi
- Department of Neurosurgery, Kawasaki Medical School, Okayama, Japan
| | | | - Hiroki Ohashi
- Department of Neurosurgery, The Jikei University, Tokyo, Japan
| | - Taku Sugawara
- Department of Spinal Surgery, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
| | | | - Yukoh Ohara
- Spine and Spinal Cord center, Juntendo University, Tokyo, Japan
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Toshiki Endo
- Division of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - for the Investigators of Intramedullary Spinal Cord Tumors in the Neurospinal Society of Japan
- Spine and Spinal Cord center, Juntendo University, Tokyo, Japan
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
- Department of Minimum-Invasive Neurospinal Surgery, Mie University, Mie, Japan
- Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
- Department of Neurosurgery, Kawasaki Medical School, Okayama, Japan
- Uchikado Neuro-Spine Clinic, Fukuoka, Japan
- Department of Neurosurgery, The Jikei University, Tokyo, Japan
- Department of Spinal Surgery, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
- Department of Neurosurgery, Nara Medical University, Nara, Japan
- Division of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| |
Collapse
|
6
|
Doi K, Mizuno J, Ohara Y, Tani S. Comparison of the Degree of Expanded Spinal Canal Area between the Hinge-Side Area and the Open-Side Area in Cervical Open-Door Laminoplasty. Neurol India 2023; 71:689-692. [PMID: 37635499 DOI: 10.4103/0028-3886.383874] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background There have been reports on the significant canal cross-sectional area (CSA) expansion difference between pre- and post-operation, but no comparison of CSA expansion between the hinge-side area (Area H) and the open-side area (Area O) has been reported. This study aimed to measure the spinal CSA expansion between Area H and Area O retrospectively after open-door laminoplasty using new titanium spacers and evaluated this common decompression procedure's effectiveness. Materials and Methods This study included 27 patients diagnosed with cervical spondylotic radiculopathy or myelopathy, ossification of the posterior longitudinal ligament, and developmental canal stenosis from February 2021 to October 2022. The CSA difference between pre- and post-cervical laminoplasty (C4-C6 levels) was measured with cervical transverse computed tomography scan images. The CSA difference in Area H and Area O between pre- and post-laminoplasty was similarly calculated. Results The spinal canal areas of each segment after open-door laminoplasty were significantly enlarged (P < 0.05). Area O was also significantly enlarged compared to that of Area H (P < 0.05). Conclusion Area O was more enlarged than Area H, and both sides were statistically enlarged after open-door laminoplasty.
Collapse
Affiliation(s)
- Kazuma Doi
- Center for Minimally Invasive Spinal Surgery, Shin Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Junichi Mizuno
- Center for Minimally Invasive Spinal Surgery, Shin Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Yukoh Ohara
- Center for Minimally Invasive Spinal Surgery, Shin Yurigaoka General Hospital, Kawasaki, Kanagawa; Department of Neurosurgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Tani
- Center for Minimally Invasive Spinal Surgery, Shin Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| |
Collapse
|
7
|
Nojiri H, Okuda T, Takano H, Gomi M, Takahashi R, Shimura A, Tamagawa S, Hara T, Ohara Y, Ishijima M. Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery. Medicina (Kaunas) 2023; 59:medicina59040730. [PMID: 37109688 PMCID: PMC10145782 DOI: 10.3390/medicina59040730] [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] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/13/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: The lateral approach is commonly used for anterior column reconstruction, indirect decompression, and fusion in patients with lumbar degenerative diseases and spinal deformities. However, intraoperative lumbar plexus injury may occur. This is a retrospective comparative study to investigate and compare neurological complications between the conventional lateral approach and a modified lateral approach at L4/5. Materials and Methods: Patients with a lumbar degenerative disease requiring single-level intervertebral fusion at L4/5 were included and categorized into group X and group A. Patients in group X underwent conventional extreme lateral interbody fusion, while those in group A underwent a modified surgical procedure that included splitting of the anterior third of the psoas muscle, which was dilated by the retractor on the anterior third of the intervertebral disc. The incidence of lumbar plexus injury, defined as a decrease of ≥1 grade on manual muscle testing of hip flexors and knee extensors and sensory impairment of the thigh for ≥3 weeks, on the approach side, was investigated. Results: Each group comprised 50 patients. No significant between-group differences in age, sex, body mass index, and approach side were observed. There was a significant between-group difference in intraoperative neuromonitoring stimulation value (13.1 ± 5.4 mA in group X vs. 18.5 ± 2.3 mA in group A, p < 0.001). The incidence of neurological complications was significantly higher in group X than in group A (10.0% vs. 0.0%, respectively, p < 0.05). Conclusions: In our modified procedure, the anterior third of the psoas muscle was entered and split, and the intervertebral disc could be reached without damaging the lumbar plexus. When performing lumbar surgery using the lateral approach, lumbar plexus injury can be avoided by following surgical indication criteria based on the location of the lumbar plexus with respect to the psoas muscle and changing the transpsoas approach to the intervertebral disc.
Collapse
Affiliation(s)
- Hidetoshi Nojiri
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Takatoshi Okuda
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Hiromitsu Takano
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Motoshi Gomi
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Ryosuke Takahashi
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Arihisa Shimura
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Shota Tamagawa
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
| | - Takeshi Hara
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
- Department of Neurosurgery, Juntendo University, Tokyo 113-8421, Japan
| | - Yukoh Ohara
- Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan
- Department of Neurosurgery, Juntendo University, Tokyo 113-8421, Japan
| | - Muneaki Ishijima
- Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan
| |
Collapse
|
8
|
Hara T, Ohara Y. Perioperative Management for Full-Endoscopic Lumbar Discectomy: Consideration From the Perspective of Preventing Complication. Neurospine 2023; 20:28-32. [PMID: 37016851 PMCID: PMC10080411 DOI: 10.14245/ns.2346056.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/02/2023] [Indexed: 04/03/2023] Open
Abstract
In recent years, full-endoscopic discectomy (FED) has expanded its range of indications with the development of devices and various techniques. The advantage of FED over conventional surgery is that it is a minimally invasive procedure. However, intraoperative and postoperative precautions must be taken to prevent complications. It is necessary to avoid complications that could compromise the outcome of the procedure. Effective perioperative management is necessary to avoid complications; however, there is no set view for perioperative management in FED. In this study, we perform a literature review to examine the effectiveness of perioperative management methods for FED. The key to ensuring the efficacy and minimal invasiveness of FED is prevention of complications. Based on the result and literature review, we believe that the most manageable postoperative management after FED is prevention of recurrent disc herniation and hematoma formation. A drain should be placed to prevent postoperative hematoma formation. It is advisable to evaluate the patient’s symptoms and monitor C-reactive protein and erythrocyte sedimentation rate levels during the first week after surgery. Postoperative antibiotics were administered for 1 day.
Collapse
Affiliation(s)
- Takeshi Hara
- Spine and Spinal Cord Center, Juntendo University, Tokyo, Japan
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
- Corresponding Author Takeshi Hara Department of Neurosurgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yukoh Ohara
- Spine and Spinal Cord Center, Juntendo University, Tokyo, Japan
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
9
|
Kim HS, Sairyo K, Ohara Y, Chen CM. Evidence-Based Endoscopic Spinal Surgery Special Section. World Neurosurg 2022; 168:323. [DOI: 10.1016/j.wneu.2022.10.046] [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: 12/15/2022]
|
10
|
Sato T, Nojiri H, Okuda T, Miyagawa K, Kobayashi N, Takahashi R, Shimura A, Tamagawa S, Ohara Y, Hara T, Ishijima M. Three-dimensional morphological analysis of the thoracic pedicle and related radiographic factors in adolescent idiopathic scoliosis. BMC Musculoskelet Disord 2022; 23:847. [PMID: 36068555 PMCID: PMC9450434 DOI: 10.1186/s12891-022-05799-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the laterality of the pedicle morphology at the apical vertebra (AV) level and identify the radiographic factors associated with the laterality ratio of the pedicle morphology at the AV level in patients with adolescent idiopathic scoliosis (AIS). Methods Overall, 684 pedicles in 57 AIS patients aged 10–20 years, who underwent preoperative computed tomography (CT) and had Lenke type 1 or 2 with right convex main thoracic curves (MTC), were evaluated. Pedicle diameters of the MTC were assessed. We defined and compared the region containing two vertebrae adjacent to the AV (APEX±1) and the region containing two vertebrae adjacent to the neutral vertebra. We analyzed the pedicle diameter and laterality ratio of APEX±1 and performed multiple linear regression analysis to identify the radiographic factors associated with the laterality of the pedicle diameter. Results On the concave side of APEX±1, the pedicles of 15 patients (26.3%) did not accept a 4-mm-diameter pedicle screw (PS), even with 25% cortical bone width expansion. Laterality ratio differences in the pedicle diameters of the cortical bone width in APEX±1 were large in patients with more proximal AV level (p < 0.001) and smaller apical vertebral rotation (AVR) (p = 0.029). Conclusions Preoperative planning to accurately select and insert the PS in AIS should be based on the anatomical limitations in APEX±1, AV level, and AVR degree. In APEX±1, the correlation between AVR and the laterality ratio of the pedicle diameter may be useful for pathoetiological interpretation of the AIS deformity. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05799-4.
Collapse
Affiliation(s)
- Tatsuya Sato
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Hidetoshi Nojiri
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan.
| | - Takatoshi Okuda
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Kei Miyagawa
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Nozomu Kobayashi
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Ryosuke Takahashi
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Arihisa Shimura
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Shota Tamagawa
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Takeshi Hara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, Japan
| |
Collapse
|
11
|
Ishikawa T, Mizuta S, Yamaguchi K, Ohara Y, Doshida M, Takeuchi T, Matsubayashi H. O-207 Incidence of Y chromosome microdeletions and microdissection testicular sperm extraction (micro TESE) in patients with Japanese azoospermic patients. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.126] [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: 11/12/2022] Open
Abstract
Abstract
Study question
What is the frequency of azoospermia factor (AZF) microdeletions and sperm retrieval rate (SRR) by micro TESE in patients with these deletions?
Summary answer
AZFc is most frequent of Y chromosome microdeletions and a predictor of micro TESE outcome in Japanese azoospermic men.
What is known already
After Klinefelter syndrome, Y chromosome microdeletions are the second most frequent genetic cause of male infertility, with a prevalence of 2%-10% in non-obstructive azoospermia (NOA) and three spermatogenesis loci in the Y chromosome long arm (Yq11) have been classified as AZFa, AZFb, and AZFc. The classical correlation of histopathology phenotypes with these three microdeletions comprises of complete absence of germ cells (Sertoli cell-only syndrome) in patients with AZFa microdeletions, maturation arrest of meiosis in patients with AZFb microdeletions, and hypospermatogenesis in patients with AZFc microdeletions, however, individual variation in the extent of deletions has led to various spermatogenic phenotypes.
Study design, size, duration
We performed a retrospective study based on two reproduction centers in Japan and evaluated 1373 azoospermic patients in our clinics between September 2013 and December 2021. We investigated the frequency of AZF microdeletions and SRR by micro TESE in patients with these microdeletions and therefore aimed to evaluate the correlation between AZF microdeletions and micro TESE results.
Participants/materials, setting, methods
A total of 1373 azoospermic were enrolled. After the diagnosis of azoospermia, karyotype analysis and detection of Y chromosome microdeletions were performed on peripheral blood lymphocytes of these patients. Y chromosome microdeletions in AZFa, AZFb, and AZFc regions were detected using Promega Y Chromosome AZF Analysis System version 2.0 (Promega Co.). Twenty sequence-tagged sites within the AZF region of Yq11 and the sex-determining region Y gene were targeted for polymerase chain reaction (PCR) amplification.
Main results and the role of chance
One hundred and fifty-two AZF microdeletions (11.1%) were detected in the azoospermic patients. The most common deleted region was AZFc (60 cases, 4.4%). Among the patients, 17 (1.2%), 1 (0.1%), 42 (3.1%), 13 (1.0%), and 6 (0.5%) had AZFa, AZFa+b, AZFb+c, AZFb, and AZFa+b+c microdeletions, respectively. When the cases were grouped according to causes of infertility that could be detected, no Y chromosome microdeletions were detected in some groups (cases with Klinefelter Syndrome, hypogonadotropic hypogonadism, congenital absence of vas deferens, and 47, XYY karyotype). Fifty-three azoospermic men with AZFc microdeletions underwent micro TESE, and spermatozoa were detected in 88.7% (47/53) of these men. In contrast, we detected spermatozoa in only 20.4% (109/534) of the azoospermic men without AZF microdeletions. The SRR was much higher in patients with AZFc microdeletions than that of patients without AZF deletions. Although three azoospermic men with AZFb+c microdeletions had also undergone micro TESE following patient request, we did not retrieve spermatozoa.
Limitations, reasons for caution
We excluded post chemotherapy NOA showing 46, XX and AZFa+b+c deletions post bone marrow transplantation from female donor. Additionally, we did not detect AZFc partial deletion including gr/gr deletion. The cohort size of this study is not small, however, our screened population of infertile men may be biased.
Wider implications of the findings
NOA patients with AZFc microdeletions had a high percentage of successful sperm retrieval by micro TESE. Our study emphasizes that diagnosis of Y chromosome microdeletions is critical for preconception genetic counseling and provides clinically valuable prognostic information to couples considering surgical sperm retrieval.
Trial registration number
None
Collapse
Affiliation(s)
- T Ishikawa
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - S Mizuta
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - K Yamaguchi
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - Y Ohara
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - M Doshida
- Reproduction Clinic Tokyo , Reproductive medicine , Tokyo, Japan
| | - T Takeuchi
- Reproduction Clinic Tokyo , Reproductive medicine , Tokyo, Japan
| | - H Matsubayashi
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| |
Collapse
|
12
|
Handa M, Takiuchi T, Kawaguchi S, Komukai S, Kitamura T, Miyake T, Ohara Y, Doshida M, Takeuchi T, Matsubayashi H, Ishikawa T, Kimura T. O-130 Reproductive outcomes of normal ovarian reserve patients after progestin-primed ovarian stimulation with chlormadinone acetate vs GnRH antagonist: A retrospective study with inverse-probability-of-treatment weighting. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.030] [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: 11/14/2022] Open
Abstract
Abstract
Study question
To evaluate the effectiveness of chlormadinone acetate (CMA) for preventing premature LH surge in patients with normal ovarian reserve compared to cetrorelix.
Summary answer
In progestin-primed ovarian stimulation (PPOS) than GnRH antagonist (GnRH-ant), the incidence of premature LH surge was significantly lower, without significant difference in oocyte maturation rate.
What is known already
The GnRH-ant protocol is one of the conventional protocols which has some disadvantages including increased premature LH surge rate and cancelation rate. In recent years, the PPOS protocol has attracted attention as a new ovarian stimulation using progestin as an alternative to GnRH analog for suppressing a premature LH surge, however its efficacy is still controversial. In addition, many studies have investigated the reproductive outcomes of PPOS using medroxy-progesterone acetate or dydrogesterone; however, there are few reports of CMA, an oral progestin, which is inexpensive and widely used in Japan.
Study design, size, duration
This retrospective cohort study was performed in a reproduction center between March 2018 and October 2020 which included 977 Japanese patients with normal ovarian reserve undergoing PPOS with CMA (n = 299), or GnRH antagonist (GnRH-ant) with cetrorelix (n = 608) in their first IVF cycle at the reproduction center. In subgroup analysis, pregnancy outcomes after frozen embryo transfers (FET) between PPOS (n = 284) and GnRH-ant (n = 579) were also compared.
Participants/materials, setting, methods
The inclusion criteria were patients aged < 40 years and AMH ≧ 1.1 ng/mL, who underwent autologous oocyte retrieval in their first IVF cycle with freeze-all strategy. The primary outcome was the incidence of premature LH surge, the secondary outcomes was oocyte maturation rate. To reduce the impact of treatment bias and potential confounding factors, we conducted logistic regression models with inverse-probability-of-treatment weighting (IPTW).
Main results and the role of chance
After IPTW, baseline clinical data were well-balanced between the two groups, including age, AMH, BMI, the duration, type, and cause of infertility, antral follicle count, the history of recurrent spontaneous abortion, and previous IVF attempts. The premature LH surge rate was significantly lower with PPOS (3.1%) compared to GnRH-ant (20.1%) (odds ratio, 0.21; 95% confidence interval, 0.11–0.36). No significant differences were found in total gonadotropin dose (2400IU for PPOS vs 2400IU for GnRH-ant, p = 0.136), the number of oocyte retrieval (n = 15 vs n = 15, p = 0.484), oocyte maturation rate (78.8% vs 77.8%, p = 0.275), fertilization rate (73.0% vs 72.0%, p = 0.412), viable embryo rate per oocyte retrieval (40% vs 40%, p = 0.890), and good quality blastocyst rate (72.0% vs 69.6%, p = 0.092). However, the good quality day-3 embryo rate was significantly lower with PPOS (37.2% vs 49.1%, p < 0.05). There were no differences in the incidence of moderate-to-severe OHSS (0.3% vs 0.7%, p = 0.481). In FET cycles, the pregnancy outcomes, such as implantation rate (43.1 % vs 51.9 %, p = 0.013) and clinical pregnancy rate (46.5% vs 54.7%, p = 0.027) were significantly lower with PPOS, however, no significant differences were found in ongoing pregnancy rate (75.6% vs 80.5%, p = 0.325), and live birth rate (72.4% vs 79.5 %, p = 0.142).
Limitations, reasons for caution
This was a retrospective cohort study conducted in a single center. The participants in this study were limited to Japanese ethnicity. The results need to be validated across different centers and other ethnicities.
Wider implications of the findings
This is the first report assessing the reproductive outcomes on PPOS using CMA, widely used in Japan. The PPOS with CMA significantly suppressed the premature LH surge rate compared to GnRH-ant protocol, without decrease in oocyte maturation rate.
Trial registration number
N/A
Collapse
Affiliation(s)
- M Handa
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
| | - T Takiuchi
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
- Osaka university Graduate School of Medicine, Clinical Genomics , Osaka, Japan
| | - S Kawaguchi
- Osaka university Graduate School of Medicine, Division of Biomedical Statistics- Integrated Medicine , Osaka, Japan
| | - S Komukai
- Osaka university Graduate School of Medicine, Division of Biomedical Statistics- Integrated Medicine , Osaka, Japan
| | - T Kitamura
- Osaka university Graduate School of Medicine, Division of Environmental Medicine and Population Services- Social and Environmental Medicine , Osaka, Japan
| | - T Miyake
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
| | - Y Ohara
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
| | - M Doshida
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Takeuchi
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - H Matsubayashi
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Ishikawa
- Reproduction Clinic Osaka, Reproductive Medicine , Osaka, Japan
- Reproduction Clinic Tokyo, Reproductive Medicine , Tokyo, Japan
| | - T Kimura
- Osaka university Graduate School of Medicine, Obstetrics and Gynecology , Osaka, Japan
| |
Collapse
|
13
|
Okazaki T, Ohara Y, Matsuoka H, Shimoji K, Kogure K, Kikuchi N, Kimura T, Nakajima S, Tani S, Mizuno J, Arai H, Oishi H. Cervical Extradural Arteriovenous Fistula without Intradural Drainage Successfully Treated with Endovascular Treatment Using Both Transvenous and Transarterial Approach: Case Report and Review of Literatures. NMC Case Rep J 2022; 8:335-342. [PMID: 35079485 PMCID: PMC8769398 DOI: 10.2176/nmccrj.cr.2020-0260] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/21/2020] [Indexed: 11/20/2022] Open
Abstract
The classification of spinal extradural arteriovenous fistulas (AVFs) was reported based on a case series treated by microsurgery in 2009 and endovascular interventions in 2011. The present report describes a patient with extradural AVFs at the cervical spine manifesting gradual progressive radiculomyelopathy of bilateral upper extremities. Magnetic resonance imaging (MRI) revealed a mass sign from C1 to C4 at the right ventral side and the spinal cord was deviated to the left and indicated as a flow void sign. Diagnostic angiography revealed an extradural AVFs located at the C1-C4 level that was supplied by bilateral radicular artery from the vertebral artery (VA) and right ascending cervical artery (ACA). The shunting points were recognized multiply at C2/3 and C3/4 levels on the right. The transvenous embolization to the enlarged extradural venous plexus around the shunting points via right hypoglossal canal and the transarterial embolization against multi-feeders of the branch of left radicular artery, right ACA achieved complete occlusion of the lesions. His symptom was gradually recovered, and angiography performed 2 weeks after embolization showed no recurrence. When the arteriovenous shunts in the upper cervical spine were high flow shunts, transvenous approach via the hypoglossal canal might be one option for the treatment of spinal extradural AVFs.
Collapse
Affiliation(s)
- Toshiyuki Okazaki
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Yukoh Ohara
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan.,Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hidenori Matsuoka
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Kazuaki Shimoji
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kazunari Kogure
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Nahoko Kikuchi
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Takaoki Kimura
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Shintaro Nakajima
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Tani
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Junichi Mizuno
- Center for Minimally Invasive Spinal Surgery, Shin-yurigaoka General Hospital, Kawasaki, Kanagawa, Japan
| | - Hajime Arai
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hidenori Oishi
- Department of Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Tamagawa S, Okuda T, Nojiri H, Sato T, Momomura R, Ohara Y, Hara T, Ishijima M. Anatomy of the L5 nerve root in the pelvis for safe sacral screw placement: a cadaveric study. J Neurosurg Spine 2021:1-6. [PMID: 34798616 DOI: 10.3171/2021.8.spine21962] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/09/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Previous reports have focused on the complications of L5 nerve root injury caused by anterolateral misplacement of the S1 pedicle screws. Anatomical knowledge of the L5 nerve root in the pelvis is essential for safe and effective placement of the sacral screw. This cadaveric study aimed to investigate the course of the L5 nerve root in the pelvis and to clarify a safe zone for inserting the sacral screw. METHODS Fifty-four L5 nerve roots located bilaterally in 27 formalin-fixed cadavers were studied. The ventral rami of the L5 nerve roots were dissected along their courses from the intervertebral foramina to the lesser pelvis. The running angles of the L5 nerve roots from the centerline were measured in the coronal plane. In addition, the distances from the ala of the sacrum to the L5 nerve roots were measured in the sagittal plane. RESULTS The authors found that the running angles of the L5 nerve roots changed at the most anterior surface of the ala of the sacrum. The angles of the bilateral L5 nerve roots from the right and left L5 intervertebral foramina to their inflection points were 13.77° ± 5.01° and 14.65° ± 4.71°, respectively. The angles of the bilateral L5 nerve roots from the right and left inflection points to the lesser pelvis were 19.66° ± 6.40° and 20.58° ± 5.78°, respectively. There were no significant differences between the angles measured in the right and left nerve roots. The majority of the L5 nerves coursed outward after changing their angles at the inflection point. The distances from the ala of the sacrum to the L5 nerve roots in the sagittal plane were less than 1 mm in all cases, which indicated that the L5 nerve roots were positioned close to the ala of the sacrum and had poor mobility. CONCLUSIONS All of the L5 nerve roots coursed outward after exiting the intervertebral foramina and never inward. To prevent iatrogenic L5 nerve root injury, surgeons should insert the S1 pedicle screw medially with an angle > 0° toward the inside of the S1 anterior foramina and the sacral alar screw laterally with an angle > 30°.
Collapse
Affiliation(s)
- Shota Tamagawa
- 1Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo
| | - Takatoshi Okuda
- 1Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo
| | - Hidetoshi Nojiri
- 1Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo
| | - Tatsuya Sato
- 1Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo
| | - Rei Momomura
- 2Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, Chiba; and
| | - Yukoh Ohara
- 3Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Takeshi Hara
- 3Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- 1Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo
| |
Collapse
|
15
|
Ohara Y, Hara T, Abe E. [How to Treat Osteoporotic Vertebral Fracture?]. No Shinkei Geka 2021; 49:1286-1297. [PMID: 34879347 DOI: 10.11477/mf.1436204514] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In very elderly patients with low back pain, we must consider the possibility of osteoporotic vertebral fracture (OVF). In most patients with OVF, improvement can be observed without surgical intervention. However, even after providing the best possible conservative treatment, symptom recovery is not observed in some patients, and such patients experience delayed neurological deficits due to neural compression with the proceeding deformity of the vertebral body. Moreover, it is well known that once patients have OVF, the risk of another osteoporotic fracture in them increases. The clinical course of such patients eventually results in the loss of healthy life and increased mortality. Therefore, we should initiate medical treatment for osteoporosis at the earliest possible when OVF is detected in a patient. Patients who remain symptomatic even after undergoing adequate conservative therapy are candidates for balloon kyphoplasty. However, this minimally invasive surgery has some pitfalls. Furthermore, occasionally, we have to select instrumentation surgery for patients with delayed neurological deficits. In this "super-aged society," neurosurgeons also encounter patients with OVF not only in surgical situations but also in outpatient clinics. Thus, we should be aware about the clinical options for the management of osteoporosis.
Collapse
Affiliation(s)
- Yukoh Ohara
- Department of Neurosurgery, Juntendo University
| | | | | |
Collapse
|
16
|
Ohara Y, Hara T, Abe E. [Posterior Lumbar Decompression:Variations and Pitfalls]. No Shinkei Geka 2021; 49:1246-1256. [PMID: 34879344 DOI: 10.11477/mf.1436204511] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Lumbar canal stenosis is the most common pathological condition causing spinal degeneration. Symptomatic patients who fail conservative treatment are considered candidates for surgical treatment. Many types of minimally invasive procedures for lumbar decompression have been proposed, most of which are effective and have shown good long-term results. However, in special cases, a second operation may be needed for spondylolisthesis caused by degeneration of the same segment. Two major minimally invasive approaches are available for bilateral decompression of lumbar canal stenosis: unilateral approach and midline approach. The unilateral approach is used to preserve midline structures, the contralateral facet joint, and the contralateral paravertebral muscle. The midline approach is used to preserve the left and right facet joints and the enthesis of the paravertebral muscle. These two approaches are suitable for specific situations based on their own concepts. Nevertheless, it is important to understand the advantages and disadvantages of each procedure. In this article, the varieties of lumbar decompressive methods and the pitfalls of decompression procedures will be discussed.
Collapse
Affiliation(s)
- Yukoh Ohara
- Department of Neurosurgery, Juntendo University
| | | | | |
Collapse
|
17
|
Hara T, Ohara Y, Abe E, Takami K, Orías AAE, Arai H, Inoue N. Cervical endplate bone density distribution measured by CT osteoabsorptiometry and direct comparison with mechanical properties of the endplate. Eur Spine J 2021; 30:2557-2564. [PMID: 34268667 DOI: 10.1007/s00586-021-06920-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 06/26/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Intervertebral device subsidence is one of the complications of anterior cervical discectomy and fusion. The biomechanical properties of vertebral bony endplate may be related to device subsidence. The aim of this study is to measure the cervical endplate bone density distribution using a novel 3D measurement method. METHODS Eight human cadaver cervical spines were obtained and levels C3-C7 were dissected and CT scanned. Three-dimensional (3D) CT model was created with the same 3D coordinates of the original DICOM dataset. The regional strength and stiffness of the endplate were determined by indentation testing. The indentation points were recorded by a photograph and the location of the indentation points was projected to the 3D CT model. Three-dimensional coordinates of the indentation point was obtained in the 3D space determined by the DICOM dataset. The area underneath the indentation point was calculated by a trilinear interpolation method directly. Data in HU and correlations with the indentation strength and stiffness were analysed. RESULTS A positive correlation was found between HU and strength (r = 0.52) and between HU and stiffness (r = 0.41). Overall, mechanical strength and stiffness and HU in the superior endplate of the caudal vertebra were lower than those in the inferior endplate of the cranial vertebra in the same intervertebral disc. CONCLUSIONS The mechanical properties and the HU were found to be significantly correlated, which employed a novel 3D HU measurement method, thus demonstrating potential to predict cervical endplate failure risk in a clinical setting.
Collapse
Affiliation(s)
- Takeshi Hara
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Eiji Abe
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kaosu Takami
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, USA
| | | | - Hajime Arai
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Nozomu Inoue
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, USA
| |
Collapse
|
18
|
Makizako H, Nishita Y, Jeong S, Otsuka R, Shimada H, Iijima K, Obuchi S, Kim H, Kitamura A, Ohara Y, Awata S, Yoshimura N, Yamada M, Toba K, Suzuki T. TRENDS IN THE PREVALENCE OF FRAILTY IN JAPAN: A META-ANALYSIS FROM THE ILSA-J. J Frailty Aging 2021; 10:211-218. [PMID: 34105703 DOI: 10.14283/jfa.2020.68] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine whether age-specific prevalence of frailty in Japan changed between 2012 and 2017. DESIGN This study performed meta-analyses of data collected from 2012 to 2017 using the Integrated Longitudinal Studies on Aging in Japan (ILSA-J), a collection of representative Japanese cohort studies. SETTING The ILSA-J studies were conducted on community-living older adults. PARTICIPANTS ILSA-J studies were considered eligible for analysis if they assessed physical frailty status and presence of frailty in the sample. Seven studies were analyzed for 2012 (±1 year; n = 10312) and eight studies were analyzed for 2017 (±1 year; n = 7010). Five studies were analyzed for both 2012 and 2017. MEASUREMENTS The study assessed the prevalence of frailty and frailty status according to 5 criteria: slowness, weakness, low activity, exhaustion, and weight loss. RESULTS The overall prevalence of physical frailty was 7.0% in 2012 and 5.3% in 2017. The prevalence of frailty, especially in people 70 years and older, tended to decrease in 2017 compared to 2012. Slight decreases were found in the prevalence of frailty subitems including weight loss, slowness, exhaustion, and low activity between 2012 and 2017, but change in the prevalence of weakness was weaker than other components. CONCLUSIONS The prevalence of physical frailty decreased from 2012 to 2017. There are age- and gender-related variations in the decrease of each component of frailty.
Collapse
Affiliation(s)
- H Makizako
- Hyuma Makizako, Department of Physical Therapy, Faculty of Medicine, School of Health Sciences, Kagoshima University, Kagoshima, Japan,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Ohara Y, Yoshimura Y, Fukuoka Y, Tanioka K, Yamamoto K. Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with coronary artery disease and preserved left ventricular ejection faction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.115] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Elevated left ventricular (LV) filling pressures are the main physiologic consequence of LV diastolic dysfunction. Left atrial (LA) strain was recently found useful to predict elevated LV filling pressures noninvasively. However, there are few reports on the role of LA strain when predicting LV filling pressure in patients with coronary artery disease (CAD). The aim of this study was to explore the correlation between LA strain and LV end-diastolic pressure (LVEDP) in patients with CAD and preserved LV ejection fraction.
Methods
Fifty-four patients with stable CAD were enrolled. Global atrial longitudinal strain was measured by averaging all atrial segments. Resorvoir (S-LAs), conduit (S-LAe), and contractile (S-LAa) phase strain were obtained. LVEDP was invasively obtained by left heart catheterization.
Results
Patients were divided into two groups: elevated LVEDP group (LVEDP > 15mmHg group: n = 23) and normal LVEDP group (LVEDP ≤ 15mmHg group: n = 31). Elevated LVEDP group showed significantly decreased S-LAs and S-LAa (S-LAs: 21.3 ± 7.2% vs. 27.5 ± 7.8%, p < 0.005; S-LAa: 9.7 ± 3.3% vs. 14.6 ± 3.4%, p < 0.0001). However, E/Ea and S-LAe were not significantly different between the two groups. LVEDP significantly correlated with S-LAa (r=-0.596, p < 0.0001) and S-LAs (r=-0.431, p < 0.001). Receiver operating characteristics curve analysis showed that S-LAa could predict elevated LVEDP (AUC = 0.84) and a cut-off value of S-LAa < 11.6% was able to most accurately identify patients with elevated LVEDP.
Conclusions
LA strain, especially S-LAa, provided additional diagnostic value for the noninvasive assessment of LV filling pressure in CAD patients with preserved LV ejection fraction.
Collapse
Affiliation(s)
- Y Ohara
- Kochi Health Sciences Center, Kochi, Japan
| | | | - Y Fukuoka
- Kochi Health Sciences Center, Kochi, Japan
| | - K Tanioka
- Kochi Health Sciences Center, Kochi, Japan
| | - K Yamamoto
- Kochi Health Sciences Center, Kochi, Japan
| |
Collapse
|
20
|
Iwamuro H, Ohara Y, Umemura A, Hattori N, Arai H. [Management of Spinal Disorders in Parkinson's Disease]. No Shinkei Geka 2021; 49:171-184. [PMID: 33494064 DOI: 10.11477/mf.1436204373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Parkinson's disease(PD)is a degenerative disorder of the central nervous system. Its cardinal features are resting tremor, rigidity, bradykinesia, and postural instability. Several years after disease onset, many patients with PD exhibit postural deformities, including camptocormia, Pisa syndrome, and dropped head syndrome, which can lead to spinal deformities. In addition, spinal degenerative disorders are frequently associated with PD and can further impact the patients' quality of life. Current evidence suggests a multifactorial etiology for postural deformities and spinal degenerative disorders in PD, which includes abnormal stress on the spine(biomechanical factors), postural instability and impairment of postural compensation(physiological factors), and imbalance of dopaminergic signals(pharmacological factors). The relative contribution of these factors varies between patients and across symptoms. Consequently, neurologists have difficulty treating these axial problems. Moreover, many studies have reported poor outcomes and high complication rates of spinal surgery in patients with PD, which embarrasses spinal surgeons. An improved understanding of the mechanisms underlying spinal problems in PD might ultimately lead to more effective management of these disabling complications.
Collapse
Affiliation(s)
- Hirokazu Iwamuro
- Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine
| | | | | | | | | |
Collapse
|
21
|
Kitahama Y, Shizuka H, Kimura R, Suzuki T, Ohara Y, Miyake H, Sakai K. Fluid Lubrication and Cooling Effects in Diamond Grinding of Human Iliac Bone. ACTA ACUST UNITED AC 2021; 57:medicina57010071. [PMID: 33466923 PMCID: PMC7830225 DOI: 10.3390/medicina57010071] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Although there have been research on bone cutting, there have been few research on bone grinding. This study reports the measurement results of the experimental system that simulated partial laminectomy in microscopic spine surgery. The purpose of this study was to examine the fluid lubrication and cooling in bone grinding, histological characteristics of workpieces, and differences in grinding between manual and milling machines. Materials and Methods: Thiel-fixed human iliac bones were used as workpieces. A neurosurgical microdrill was used as a drill system. The workpieces were fixed to a 4-component piezo-electric dynamometer and fixtures, which was used to measure the triaxial power during bone grinding. Grinding tasks were performed by manual activity and a small milling machine with or without water. Results: In bone grinding with 4-mm diameter diamond burs and water, reduction in the number of sudden increases in grinding resistance and cooling effect of over 100 °C were confirmed. Conclusion: Manual grinding may enable the control of the grinding speed and cutting depth while giving top priority to uniform torque on the work piece applied by tools. Observing the drill tip using a triaxial dynamometer in the quantification of surgery may provide useful data for the development of safety mechanisms to prevent a sudden deviation of the drill tip.
Collapse
Affiliation(s)
- Yoshihiro Kitahama
- Spine Center, Omaezaki Municipal Hospital, Shizuoka 437-1696, Japan;
- Medical Photonics Research Center, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
- Correspondence:
| | - Hiroo Shizuka
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
| | - Ritsu Kimura
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
| | - Tomo Suzuki
- Spine Center, Omaezaki Municipal Hospital, Shizuoka 437-1696, Japan;
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan;
| | - Hideaki Miyake
- Medical Photonics Research Center, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Katsuhiko Sakai
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
| |
Collapse
|
22
|
Hoshino D, Hirano H, Edahiro A, Motokawa K, Shirobe M, Watanabe Y, Motohashi Y, Ohara Y, Iwasaki M, Maruoka Y, Yokoyama Y, Narita M, Taniguchi Y, Shinkai S, Kitamura A. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. J Nutr Health Aging 2021; 25:361-368. [PMID: 33575729 DOI: 10.1007/s12603-020-1538-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS A total of 769 community-dwelling older persons aged 65 and over. INTERVENTIONS We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants. MEASUREMENTS OF was defined by 1-2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0-2), medium score (3-5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS. RESULTS The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219-2.335, OF; adjusted OR = 2.857, 95% CI = 1.489-5.484). CONCLUSION The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.
Collapse
Affiliation(s)
- D Hoshino
- Daichi Hoshino, Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan, Phone: +81 337 87 1151, Fax: +81 337 85 6403,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Nojiri H, Okuda T, Miyagawa K, Kobayashi N, Sato T, Hara T, Ohara Y, Kaneko K. Anterior Spinal Fusion Using Autologous Bone Grafting via the Lateral Approach with Posterior Short-Range Instrumentation for Lumbar Pyogenic Spondylitis with Vertebral Bone Destruction Enables Early Ambulation and Prevents Spinal Deformity. Spine Surg Relat Res 2020; 4:320-327. [PMID: 33195856 PMCID: PMC7661023 DOI: 10.22603/ssrr.2020-0049] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023] Open
Abstract
Introduction Pyogenic spondylitis of the lumbar spine markedly decreases the ability to perform activities of daily living and causes severe low back pain. The challenge is to improve low back pain and activities of daily living performance earlier and prevent post-infection sequelae, and conservative treatment with antibiotics is the mainstay of treatment. Methods In the present study, patients who were unable to walk following lumbar pyogenic spondylitis even in the subacute phase after successful infection control, showing bone defects expanding from endplate to vertebral body in CT, were treated with posterior percutaneous short-range instrumentation and anterior autogenous bone grafting (group S, n = 10) or with conservative treatment alone (group C, n = 10). Acute cases of absolute surgical indication with paralytic symptoms and mild cases who could walk by antibiotics administration were excluded. The two groups were compared regarding the post-treatment change in C-reactive protein level, duration of bed rest, and post-infection local spinal deformities (local scoliosis angle in the coronal plane and local kyphosis angle in the sagittal plane). Results Compared with group C, group S took a significantly shorter time for the C-reactive protein level to return to normal and required a significantly shorter duration of bed rest. Furthermore, surgery prevented the formation of kyphosis and scoliosis, while group C developed local kyphosis. Conclusions The minimally invasive surgical method of posterior percutaneous short-range instrumentation and anterior autogenous bone grafting effectively enables early control of pain and maintenance of locomotive function and prevents spinal deformity in patients with lumbar pyogenic spondylitis in the subacute phase with advanced vertebral bone destruction.
Collapse
Affiliation(s)
- Hidetoshi Nojiri
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Takatoshi Okuda
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Kei Miyagawa
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Nozomu Kobayashi
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Tatsuya Sato
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Takeshi Hara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| |
Collapse
|
24
|
Nojiri H, Okuda T, Miyagawa K, Kobayashi N, Sato T, Hara T, Ohara Y, Kudo H, Sakai T, Kaneko K. Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach. Spine Surg Relat Res 2020; 5:86-90. [PMID: 33842715 PMCID: PMC8026205 DOI: 10.22603/ssrr.2020-0074] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/09/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Transpsoas lumbar spine surgery is minimally invasive and has very good corrective effects. However, approach-side nerve complications delay post-operative rehabilitation. We anatomically investigated the localization of the lumbar plexus running in the psoas muscle. Methods We examined 27 formalin-fixed cadavers. The left-sided psoas muscle was extracted and cut parallel to the intervertebral disc at the L2/3, L3/4, and L4/5 disc levels. Using digitized photographs, we calculated the ratio of the distance from the front edge of the psoas muscle to the center of the lumbar plexus in the anteroposterior diameter of the psoas muscle (%). Then, we calculated the ratio of the distance from the lateral edge of the psoas muscle to the center of the lumbar plexus in the lateral diameter of the psoas muscle (%). Results The anterior-posterior lumbar plexus localization was 74.5 at L2/3, 74.7 at L3/4, and 81.2 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.02, 0.01, and 0.94, respectively). The lateral and medial lumbar plexus localization was 85.4 at L2/3, 83.9 at L3/4, and 77.7 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.01, 0.04, and 0.41, respectively). Conclusions The lumbar plexus was localized in the posterior one-third and medial one-third of the psoas muscle and moved to a posterolateral location at L4/5. To avoid neuropathy, consider the psoas muscle's position relative to that of the intervertebral disc. It is essential to understand lumbar plexus localization in the psoas muscle when looking directly at this muscle to enter the pricking point or route with a lower risk of nerve damage.
Collapse
Affiliation(s)
- Hidetoshi Nojiri
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Takatoshi Okuda
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Kei Miyagawa
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Nozomu Kobayashi
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Tatsuya Sato
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Takeshi Hara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Kudo
- Department of Anatomy and Life Structure, Juntendo University, Tokyo, Japan
| | - Tatsuo Sakai
- Department of Anatomy and Life Structure, Juntendo University, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo Hospital, Juntendo University School of Medicine, Tokyo, Japan
| |
Collapse
|
25
|
Ohara Y, Nakajima Y, Kimura T, Kikuchi N, Sagiuchi T. Full-Endoscopic Transcervical Ventral Decompression for Pathologies of Craniovertebral Junction: Case Series. Neurospine 2020; 17:S138-S144. [PMID: 32746527 PMCID: PMC7410384 DOI: 10.14245/ns.2040172.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/29/2020] [Indexed: 11/19/2022] Open
Abstract
Odontoidectomy is very effective for the decompression of the ventral craniovertebral junction (CVJ). Various approaches are available for the direct ventral decompression of the CVJ. Because there are many disadvantages of open transoral approach, endoscopic odontoidectomy was developed. There are 3 approaches in endoscopic odontoidectomy. We report transcervical retropharyngeal endoscopic approach for the ventral CVJ in this paper. Three patients with different pathologies received operations using this approach. The decompression was enough and surgical invasion was less in all patients. Each endoscopic approach has some advantages and different working regions due to their approach trajectories, but transcervical retropharyngeal approach is very familiar for our neurospinal surgeons and has a relatively large working area. This approach might have the chance to take the place of open transoral approach for endoscopic spinal surgeons.
Collapse
Affiliation(s)
- Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Spine and Spinal Cord Center, Juntendo University Hospital, Nagoya, Japan.,Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | | | - Takaoki Kimura
- Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | - Nahoko Kikuchi
- Center for Minimally Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | - Takao Sagiuchi
- Department of Neurosurgery, IMS Fujimidai General Hospital, Saitama, Japan
| |
Collapse
|
26
|
Uchikado H, Nishimura Y, Hattori G, Ohara Y. Micro-anatomical structures of the lumbar intervertebral foramen for full-endoscopic spine surgery: review of the literatures. J Spine Surg 2020; 6:405-414. [PMID: 32656378 DOI: 10.21037/jss.2019.10.07] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal surgical technique. PELD can be performed via 2 routes, transforaminal (TF) or interlaminar. The TF approach is a well-established modality in the treatment of patients with herniated lumbar discs. This technique makes the most of the space within the intervertebral foramen where, as Kambin claimed, the safe approach to the lesion is possible. Knowledge of the lumbar artery with its branches and various ligaments of anatomies of the intervertebral foramen are needed to perform successful surgeries and to reduce complications.
Collapse
Affiliation(s)
| | | | - Gohsuke Hattori
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
27
|
Fukui S, Ikeda Y, Kidoguchi G, Nakai T, Ozawa H, Kawaai S, Koido A, Ohara Y, Shimizu H, Tamaki H, Yamaguchi K, Okada M. FRI0535 NEWLY DETECTED HYPERTHYROIDISM WITH THERAPEUTIC INDICATIONS IN RHEUMATIC DISEASE PATIENTS AND HEALTHY CONTROLS IN JAPAN: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.409] [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
Background:Thyroid disorders are known as common comorbidities of rheumatic diseases(RD) [1]. However, data regarding prevalence of hyperthyroidism with treatment indication in RD patients are limited.Objectives:This study aims to reveal and compare the frequency of newly developed hyperthyroidism with treatment indication between RD patients and healthy controls (HC), and identify risk factors to identify patients whose thyroid function should be followed up carefully.Methods:We retrospectively reviewed charts of RD patients and HC who had thyroid stimulating hormone (TSH) measured at least once between 2004 and 2018 from immuno-rheumatology center and preventive medicine center in St. Luke’s International Hospital, Japan. We compared frequency of hyperthyroidism requiring treatment (TSH ≦ 0.1μU/mL or for which physicians started treatment) with Kaplan-Meier curve and log rank test. Cox regression multivariate analysis was performed to reveal risk factors for the new onset of hyperthyroidism with treatment indication in participants without treatment-indicated hyperthyroidism at initial assessments.Results:Overall, 2307 RD patients and 78251 HC were included. Newly detected hyperthyroidism with treatment indication were significantly more frequent in RD patients at initial assessment (1.3% vs 0.5 %, p < 0.001) and in total (2.9% vs 1.7%, p<0.001) (Table 1, Figure 1). Cox regression multivariate analysis revealed systemic lupus erythematosis (SLE), polymyositis dermatomyositis (PMDM), mixed connective tissue disease (MCTD) as significant risk factors of new developments of hyperthyroidism during follow up after adjusting confounders. (Table 2)Table 1.Patients characteristics and results of hyperthyroidismRheumatic Disease (n = 2307)Control (n = 78251)p.valueAge(yr)53.7 (16.2)46.1 (11.9)<0.001Female (%)1826 (79.2)38632 (49.4)<0.001 Rheumatoid arthritis (%)1091 (47.3)-NA Spondyloarthritis161 (7.0)-NA ANA associated disease (%)944 (40.9)-NA SLE(%)363 (15.7)-NA SS (%)396 (17.2)-NA PMDM(%)104 (4.5)-NA SSc (%)222 (9.6)-NA MCTD (%)43 (1.9)-NA Vasculitis (%)202 (8.8)-NA Others (%)244 (10.6)-NATimes of TSH measurement2.0 [1.0, 5.0]5.0 [3.0, 9.0]<0.001Follow up of TSH (days)258.00 [0, 1315]1992 [958, 3632]<0.001Baseline TSH (μU/mL)2.28 (3.21)2.15 (4.07)0.137 ≦0.45 μU/mL (%)86 (3.7)1371 (1.8)<0.001 ≦0.1 μU/mL (%)29 (1.3)389 (0.5)<0.001Baseline FreeT4 (μU/mL)1.16 (0.24)1.30 (0.20)<0.001≧1.65 μU/mL (%)17 (0.8)2355 (3.0)<0.001TSH level in follow up ≦0.45 μU/mL (%)231 (0.0)3926 (5.0)<0.001 ≦0.1 μU/mL (%)84 (3.6)1388 (1.8)<0.001Newly detected hyperthyroidism with treatment indication (%)68 (2.9)1350 (1.7)<0.001 At initial assessment (%)29 (1.3)389 (0.5)<0.001 In follow up (%)39 (1.6)961 (1.2)<0.001Treatment for hyperthyroidism (%)21 (0.9)325 (0.4)0.002Figure 1.Hyperthyroidism with treatment indication in rheumatic patients and controlTable 2.Risk factors for newly detected hyperthyroidism with treatment indicationAdjusted HRp valueAge0.99 (0.98-0.99)< 0.001Female2.68 (2.31-3.12)< 0.001BMI1.04 (1.02-1.06)< 0.001Baseline TSH ≦ 0.455.71 (4.47-7.30)< 0.001Baseline Free T4 ≧ 1.651.16 (0.79-1.69)0.45Rheumatoid arthritis1.05 (0.50-2.21)0.90ANA associated diseases-- SLE2.29 (1.11-4.71)0.025 SS1.91 (0.91-4.01)0.089 PMDM12.90 (5.50-30.22)< 0.001 SSc0.67 (0.18-2.43)0.541 MCTD8.02 (2.62-24.51)< 0.001Vasculitis1.44 (0.35-5.92)0.610Spondyloarthritis3.04 (0.74-12.52)0.120Others1.98 (0.67-5.81)0.214Conclusion:Hyperthyroidism with therapeutic indications are considerably more frequent in RD patients (particularly with SLE, PMDM and MCTD) both at initial assessment and during follow up. We recommend routine screening at initial assessment and careful follow up of thyroid function test in those patients.References:[1] Rev Bras Rheumatol 2012;52(3):417-430Disclosure of Interests:None declared
Collapse
|
28
|
Tamaki H, Fukui S, Nakai T, Kidoguchi G, Kawaai S, Ozawa H, Ikeda Y, Koido A, Ohara Y, Shimizu H, Yamaguchi K, Okada M. AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared
Collapse
|
29
|
Kawaai S, Fukui S, Nakai T, Kidoguchi G, Ozawa H, Ikeda Y, Koido A, Ohara Y, Shimizu H, Tamaki H, Yamaguchi K, Okada M. SAT0525 EFFICACY AND SAFETY OF MZR FOR IgG4-RELATED DISEASE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1983] [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: 11/03/2022]
Abstract
Background:IgG4-Related Disease (IgG4RD) is known to cause multiple organ lesions with infiltration of IgG4-positive plasma cells, and patients often have relapses with tapering treatments despite an initial good response to glucocorticoids therapy. Mizoribine (MZR) is an immunosuppressant working as an inhibitor of purine synthesis, which mechanism of action is similar to mycophenolate mofetil. Data regarding the efficacy and safety of MZR on IgG4RD is limited although some previous case reports1showed effectiveness for IgG4RD.Objectives:This study aims to assess the efficacy and safety of MZR in patients with IgG4RD.Methods:We retrospectively reviewed charts of IgG4RD patients who used MZR between January 2004 and December 2019 at Immuno-Rheumatology Center in St. Luke’s International Hospital, Tokyo, Japan. We investigated basic demographics, involved organs, results of blood tests including IgG and IgG4 titer, and medications used including glucocorticoid and other immunosuppressants (IS). We followed IgG4 titer, dose of glucocorticoid, flare of disease and retention of MZR at the beginning, 6 and 12months after starting MZR. We compared changes in PSL (prednisolone) doses and IgG4 titers over time using Friedman test with Bonferroni correction. We also checked adverse events during follow up.Results:Twenty-two patients with IgG4RD who used MZR were included. Median age was 62 years old, and 15 (68.2%) patients are male. Lacrimal and salivary glands, pancreatitis and retroperitoneal fibrosis were common lesions. All patients were initially treated with glucocorticoids. Flare was observed in 5 (22.7 %) patients before initiation of MZR. The number of patients who continued MZR without flare are 19 (86.4 %) at 6 months, and 14 (73.7 %) at 12 months. IgG4 titer significantly declined at 6 and 12 months from baseline although significant consecutive decrease in PSL dose (Figure 1, 2). Liver dysfunctions are commonest adverse events (n=16, 72.7%) but mild (grade1; n=15, 68.2%) and most cases are apparently due to other reasons. Serious infection (SI) occurred in 3 (13.6%) patients in total follow up, however no SI were observed during 1 year after MZR treatment.Conclusion:MZR can be safely used in patients of IgG4RD with high retention rate, and seemed to have steroid-sparing effect. Prospective comparative studies are needed.References:[1]Nanke Y, Kobashigawa T, Yago T, Kamatani N, Kotake S. A case of Mikulicz’s disease, IgG4-related plasmacytic syndrome, successfully treated by corticosteroid and mizoribine, and then by mizoribine alone. Intern Med 49: 1449-1453, 2010.Table 1.Patient characteristics Table 2.Disease and treatment status before and after initiation of MZR Figure 1.Serum IgG4 level changesFigure 2.Changes in the PSL dose over timeDisclosure of Interests:None declared
Collapse
|
30
|
Kidoguchi G, Fukui S, Nakai T, Kawaai S, Ozawa H, Ikeda Y, Koido A, Ohara Y, Shimizu H, Yamaguchi K, Tamaki H, Okada M. AB0198 SMOKING AND POSITIVITY OF RHEUMATOID FACTOR AND ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY IN THE GENERAL POPULATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4134] [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
Background:It is well known that rheumatoid arthritis (RA) occurs due to environmental risk factors in addition to genetic risk factors. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are strongly associated with RA, and these biomarkers could turn to be positive before development of clinical symptoms. While smoking, particularly Brinkman index (BI) is well known as a risk factor for RA and ACPA positivity, it is still unclear whether smoking intensity or smoking duration contribute more to positive RF and ACPA.Objectives:This study aims to evaluate risk factors for RF and ACPA positivity in the general population. It also describes whether smoking intensity, duration, and BI are significant.Methods:This is a cross-sectional, observational, single center study. We reviewed the baseline characteristics of the general population who checked RF and ACPA at Preventive Medicine Center in St. Luke’s International Hospital, Tokyo, Japan from January 2004 to December 2018.The data for basic demographics, dietary habit, smoking intensity, smoking duration, BI, and blood tests including RF and ACPA were extracted. The data was analyzed statistically.Results:A total of 127472 people who checked RF are included. Of these 127472 people, 64504 (50.6%) are male and the mean age was 44.9 years. RF was positive in 11477 people (9.0%). Among these, 1667 (1.2%) were checked for ACPA, and 21 people (1.3%) had positive ACPA. None of variables demonstrated significant association with RF positivity. In contrast, BI and smoking duration was significantly associated with an increased risk of ACPA positivity (13.3 years vs 7.49 years, p value = 0.023), although the number of cigarettes smoked was not. The smoking duration for 10 years or more was associated with an increased risk of ACPA positivity even after adjusted for age and sex (adjusted hazard ratio: 2.47 [95% confidence interval: 1.04-5.87]; p=0.04).Conclusion:In this study, no significant risk factor for positive RF was found. Even smoking was not associated with RF positivity. On the other hand, smoking duration, not smoking intensity was significantly associated with an increased risk of ACPA positivity.References:[1]Verpoort KN. Association of smoking with the constitution of the anti-cyclic citrullinated peptide response in the absence of HLA-DRB1 shared epitope alleles. Arthritis Rheum 2007;56:29138.Table 1.Patient characteristics with RF and ACPA positivityRF positive (n=11477)RF negative (n=115995)p valueACPA positive (n=21)ACPA negative (n=1646)p valueAge44.86 (12.32)44.94 (12.47)0.5437.90 (9.07)45.26 (12.58)0.008Male (%)5659 (49.3)57309 (49.4)0.84511 (52.4)834 (50.7)1Body Mass Index22.33 (3.38)22.35 (3.40)0.52121.64 (3.28)22.34 (3.37)0.346Smoker, total (%)4509 (39.3)45738 (39.4)0.77212 (57.1)642 (39.0)0.115Current smoker (%)1959 (17.1)20483 (17.7)0.1148 (38.1)277 (16.8)0.017Previous smoker (%)2550 (22.2)25255 (21.8)0.2714 (19.0)365 (22.2)1Brinkman index144.8 (299.3)145.2 (313.8)0.897280.9 (409.7)145.3 (300.3)0.041Number of cigarettes (/day)17.7 (18.5)17.4 (13.3)0.16619.8 (12.0)17.4 (12.1)0.511Smoking Duration (years)7.43 (11.68)7.45 (11.66)0.85113.33 (14.11)7.49 (11.68)0.023Alcohol Drinker (%)6972 (60.7)70010 (60.4)0.41810 (47.6)1005 (61.1)0.261Alcohol Intake (g/day)13.67 (21.88)13.58 (21.32)0.67616.70 (26.89)14.06 (22.16)0.59Exercise ≧3 times/week (%)2792 (24.3)28293 (24.4)0.8825 (23.8)402 (24.4)1White blood cell (103/μL)5.32 (1.46)5.35 (1.50)0.135.59 (2.05)5.37 (1.54)0.52Hemoglobin (g/dL)13.82 (1.44)13.82 (1.45)0.75314.12 (1.03)13.83 (1.43)0.36Creatinine (mg/dL)0.73 (0.20)0.73 (0.25)0.1940.76 (0.16)0.73 (0.18)0.586AST (U/L)21.89 (9.39)21.93 (11.65)0.78220.95 (6.02)21.68 (8.29)0.69LDL cholesterol (mg/dL)115.41 (30.90)115.48 (30.77)0.815112.62 (33.26)115.36 (31.03)0.688Triglyceride (mg/dL)97.63 (78.46)97.70 (80.36)0.929100.57 (63.40)97.85 (78.37)0.874Uric Acid (mg/dL)5.32 (1.42)5.33 (1.42)0.6235.76 (1.34)5.34 (1.42)0.172Disclosure of Interests:None declared
Collapse
|
31
|
Matsuoka H, Ohara Y, Kimura T, Kikuchi N, Nakajima Y, Mizuno J. Clinical outcome and radiological findings after cervical open door laminoplasty with titanium basket. J Clin Neurosci 2020; 73:140-143. [PMID: 31987631 DOI: 10.1016/j.jocn.2019.12.065] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
Abstract
OBJECT Cervical laminoplasty, which is well described in the Japanese literature, is the gold standard for decompressing multilevel spinal cord compression. Several spacers have been introduced to provide enough decompression of the spinal canal and reconstruct the stable posterior elements. The purpose of this study was to retrospectively evaluate radiological outcomes after open door laminoplasty using the titanium spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo). METHODS Between July 2014 and June 2016, 31 patients with cervical spondylotic disease, including OPLL, were underwent open door laminoplasty with this device. All patients were clinically assessed by JOA score. The average follow-up period was 48.9 months with a range of 37-60 months. Postoperative radiological evaluation revealed bone union on both the open side and the gutter side from 12 months to 36 months after surgery on computed tomography. RESULTS The clinical outcome improved from 10.9 points on the Japanese Orthopaedic Association scale to 15.8 points at 3 months after surgery and there were no significant major complications such as the implant failure. The bone union rate of the gutter side was 85.9% (85/99) at 1 year, 96.0% (95/99) at 3 years after surgery and of the open side was 57.6% (57/99) at 1 year, 89.9% (89/99) at 3 years after surgery. Circumferential fusion was confirmed 85.9% (85/99) of the time. CONCLUSION This titanium spacer seemed to have the potential of promoting bone union between the spacer and both lamina, and lateral mass in cervical laminoplasty which is a safe procedure with satisfactory clinical results.
Collapse
Affiliation(s)
- Hidenori Matsuoka
- Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan.
| | - Yukoh Ohara
- Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan; Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | - Takaoki Kimura
- Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Nahoko Kikuchi
- Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | | | - Junichi Mizuno
- Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| |
Collapse
|
32
|
Yamamoto K, Motokawa K, Yoshizaki T, Yano T, Hirano H, Ohara Y, Shirobe M, Inagaki H, Awata S, Shinkai S, Watanabe Y. Association of Dietary Variety and Appetite with Sleep Quality in Urban-Dwelling Older Japanese Adults. J Nutr Health Aging 2020; 24:152-159. [PMID: 32003404 DOI: 10.1007/s12603-019-1297-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Although it has been shown that specific foods and nutrients are associated with sleep quality, few studies have examined the association of dietary variety and appetite with sleep quality in older adults. DESIGN AND SETTING A cross-sectional study was conducted that examined the association of dietary variety and appetite with sleep quality in Japanese adults aged ≥70 years who resided in the metropolitan area of Tokyo, Japan. PARTICIPANTS Data were collected in two steps: a mailed interview survey and an on-site survey. Those who responded to the surveys and met the inclusion criteria were included. MEASUREMENTS Dietary variety, appetite, and sleep quality were assessed using a Dietary Variety Score (DVS), Council on Nutrition Appetite Questionnaire (CNAQ) score, and sleep efficiency, respectively. The sleep efficiency is the ratio of sleep duration to total time in bed (retiring time-awakening time). We defined the individuals with a sleep efficiency less than 75% as having poor sleep quality. RESULTS Mean DVS and CNAQ score were 3.8 and 29.6 points, respectively. The rate of individuals with poor sleep quality was 11.7%. In the fully adjusted model, the odds ratios (OR) for low sleep efficiency in the middle and highest group categories of the DVS were 0.83 (95% confidence interval [CI], 0.54-1.29) and 0.50 (95% CI, 0.28-0.90), respectively, in reference to the lowest group category (p for trend = 0.023). The OR for low sleep efficiency in the middle and highest group categories of the CNAQ score were 0.73 (95% CI, 0.47-1.14) and 0.54 (95% CI, 0.30-0.96), respectively, in reference to the lowest group category (p for trend = 0.031). CONCLUSIONS The higher DVS and CNAQ scores were significantly associated with higher sleep efficiency. Thus, dietary variety and good appetite might help maintain good sleep quality in urban-dwelling older Japanese adults.
Collapse
Affiliation(s)
- K Yamamoto
- Keiko Motokawa, Tokyo Metropolitan Institute of Gerontology, 35-2, Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Tel: +81-3-3964-1141 (ext. 4213); Fax: +81-3-3964-2316; E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Kageyama H, Kakumoto K, Yasuoka H, Arimoto H, Ohara Y. Cardiopulmonary arrest induced by atlantoaxial dislocation with subarachnoid hemorrhage: a case report and review of the literature. Spinal Cord Ser Cases 2019; 5:100. [PMID: 31871765 PMCID: PMC6908628 DOI: 10.1038/s41394-019-0247-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 11/08/2022] Open
Abstract
Introduction Spinal cord injury (SCI) with atlantoaxial dislocation (AAD) is often fatal. We present the case of a resuscitated patient with AAD and traumatic subarachnoid hemorrhage (SAH) at the craniovertebral junction (CVJ). Case presentation We present the case of an 84-year-old man who suffered an observed cardiopulmonary arrest. Cardiopulmonary resuscitation was initiated and spontaneous circulation returned. In the emergency room, the patient's Glasgow Coma Scale was 3 (E1V1M1). No spontaneous respiration was noted. Neuroimaging revealed SAH at the CVJ. Contrast-enhanced computed tomography (CT) revealed a vessel running through the left C2/3 intervertebral foramen into the spinal canal. The ventral space of spinal cord revealed contrast enhancement. Angiography revealed extravasation from the spinal branch of the left vertebral artery, without venous filling. It did not appear to be a vascular malformation with an arteriovenous shunt, but rather a traumatic laceration of the artery. Plain CT and CT angiography suggested AAD. Magnetic resonance imaging revealed injury to the medulla oblongata and upper cervical spinal cord, with AAD and retrodental subligamentous hemorrhage. We embolized the branch of the left vertebral artery and performed a C1 laminectomy. The patient moved his extremities postoperatively. Discussion This was a case of injury to the medulla oblongata and upper cervical spinal cord due to AAD with SAH. This is the first report of resuscitated case of traumatic AAD with SAH in the CVJ. Traumatic AAD should be included in the differential diagnosis in case of SAH in CVJ, which may be misdiagnosed as intrinsic SAH.
Collapse
Affiliation(s)
- Hiroshi Kageyama
- Department of Neurosurgery, Shin-Kuki General Hospital, Kuki, Saitama, Japan
| | - Kousuke Kakumoto
- Department of Neurosurgery, Shin-Kuki General Hospital, Kuki, Saitama, Japan
| | - Hiroki Yasuoka
- Department of Orthopedic surgery, Tokorozawa Meisei Hospital, Tokorozawa, Saitama, Japan
| | - Hirohiko Arimoto
- Department of Neurosurgery, Shin-Kuki General Hospital, Kuki, Saitama, Japan
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
34
|
Hara T, Iwamuro H, Ohara Y, Matsuoka H, Kikuchi N, Kimura T, Arai H, Mizuno J. Efficacy of Atlantoaxial Transarticular Screw Fixation Using Navigation-Guided Drill: Technical Note. World Neurosurg 2019; 134:378-382. [PMID: 31698122 DOI: 10.1016/j.wneu.2019.10.176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 08/04/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atlantoaxial transarticular screw fixation (TASF) is a procedure that involves inserting screws vertically into the articular processes of C1 and C2. However, this procedure is associated with a risk of injury to surrounding structures including the vertebral artery, carotid artery, pharynx, and spinal cord by misinserting K-wires or screws. This study was performed to evaluate the risk of TASF using 3-dimensional navigation-guided drilling and screw insertion tract creation. METHODS Three patients underwent the surgical procedure using a navigation system guided by intraoperative computed tomography. The insertion tract of the screw was created using the navigation system to avoid penetration of the C1 anterior arch or damage to the vertebral artery. A blunt-tipped guide wire was used, which was safe to advance to the cortex of the anterior arch of C1. RESULTS There were no complications or instrument failures in any of the surgeries. In each case, the total radiation dose delivered was 5.31-7.02 mGy, and total radiation exposure time was 55.6-106.8 seconds. Bone fusion was achieved in all cases. CONCLUSIONS TASF using a navigation system for drilling is useful for accurate placement of K-wire and preventing damage of the vital structures, lowering the risk of the procedure.
Collapse
Affiliation(s)
- Takeshi Hara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.
| | | | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | | | | | | | - Hajime Arai
- Department of Neurosurgery, Juntendo University, Tokyo, Japan
| | | |
Collapse
|
35
|
Ohara Y, Yabuki A, Nakamura R, Ichii O, Mizukawa H, Yokoyama N, Yamato O. Renal Infiltration of Macrophages in Canine and Feline Chronic Kidney Disease. J Comp Pathol 2019; 170:53-59. [PMID: 31375159 DOI: 10.1016/j.jcpa.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022]
Abstract
During the progression of chronic kidney disease (CKD), macrophage infiltration is a crucial event leading to tubulointerstitial fibrosis. In the present study, macrophages infiltrating renal tissue in dogs and cats with CKD were analysed immunohistochemically. Iba-1 was used as a pan-macrophage marker, CD204 was used as a marker of M2 macrophages and tumour necrosis factor (TNF)-α was used as a marker of M1 macrophages. Signals for Iba1 and CD204 were observed in the interstitium of all tested kidney samples. In dogs, the signals were diffusely scattered. In cats, both diffuse and focal signals were observed. Cells that were positive for Iba1 and CD204 were also observed in the tubular lumina in cats. Co-expression of Iba1 and CD204 was also observed in the infiltrating cells by immunofluorescence labelling, and these cells were negative for TNF-α. By quantitative analysis, the indices for Iba1- and CD204-positive cells were significantly correlated with the concentrations of plasma creatinine and/or urea and the extent of interstitial fibrosis in both dogs and cats. These results demonstrated that renal infiltration of M2 macrophages plays an important role in the progression of CKD in dogs and cats. The distribution pattern of the kidney-infiltrating macrophages was unique in cats and may be associated with a cat-specific renal fibrotic process.
Collapse
Affiliation(s)
- Y Ohara
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - A Yabuki
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima.
| | - R Nakamura
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - O Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo
| | - H Mizukawa
- Laboratory of Environmental Analytical Chemistry, Department of Science and Technology for Biological Resources and Environment, Graduate School of Agriculture, Ehime University, Matsuyama
| | - N Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - O Yamato
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| |
Collapse
|
36
|
Nishimoto M, Tanaka T, Hirano H, Kikutani T, Watanabe Y, Ohara Y, Huruya H, Iijima K. HEALTH LITERACY AND ORAL HEALTH BEHAVIORS DECREASE THE RISK OF ORAL FRAILTY IN JAPANESE ELDERLY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2660] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Nishimoto
- Institute of Gerontology, The University of Tokyo, Japan
| | - T Tanaka
- Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Institute of Gerontology, Japan
| | - T Kikutani
- Division of Clinical Oral Rehabilitation, Nippon Dental University Graduate School of Life Dentistry at Tokyo, Japan
| | - Y Watanabe
- Tokyo Metropolitan Institute of Gerontology, Japan
| | - Y Ohara
- Department of Oral Health Care Education, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Huruya
- Division of Clinical Oral Rehabilitation, Nippon Dental University Graduate School of Life Dentistry at Tokyo, Japan
| | - K Iijima
- Institute of Gerontology, The University of Tokyo, Japan
| |
Collapse
|
37
|
Murakami M, Watanabe Y, Edahiro A, Ohara Y, Obuchi S, Kawai H, Kim H, Fujiwara Y, Ihara K, Murakami M, Hirano H. Factors related to dissociation between objective and subjective masticatory function in Japanese community-dwelling elderly adults. J Oral Rehabil 2018; 45:598-604. [PMID: 29761827 DOI: 10.1111/joor.12650] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Abstract
Clinicians' evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. Study participants included 635 elderly community-dwelling Japanese adults who underwent a comprehensive geriatric health examination in 2012. SMF was assessed with a question from the Kihon Checklist on eating difficulties (poor or good). OMF was assessed by a colour-changing gum (poor or good). Also investigated were age, sex, depressive symptoms, instrumental activities of daily living (I-ADLs), number of people who joined the participant at dinner, grip strength, usual walking speed, number of remaining teeth, number of functional teeth and their occlusal force. The group with good OMF and good SMF, defined as group 1, and the group with good OMF but poor SMF, group 2, were compared. Logistic regression analyses confirmed that the number of remaining and functional teeth participants had was statistically unrelated to differences between OMF and SMF. Instead, differences were related to stronger depressive symptoms (OR = 1.67, CI = 1.14-2.44), less ability to conduct I-ADL activities (OR = 0.73, CI = 0.59-0.91), slower usual walking speeds (OR = 0.18, CI = 0.06-0.58) and less occlusal force (OR = 0.99, CI = 0.99-1.00). Depressive symptoms, I-ADLs, and physical function are shown to be significantly related to divergence between objective and subjective masticatory function in elderly Japanese. This suggests that dissociations between objective and subjective dental evaluations of elderly adults indicate need for assessment of their mental and physical function.
Collapse
Affiliation(s)
- M Murakami
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - A Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Ohara
- Tokyo Medical and Dental University, Tokyo, Japan
| | - S Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - K Ihara
- Toho University, Tokyo, Japan
| | - M Murakami
- International University of Health and Welfare Sanno Hospital, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| |
Collapse
|
38
|
Ohara Y, Asakura T, Ueda S, Yamada Y, Ishii M, Betsuyaku T. Bilateral upper lobe Pneumocystis pneumonia during aerosolized pentamidine prophylaxis. QJM 2018; 111:337-338. [PMID: 29211898 DOI: 10.1093/qjmed/hcx233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/14/2022] Open
Affiliation(s)
- Y Ohara
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - T Asakura
- Department of Diagnostic Radiology, Keio University School of Medicine, Japan
| | - S Ueda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Y Yamada
- Department of Diagnostic Radiology, Keio University School of Medicine, Japan
| | - M Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - T Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| |
Collapse
|
39
|
Inoue T, Ohara Y, Niiro T, Endo T, Tominaga T, Mizuno JI. Cervical Periosteal Chondroma Causing Spinal Cord or Nerve Compression: 2 Case Reports and Literature Review. World Neurosurg 2018; 114:99-105. [PMID: 29550598 DOI: 10.1016/j.wneu.2018.03.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 12/20/2017] [Revised: 03/04/2018] [Accepted: 03/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chondroma is a rare benign cartilaginous tumor that originates in chondrocytes and is commonly seen in the long bones; however, it infrequently occurs in the cervical spine. CASE DESCRIPTIONS We report 2 patients with cervical periosteal chondroma that originated in the C2 vertebral body and C1 lamina as extramedullary tumors. The first patient was a 28-year-old man who presented with right upper extremity weakness and numbness. Cervical radiography revealed a bony tumor with evidence of severe spinal cord compression. The second patient was a 26-year-old woman with left occipital neuralgia. Cervical radiography demonstrated a bony tumor arising from the left C1 lateral mass that compressed the C2 nerve root. Both patients underwent surgical removal of the bony tumors, which were diagnosed as periosteal chondroma. CONCLUSIONS The authors herein summarized 16 previous reports of cervical chondroma and compared the clinical courses and treatments. Recommended treatment included maximal surgical resection, especially when significant compression of the cervical cord and signal abnormality within the cord was observed. Annual postoperative follow-up is mandatory to ensure proper neurologic improvement.
Collapse
Affiliation(s)
- Tomoo Inoue
- Department of Spine, Spinal Cord, Peripheral Nerve Surgery, Shin-yurigaoka General Hospital, Kawasaki, Japan; Department of Neurosurgery, Sendai Medical Center, Sendai, Japan
| | - Yukoh Ohara
- Department of Spine, Spinal Cord, Peripheral Nerve Surgery, Shin-yurigaoka General Hospital, Kawasaki, Japan.
| | - Tadaaki Niiro
- Department of Neurosurgery, Kirishima Medical Center, Kirishima, Japan
| | - Toshiki Endo
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jyun-Ichi Mizuno
- Department of Spine, Spinal Cord, Peripheral Nerve Surgery, Shin-yurigaoka General Hospital, Kawasaki, Japan
| |
Collapse
|
40
|
Nakazawa T, Ohara Y, Benkowski R, Makinouchi K, Takami Y, Ohtsubo S, Kawahito K, Tasai K, Glueck J, Noon G, Sueoka A, Schmallegger H, Schima H, Wolner E, Nosé Y. A Pivot Bearing-Supported Centrifugal Pump for a Long-Term Assist Heart. Int J Artif Organs 2018. [DOI: 10.1177/039139889702000407] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A pivot bearing-supported centrifugal blood pump has been developed. It is a compact, cost effective, and anti-thrombogenic pump with anatomical compatibility. A preliminary evaluation of five paracorporeal left ventricular assist studies were performed on pre-conditioned bovine (70-100 kg), without cardiopulmonary bypass and aortic cross-clamping. The inflow cannula was inserted into the left ventricle (LV) through the apex and the outflow cannula affixed with a Dacron vascular graft was anastomosed to the descending aorta. All pumps demonstrated trouble free performance over a two-week screening period. Among these five studies, three implantations were subjected for one month system validation studies. All the devices were trouble free for longer than 1 month. (35, 34, and 31 days). After achieving one month studies, all experiments were terminated. There was no evidence of device induced thrombus formation inside the pump. The plasma free hemoglobin levels were within normal ranges throughout all experiments. As a consequence of these studies, a mass production model C1E3 of this pump was fabricated as a short-term assist pump. This pump has a Normalized Index of Hemolysis of 0.0007 mg/100L and the estimated wear life of the impeller bearings is longer than 8 years. The C1E3 will meet the clinical requirements as a cardiopulmonary bypass pump. For the next step, a miniaturized pivot bearing centrifugal blood pump PI-601 has been developed for use as a permanently implantable device after design optimization. The evolution from C1E3 to the PI-601 converts this pivot bearing centrifugal pump as a totally implantable centrifugal pump. A pivot bearing centrifugal pump will become an ideal assist pump for the patients with failing heart.
Collapse
Affiliation(s)
- T. Nakazawa
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - Y. Ohara
- Department of Thoracic and Cardiovascular Surgery, Nagoya University School of Medicine, Nagoya - Japan
| | - R. Benkowski
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - K. Makinouchi
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - Y. Takami
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - S. Ohtsubo
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - K. Kawahito
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - K. Tasai
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - J. Glueck
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - G.P. Noon
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - A. Sueoka
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| | - H. Schmallegger
- Univ. of Vienna, Boltzman Inst. for Cardiosurgical Research, Vienna - Austria
| | - H. Schima
- Univ. of Vienna, Boltzman Inst. for Cardiosurgical Research, Vienna - Austria
| | - E. Wolner
- Univ. of Vienna, Boltzman Inst. for Cardiosurgical Research, Vienna - Austria
| | - Y. Nosé
- Department of Surgery, Baylor College of Medicine, Houston, Texas - USA
| |
Collapse
|
41
|
Ohara Y. Ossification of the Ligaments in the Cervical Spine, Including Ossification of the Anterior Longitudinal Ligament, Ossification of the Posterior Longitudinal Ligament, and Ossification of the Ligamentum Flavum. Neurosurg Clin N Am 2018; 29:63-68. [DOI: 10.1016/j.nec.2017.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
42
|
Matsuoka H, Ohara Y, Tomita Y, Kikuchi N, Hirano Y, Uchikado H, Mizuno J. Initial radiological findings utilizing titanium basket for cervical open door laminoplasty. Surg Neurol Int 2017; 8:217. [PMID: 28966823 PMCID: PMC5609440 DOI: 10.4103/sni.sni_204_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/24/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cervical laminoplasty, utilizing different spacers to ''keep the door open,'' is the gold standard in Japan for treating ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM). Here, we utilized a novel titanium ''basket'' spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo) to perform open door cervical laminoplasty to keep the "door open" while also allowing for bony fusion across the open door. METHODS Twenty-seven patients with/without OPLL were treated with open door laminoplasty utilizing the basket spacer. Patients were analyzed with preoperative/postoperative JOA scores, and X-rays/computed tomography (CT) at least 12 months (range, 12-19 months) postoperatively. RESULTS Improvement from the preoperative JOA score of 10.3 points to the postoperative JOA of 14.8 points was noted 3 months postoperatively. There were no complications except one patient who had transient C5 palsy. Twelve months postoperatively, X-rays/CT documented fusion on both the open (62%) and hinge sides (90.2%); circumferential fusion was observed 59.8% of the time. CONCLUSION This titanium "basket" spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo) promoted bone union between the spacer and both lamina, lateral masses following cervical laminoplasty without undue complications.
Collapse
Affiliation(s)
- Hidenori Matsuoka
- Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| | - Yukoh Ohara
- Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| | - Yoshiyuki Tomita
- Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| | - Nahoko Kikuchi
- Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| | - Yoshitaka Hirano
- Spine Section, Department of Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan
| | | | - Junichi Mizuno
- Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| |
Collapse
|
43
|
Kakuta T, Hirata S, Mori S, Konishi S, Kawamura Y, Nishi M, Ohara Y. Conceptual Design of the Blanket Tritium Recovery System for the Prototype Fusion Reactor. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Kakuta
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Hirata
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Mori
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Konishi
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - Y. Kawamura
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - M. Nishi
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - Y. Ohara
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| |
Collapse
|
44
|
Ohara Y, Yoshimura Y, Fukuoka Y, Furukawa A, Hosogi S, Yamamoto K. P1444Comparison of global myocardial function with 2 types of pressure-overload left ventricular hypertrophy using 2-dimentional speckle-tracking echocardiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1444] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
45
|
Edahiro A, Hirano H, Watanabe Y, Ohara Y, Motokawa K, Shirobe M, Yasuda J, Awata S. EATING DYSFUNCTION ACCOMPANYING DETERIORATION OF AD ON THE BASIS OF FUNCTIONAL ASSESSMENT STAGING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.664] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A. Edahiro
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - H. Hirano
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - Y. Watanabe
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - Y. Ohara
- Department of Oral Health Education, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - K. Motokawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - M. Shirobe
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - J. Yasuda
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| | - S. Awata
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashiku, Tokyo, Japan,
| |
Collapse
|
46
|
Watanabe Y, Arai H, Hirano H, Ohara Y, Edahiro A, Shimada H, Kikutani T, Suzuki T. IDENTIFYING ORAL FUNCTION AS AN INDEXING PARAMETER FOR DETECTION OF MILD COGNITIVE IMPAIRMENT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1441] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Y. Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - H. Arai
- National Center for Geriatrics and Gerontology, Obu, Japan,
| | - H. Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - Y. Ohara
- Department of Oral Health Education, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan,
| | - A. Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - H. Shimada
- National Center for Geriatrics and Gerontology, Obu, Japan,
| | - T. Kikutani
- Division of Clinical Oral Rehabilitation, Graduate School of Life Dentistry, Nippon Dental University, Tokyo, Japan
| | - T. Suzuki
- National Center for Geriatrics and Gerontology, Obu, Japan,
| |
Collapse
|
47
|
Shirobe M, Nakayama R, Ohara Y, Endo K, Watanabe Y, Hirano H, Hakuta C. EFFECT OF ORAL HEALTH CARE ON HYPERSENSITIVITY SYNDROME AMONG THE ELDERLY IN LONG-TERM CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1443] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M. Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - R. Nakayama
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y. Ohara
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - K. Endo
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y. Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - H. Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - C. Hakuta
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
48
|
Kuriyama M, Akino N, Ebisawa N, Grisham L, Honda A, Itoh T, Kawai M, Kazawa M, Mogaki K, Ohara Y, Ohga T, Okumura Y, Oohara H, Umeda N, Usui K, Watanabe K, Yamamoto M, Yamamoto T. Operation and Development of the 500-keV Negative-Ion-Based Neutral Beam Injection System for JT-60U. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a237] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Kuriyama
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - N. Akino
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - N. Ebisawa
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - L. Grisham
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - A. Honda
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - T. Itoh
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - M. Kawai
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - M. Kazawa
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - K. Mogaki
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - Y. Ohara
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - T. Ohga
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - Y. Okumura
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - H. Oohara
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - N. Umeda
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - K. Usui
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - K. Watanabe
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - M. Yamamoto
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| | - T. Yamamoto
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, 801-1 Mukohyama Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan
| |
Collapse
|
49
|
Kitada A, Min C, Kataoka Y, Kaneshita S, Suda M, Takasugi K, Ohara Y, Rokutanda R, Shimizu H, Tsuda T, Kishimoto M, Yamaguchi K, Okada M. AB0262 Verification of Antibacterial Effect of Sulfasalazine in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5309] [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: 11/03/2022]
|
50
|
Takasugi K, Okada M, Min C, Kitada A, Kataoka Y, Kaneshita S, Suda M, Ohara Y, Rokutanda R, Shimizu H, Tsuda T, Yamaguchi K, Yamaguchi K, Kishimoto M. AB0392 Safety and Tolerability of Iguratimod in Rheumatoid Arthritis with Comorbid Illnesses. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5498] [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]
|