المؤلفون: Gamada, Hisanori, Tatsumura, Masaki, Okuwaki, Shun, Asai, Reo, Funayama, Toru, Yamazaki, Masashi

المصدر: BMC Musculoskeletal Disorders ; volume 25, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الوصف: Background Fifth lumbar vertebra (L5) spondylolysis has a lower bone union rate than non-L5 spondylolysis, but the reason for this is unknown. This study aimed to evaluate the differences in patient and lesion characteristics between L5 and non-L5 spondylolysis. Methods A total of 410 patients with lumbar spondylolysis aged 18 years or younger who were treated conservatively were enrolled. Patients and lesions were divided into L5 and non-L5 (L2–L4) spondylolysis. Factors, including sex, age, presence of spina bifida occulta, stage of the main side lesion, whether the lesion was unilateral or bilateral, presence and stage of the contralateral side lesion and treatment duration, were evaluated at the first visit and compared between the two groups. Results A total of 250 patients with 349 lesions were included. The bone union rate of L5 lesions was lower than that of non-L5 lesions (75% vs. 86%, p = 0.015). Patients with L5 spondylolysis were more likely to be male (86% vs. 66%) and younger (14.0 vs. 14.6 years) than patients with non-L5 spondylolysis. Lesions of L5 spondylolysis were more likely to be in a progressive stage (28% vs. 15%), less likely to be in a pre-lysis stage (28% vs. 43%) and more likely to be in a contralateral terminal stage (14% vs. 5.3%, p = 0.013) compared with lesions of non-L5 spondylolysis. Conclusions L5 spondylolysis was characterised by a lower bone union rate, more males, younger age, more progressive stage and more contralateral pseudarthrosis than non-L5 spondylolysis.

الإتاحة: https://doi.org/10.1186/s12891-024-07190-xTest

المؤلفون: Segi, Naoki, Nakashima, Hiroaki, Ito, Sadayuki, Yokogawa, Noriaki, Sasagawa, Takeshi, Watanabe, Kota, Nori, Satoshi, Funayama, Toru, Eto, Fumihiko, Nakajima, Hideaki, Terashima, Yoshinori, Hirota, Ryosuke, Hashimoto, Ko, Onoda, Yoshito, Furuya, Takeo, Yunde, Atsushi, Ikegami, Shota, Uehara, Masashi, Suzuki, Hidenori, Imajo, Yasuaki, Uei, Hiroshi, Sawada, Hirokatsu, Kawaguchi, Kenichi, Nakanishi, Kazuo, Suzuki, Nobuyuki, Oshima, Yasushi, Hasegawa, Tomohiko, Iizuka, Yoichi, Tonomura, Hitoshi, Terai, Hidetomi, Akeda, Koji, Seki, Shoji, Ishihara, Masayuki, Inoue, Gen, Funao, Haruki, Yoshii, Toshitaka, Kaito, Takashi, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Kakutani, Kenichiro, Sakai, Daisuke, Ohba, Tetsuro, Otsuki, Bungo, Miyazaki, Masashi, Murotani, Kenta, Okada, Seiji, Imagama, Shiro, Kato, Satoshi

المصدر: Global Spine Journal ; ISSN 2192-5682 2192-5690

مصطلحات موضوعية: Neurology (clinical), Orthopedics and Sports Medicine, Surgery

الوصف: Study Design Retrospective multicenter study. Objectives The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes. Methods This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared. Results Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory. Conclusions Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.

الإتاحة: https://doi.org/10.1177/21925682241227430Test

المؤلفون: Matsunaga, Tomoya, Takahashi, Hiroshi, Koda, Masao, Funayama, Toru, Noguchi, Hiroshi, Miura, Kousei, Eto, Fumihiko, Shibao, Yosuke, Gamada, Hisanori, Inomata, Kento, Okuwaki, Shun, Sakashita, Kotaro, Shimizu, Tomoaki, Sunami, Takahiro, Yamazaki, Masashi

المصدر: JOS Case Reports ; volume 3, issue 1, page 10-13 ; ISSN 2772-9648

الإتاحة: https://doi.org/10.1016/j.joscr.2023.09.012Test
https://api.elsevier.com/content/article/PII:S2772964823000485?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772964823000485?httpAccept=text/plainTest

المؤلفون: Asai, Reo, Tatsumura, Masaki, Gamada, Hisanori, Okuwaki, Shun, Eto, Fumihiko, Nagashima, Katsuya, Takeuchi, Yousuke, Funayama, Toru, Mammoto, Takeo, Hirano, Atsushi, Yamazaki, Masashi

المصدر: BMC Musculoskeletal Disorders ; volume 24, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الوصف: Background Lumbar spondylolysis, a common identifiable cause of low back pain in young athletes, reportedly has a higher incidence rate in males. However, the reason for its higher incidence in males is not clear. This study aimed to investigate the epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis. Methods A retrospective study was conducted in 197 males and 64 females diagnosed with lumbar spondylolysis. These patients visited our institution from April 2014 to March 2020 with their main complaint being low back pain, and they were followed-up until the end of their treatment. We investigated associations between lumbar spondylosis, their background factors, and characteristics of the lesions and analyzed their treatment results. Results Males had a higher prevalence of spina bifida occulta (SBO) (p = 0.0026), more lesions with bone marrow edema (p = 0.0097), and more lesions in the L5 vertebrae (p = 0.021) than females. The popular sports disciplines were baseball, soccer, and track and field in males, and volleyball, basketball, softball in females. The dropout rate, age at diagnosis, bone union rate, and treatment period did not differ between the sexes. Conclusion Lumbar spondylolysis was more common in males than in females. SBO, bone marrow edema, and L5 lesions were more frequent in males, and sports discipline varied between the sexes.

الإتاحة: https://doi.org/10.1186/s12891-023-06679-1Test

المؤلفون: Gamada, Hisanori, Tatsumura, Masaki, Asai, Reo, Okuwaki, Shun, Funayama, Toru, Yamazaki, Masashi

المصدر: Journal of Orthopaedic Surgery and Research ; volume 18, issue 1 ; ISSN 1749-799X

مصطلحات موضوعية: Orthopedics and Sports Medicine, Surgery

الوصف: Background Factors affecting bone union in the conservative treatment of adolescent lumbar spondylolysis remain controversial. We aimed to examine these factors along with advances in diagnostic imaging using multivariable analysis of a sufficient number of patients and lesions. Methods In this retrospective study, high-school-aged patients or younger ( n = 514) who were diagnosed with lumbar spondylolysis from 2014 to 2021 were investigated. We included patients with acute fractures who showed signal changes around the pedicle on magnetic resonance imaging and who completed conservative treatment. The following factors were investigated at the initial visit: age, sex, level of lesion, main side stage, presence and stage of contralateral side lesion, and presence of spina bifida occulta. The association of each factor with bone union was evaluated through a multivariable analysis. Results Altogether, 298 lesions in 217 patients (174 boys and 43 girls; mean age: 14.3 years) were included in this study. Multivariable logistic regression analysis of all factors showed that the main side progressive stage was more likely associated with nonunion as compared to the pre-lysis (OR: 5.86; 95% confidence interval [CI]: 2.00–18.8; p = 0.0011) and early stages (OR: 3.77; 95% CI: 1.72–8.46; p = 0.0009). Regarding the contralateral side stage, the terminal stage was more likely to be associated with nonunion. Conclusion In the conservative treatment of lumbar spondylolysis, the factors affecting bone union were the main and contralateral side stages. Sex, age, level of lesion, or spina bifida occulta had no significant effects on bone union. The main, progressive, and contralateral side terminal stages were negative predictors of bone union. Trial registration This study was retrospectively registered.

الإتاحة: https://doi.org/10.1186/s13018-023-03861-yTest

المؤلفون: Tatsumura, Masaki, Eto, Fumihiko, Kato, Mikiro, Nagashima, Katsuya, Takeuchi, Yosuke, Funayama, Toru, Yamazaki, Masashi

المصدر: Journal of Medical Case Reports ; volume 17, issue 1 ; ISSN 1752-1947

مصطلحات موضوعية: General Medicine

الوصف: Background Pyogenic spondylitis by methicillin-resistant Staphylococcus aureus (MRSA) is known to be intractable. In the past, the insertion of an implant into infected vertebra was considered contraindicated in affected patients because it may exacerbate the infection, but there are increasing numbers of reports indicating the usefulness of posterior fixation to correct instability and alleviate infection. Bone grafting is often required to repair large bone defect due to infection, but free grafts can exacerbate infection and are controversial. Case presentation We present the case of a 58-year-old Asian man with intractable pyogenic spondylitis who had repeated septic shocks due to MRSA. Back pain from repeated pyogenic spondylitis caused by a huge bone defect in L1–2 rendered him unable to sit. Posterior fixation by percutaneous pedicle screws (PPSs) without bone transplantation improved spinal stability and regenerated bone in the huge vertebral defect. He regained his activities of daily living, had no reoccurrence of pyogenic spondylitis nor bacteremia, and was completely cured of the infection without antibiotics after removal of all screws. Conclusions For intractable MRSA pyogenic spondylitis with instability accompanied by a huge bone defect, posterior fixation using PPSs and administration of antibacterial agents stopped the infection, allowed the bone to regenerate, and recovered the patient’s activities of daily living.

الإتاحة: https://doi.org/10.1186/s13256-023-03942-wTest

المؤلفون: Okuwaki, Shun, Funayama, Toru, Koda, Masao, Eto, Fumihiko, Yamaji, Akihiro, Yokogawa, Noriaki, Sasagawa, Takeshi, Ando, Kei, Nakashima, Hiroaki, Segi, Naoki, Watanabe, Kota, Nori, Satoshi, Takeda, Kazuki, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Yamada, Tomohiro, Hasegawa, Tomohiko, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Shirasawa, Eiki, Inoue, Gen, Kakutani, Kenichiro, Kakiuchi, Yuji, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Takegami, Norihiko, Funao, Haruki

المصدر: Scientific Reports ; volume 13, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010–2020. We analyzed CSCI etiology in OPLL patients. We performed propensity score-adjusted analyses to compare neurological outcomes between patients with and without OPLL. Cases were matched based on variables influencing neurological prognosis. The primary neurological outcome was rated according to the American Spine Injury Association (ASIA) impairment scale (AIS) and ASIA motor score (AMS). In 332 OPLL patients, the male-to-female ratio was approximately 4:1. Half of all patients displayed low-energy trauma-induced injury and one-third had CSCI without a bony injury. Propensity score matching created 279 pairs. There was no significant difference in the AIS grade and AMS between patients with and without OPLL during hospitalization, 6 months, and 12 months following injury. OPLL patients tended to exhibit worse neurological findings during injury; nevertheless, OPLL was not associated with poor neurological improvement in older CSCI patients.

الإتاحة: https://doi.org/10.1038/s41598-023-29877-2Test
https://www.nature.com/articles/s41598-023-29877-2.pdfTest
https://www.nature.com/articles/s41598-023-29877-2Test

المؤلفون: Asada, Tomoyuki, Miura, Kousei, Kadone, Hideki, Sakashita, Kotaro, Funayama, Toru, Takahashi, Hiroshi, Noguchi, Hiroshi, Sato, Kosuke, Eto, Fumihiko, Gamada, Hisanori, Inomata, Kento, Koda, Masao, Yamazaki, Masashi

المصدر: BMC Musculoskeletal Disorders ; volume 24, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الوصف: Background Spinal alignment in patients with adult spinal deformity (ASD) changes between rest and during gait. However, it remains unclear at which point the compensated walking posture breaks down and how muscles respond. This study used time-synchronized electromyography (EMG) to investigate the relationship between dynamic spinal alignment and muscle activity during maximum walking duration to reveal compensation mechanisms. Methods This study collected preoperative three-dimensional gait analysis data from patients who were candidates for corrective surgery for ASD from April 2015 to May 2019. We preoperatively obtained dynamic spinal alignment parameters from initiation to cessation of gait using a motion capture system with time-synchronized surface integrated EMG (iEMG). We compared chronological changes in dynamic spinal alignment parameters and iEMG values 1) immediately after gait initiation (first trial), 2) half of the distance walked (half trial), and 3) immediately before cessation (last trial). Results This study included 26 patients (22 women, four men) with ASD. Spinal sagittal vertical axis distance during gait (SpSVA) increased over time (first vs. half vs. last, 172.4 ± 74.8 mm vs. 179.9 ± 76.8 mm vs. 201.6 ± 83.1 mm; P < 0.001). Cervical paravertebral muscle (PVM) and gluteus maximus activity significantly increased ( P < 0.01), but thoracic and lumbar PVM activity did not change. Dynamic spinal alignment showed significant correlation with all muscle activity (cervical PVM, r = 0.41–0.54; thoracic PVM, r = 0.49–0.66; gluteus maximus, r = 0.54–0.69; quadriceps, r = 0.46–0.55) except lumbar PVM activity. Conclusion Spinal balance exacerbation occurred continuously in patients with ASD over maximum walking distance and not at specific points. To maintain horizontal gaze, cervical PVM and gluteus maximus were activated to compensate for a dynamic spinal alignment change. All muscle activities, except lumbar PVM, increased to compensate for the spinal malalignment over time.

الإتاحة: https://doi.org/10.1186/s12891-022-06121-yTest

المؤلفون: Segi, Naoki, Nakashima, Hiroaki, Machino, Masaaki, Ito, Sadayuki, Yokogawa, Noriaki, Sasagawa, Takeshi, Funayama, Toru, Eto, Fumihiko, Yamaji, Akihiro, Watanabe, Kota, Nori, Satoshi, Takeda, Kazuki, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Yamada, Tomohiro, Hasegawa, Tomohiko, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Shirasawa, Eiki, Inoue, Gen, Kakutani, Kenichiro, Kakiuchi, Yuji, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Takegami, Norihiko, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Funao, Haruki, Oshima, Yasushi

المصدر: Global Spine Journal ; ISSN 2192-5682 2192-5690

مصطلحات موضوعية: Neurology (clinical), Orthopedics and Sports Medicine, Surgery

الوصف: Study Design Retrospective multicenter study. Objective The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures. Methods The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score–matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury. Results Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries ( P = .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality. Conclusions The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls.

الإتاحة: https://doi.org/10.1177/21925682231186757Test

المؤلفون: Segi, Naoki, Nakashima, Hiroaki, Machino, Masaaki, Ito, Sadayuki, Yokogawa, Noriaki, Sasagawa, Takeshi, Funayama, Toru, Eto, Fumihiko, Watanabe, Kota, Nori, Satoshi, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Hasegawa, Tomohiko, Yamada, Tomohiro, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Inoue, Gen, Shirasawa, Eiki, Kakutani, Kenichiro, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Funao, Haruki, Oshima, Yasushi, Yoshii, Toshitaka, Kaito, Takashi, Sakai, Daisuke, Ohba, Tetsuro

المصدر: Global Spine Journal ; page 219256822311516 ; ISSN 2192-5682 2192-5690

مصطلحات موضوعية: Neurology (clinical), Orthopedics and Sports Medicine, Surgery

الوصف: Study Design Retrospective multicenter study Objectives To investigate changes over a 10-years period in the profile of cervical spine and spinal cord injuries among the elderly in Japan. Methods The current multicenter study was a retrospective analysis of inpatients aged ≥65 years, suffering cervical fracture (CF) and/or cervical spinal cord injury (CSCI). We analyzed 1413 patients’ epidemiology (from 2010 to 2019). Moreover, 727 patients who underwent surgical treatment were analyzed in 2 groups: the early (2010-2014) and late period (2015-2019). Results Both the number of patients and number of surgical patients showed a significant increasing trend ( P < .001), while the mean age, the distribution of injury levels and paralysis severity, and the proportion of surgical indications remained the same. The number of surgical patients doubled from 228 to 499 from the early to late periods. Posterior surgery was the most common approach (90.4%), instrumentation surgery with screws increased significantly, and the range of fusion was significantly longer in the late period (2.1 vs 2.7 levels, P = .001). Significantly worsening neurological symptoms were recorded in the late period (1.3% vs 5.8%, P = .006), with C5 palsy being the major one. Otherwise, perioperative, major, and other complications, including mortality, did not differ significantly in incidence. Conclusions Both the number of elderly CF and/or CSCI patients and number of patients undergoing surgery increased dramatically over the decade without any change in profile. Instrumentation surgeries with screws increased, without an increase in systemic complications.

الإتاحة: https://doi.org/10.1177/21925682231151643Test