16 results on '"Yasuda, Tatsuya"'
Search Results
2. Selective Angiography to Detect Anterior Spinal Artery Stenosis in Thoracic Ossification of the Posterior Longitudinal Ligament.
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Yoshida G, Ushirozako H, Hasegawa T, Yamato Y, Yasuda T, Banno T, Arima H, Oe S, Mihara Y, Yamada T, Ide K, Watanabe Y, Ushio T, and Matsuyama Y
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Study Design: Single-center prospective study., Purpose: To investigate anterior spinal artery (ASA) status using preoperative selective angiography in patients undergoing surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL)., Overview of Literature: Surgery for T-OPLL has a high risk of neurological complications, which might be associated with insufficient spinal cord blood flow., Methods: This study prospectively examined nine T-OPLL patients who underwent posterior thoracic decompression with kyphosis correction and instrumented fusion at Hamamatsu University School of Medicine between 2017 and 2019. All underwent preoperative selective angiography to detect and evaluate the Adamkiewicz artery and ASA. Intraoperative neuromonitoring and Doppler ultrasonography were performed to analyze neurological complications and spinal cord blood flow., Results: All nine patients showed ASA stenosis in the area of T-OPLL. In all patients, the Adamkiewicz artery was located between T7 and L2 and the area of ASA stenosis corresponded to the level of T-OPLL and greatest spinal cord compression; intraoperative Doppler ultrasonography confirmed the ASA defect at the same spinal level. The number of spinal levels from the Adamkiewicz artery to the most compressive OPLL lesion was greater in the two patients who developed postoperative neurological deficit compared to those who did not (5.5 vs. 2.3, p=0.014)., Conclusions: This is the first study to report detection of ASA stenosis in patients with T-OPLL. Maintaining spinal cord blood flow is important in these patients to avoid neurological deterioration. more...
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- 2022
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3. Association between Pelvic Parameters and Vaginal Delivery.
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Yamada T, Yamato Y, Hasegawa T, Yoshida G, Yasuda T, Banno T, Arima H, Oe S, Mihara Y, Ushirozako H, Ide K, Watanabe Y, Hosino H, and Matsuyama Y
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Study Design: Cross-sectional study., Purpose: To investigate the association between vaginal delivery and pelvic parameters and clarify the effect of parity on parameter fluctuations., Overview of Literature: During vaginal delivery, the sacroiliac joint widens and the sacrum nutates (nods). However, the association between these pelvic parameters and parity is unknown., Methods: As part of a 2016 health screening, 320 female volunteers underwent whole-spine radiographs. Age-matched healthy women were grouped according to the number of vaginal deliveries (0, 1-2, or ≥3). Demographic variables and spinopelvic parameters were compared among the three groups., Results: Of the 320 volunteers, 213 were enrolled (mean age, 71.1±7.2 years). The mean number of vaginal deliveries was 2.2. The average pelvic incidence (PI) was 55.6°±11.1° and was significantly higher in the 90 women with three or more vaginal deliveries than in the other two groups (p<0.001). The average sacral slope was 33.4°±11.1° and was significantly higher in the women with three or more vaginal deliveries than in the 18 who did not deliver vaginally (p<0.001). The 105 women with one or two vaginal deliveries had significantly higher PIs and sacral slopes than did those who did not deliver vaginally (p<0.001)., Conclusions: This is the first study documenting an association between vaginal delivery and pelvic parameters. Bony birth canal realignment during vaginal delivery can affect postnatal PI. Our study helps in understanding the PI changes over a woman's life span. more...
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- 2022
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4. Impact of Spinal Correction Surgeries with Osteotomy and Pelvic Fixation in Patients with Kyphosis Due to Osteoporotic Vertebral Fractures.
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Hasegawa T, Ushirozako H, Yamato Y, Yoshida G, Yasuda T, Banno T, Arima H, Oe S, Yamada T, Ide K, Watanabe Y, and Matsuyama Y
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Study Design: Combination of retrospective and prospective study., Purpose: We aimed to compare the clinical outcomes between local fixation surgery and spinopelvic fixation surgery for the treatment of kyphosis secondary to osteoporotic vertebral fractures with spinopelvic malalignment., Overview of Literature: The clinical characteristics of patients with rigid kyphosis due to osteoporotic vertebral fracture differ from that of middle-aged patients with vertebral fractures in terms of bone fragility and presence of spinopelvic malalignment. Little is known about the surgical strategies for these deformities, most especially the extent of fusion of vertebra involved., Methods: We analyzed 24 patients with vertebral osteotomy at the level of the fracture and spinal fixation without pelvic fixation (local group), and 22 patients with vertebral osteotomy and pelvic fixation (pelvic group). Radiographic parameters, the incidence of proximal junctional kyphosis (PJK), distal junctional kyphosis (DJK), rod fractures, and the Oswestry Disability Index (ODI) were compared between the two groups over a 2-year follow-up period., Results: In the pelvic group, postoperative spinopelvic parameters significantly improved, with the improvements maintained. No remarkable changes in spinopelvic parameters were seen in the local group. The mean ODI scores 2 years after surgery were 45.3 and 33.0 in the local and pelvic group, respectively (p-value <0.05). There was no significant difference in the incidence of PJK in the local and pelvic groups, but there was a higher rate of DJK (41.7%) in the local group. In contrast, rod fractures were more common in the pelvic group (45.5%). Patients with DJK had higher ODI scores 2 years after surgery (52.0 in DJK patients vs. 34.8 in non-DJK patients; p-value <0.05)., Conclusions: For patients with rigid kyphosis due to osteoporotic vertebral fractures, better spinopelvic alignment and health-related quality of life can be achieved through extensive corrective surgery with pelvic fixation. more...
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- 2021
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5. Relationship between Knee Osteoarthritis and Spinopelvic Sagittal Alignment in Volunteers over 50 Years of Age.
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Yasuda T, Togawa D, Hasegawa T, Yamato Y, Kobayashi S, Yoshida G, Banno T, Arima H, Oe S, Hoshino H, Koyama H, Hanada M, Imada T, and Matsuyama Y
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Study Design: Large cohort study of volunteers., Purpose: The purpose of this study was to investigate the relationship between the severity of knee osteoarthritis, assessed using the Kellgren-Lawrence (KL) grading scale, and spinopelvic sagittal alignment in older adult volunteers., Overview of Literature: The relationship between spinopelvic alignment in the sagittal plane and knee osteoarthritis in the coronal plane is unclear., Methods: Volunteers over 50 years of age underwent radiographic analysis. Radiographic parameters including pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), thoracic kyphosis, and sagittal vertical axis (SVA) were measured. The the three Scoliosis Research Society-Schwab sagittal modifiers (PT, SVA, PI-LL) were categorized and the KL grade was assessed. Differences in spinopelvic parameters and Oswestry Disability Index (ODI) scores among KL grades were evaluated., Results: A total of 396 volunteers (160 men, 236 women; mean age, 74.4 years) were analyzed. PI-LL and PT in KL4 were significantly higher compared to that in the other KL grades. However, there were no significant group differences in SVA. In women, but not in men, higher frequencies of the worst modifier grade (++) were observed for PI-LL and PT in the KL3 and KL4 groups compared to those for the other KL grades. In women, the ODI score in KL4 was worse compared to that in the other KL grades., Conclusions: Individuals over 50 years of age with severe knee osteoarthritis had poor lumbo-pelvic sagittal alignment. Moreover, the progression severity of knee osteoarthritis had more impact onstronger relationship with lumbo-pelvic malalignment and disability-related low back pain in women than in men. more...
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- 2020
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6. Spinal Sagittal Alignment, Hospital Anxiety and Depression Scale Scores, and Patient-Reported Outcome among People with Sporting Activity.
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Oe S, Yamato Y, Hasegawa T, Yoshida G, Kobayashi S, Yasuda T, Banno T, Arima H, Mihara Y, Ushirozako H, Yamada T, Ide K, Watanabe Y, Niwa H, and Matsuyama Y
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Study Design: Retrospective cohort study., Purpose: This study aimed to investigate how participation in sporting activity affects patient-reported outcome (PRO), including Neck Disability Index (NDI), in males and females., Overview of Literature: Previously, our study reported that factors with a negative influence on the NDI in females were a lack of sporting activities. However, it was still unclear why it affected poor scores of NDI., Methods: The subjects were 473 volunteers. They were divided into two groups (activity and non-activity) according to participation or non-participation in sporting activities using a self-filled questionnaire. The evaluation items were height, weight, grip strength, bone density, Hospital Anxiety and Depression Scale (HADS) score, standing radiographic parameters, PRO (evaluated by EuroQol-5 dimension [EQ-5D], Oswestry Disability Index [ODI]), and NDI., Results: There were 101 males in the non-activity group and 69 in the activity group and 178 females in the non-activity group and 125 in the activity group. For the males, the evaluation items with significant influence were cervical lordosis (non-activity group:activity group, 17°:22°) and T1 slope minus cervical lordosis (10°:6°, p <0.05). For the females, the evaluation items with significant influence were sagittal vertical axis (28:14 mm), HADS (10.4:8.4), EQ-5D (0.79:0.86), ODI (17:12), and NDI (12:9, p <0.01). HADS and PRO in the females were significantly correlated with the EQ-5D (-0.40), ODI (0.43), and NDI (0.55)., Conclusions: Males who participated in sporting activities had better cervical spine alignment but no effect on PRO. Females with sporting activities had better spinal global alignment and less mental stress. It is suggested that sporting activity in females might be associated with PRO because HADS highly correlates with PRO. more...
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- 2020
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7. Hypertension Is Related to Positive Global Sagittal Alignment: A Cross-Sectional Cohort Study.
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Arima H, Togawa D, Hasegawa T, Yamato Y, Yoshida G, Kobayashi S, Yasuda T, Banno T, Oe S, Mihara Y, Ushirozako H, Hoshino H, and Matsuyama Y
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Study Design: Cross-sectional cohort study., Purpose: This study aimed to investigate the relationship between hypertension and spino-pelvic sagittal alignment in middle-aged and elderly individuals., Overview of the Literature: Positive global sagittal alignment is associated with poor health-related quality of life. Hypertension is associated with tissue microcirculation disorders of the skeletal muscle. We hypothesized that hypertension may be involved in positive global sagittal alignment., Methods: In this institutional review board-approved study, 655 participants (262 men and 393 women; mean age, 72.9 years; range, 50-92 years) who underwent musculoskeletal screening in Toei town, Aichi, Japan were included. Whole spine and pelvic radiographs were taken, and radiographic parameters (thoracic kyphosis, lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and sagittal vertical axis [SVA]) were measured using an image-analysis software. Hypertension was assessed using the standard criteria. The study participants were divided into three subgroups as per age (50-64 years, 65-74 years, and ≥75 years). We examined the differences in the radiographic parameters of those with and without hypertension in each age subgroup., Results: In each age subgroup, there was no significant difference in the age and sex of those with and without hypertension. SVA was significantly shifted forward in the hypertension group than in the non-hypertension group in those aged 50-64 years old (32.4 mm vs. 16.0 mm, p=0.018) and in those aged 65-74 years old (42.7 mm vs. 30.6 mm, p=0.012). There was no significant difference between the hypertension and non-hypertension groups in terms of the alignment of the lumbar and thoracic spine in all the subgroups. In multivariate analysis, hypertension was a significant independent factor of forward-shifted SVA (standardized beta 0.093, p=0.015)., Conclusions: This study showed that hypertension was associated with forward-shifted global sagittal alignment. more...
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- 2019
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8. Multi-Rod Constructs Can Increase the Incidence of Iliac Screw Loosening after Surgery for Adult Spinal Deformity.
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Banno T, Hasegawa T, Yamato Y, Togawa D, Yoshida G, Kobayashi S, Yasuda T, Arima H, Oe S, Mihara Y, Ushirozako H, and Matsuyama Y
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Study Design: A retrospective study., Purpose: To investigate the incidence of iliac screw loosening with a two-rod vs. multi-rod construct and the effect on clinical and radiographic outcomes after surgery for adult spinal deformity (ASD)., Overview of Literature: Multi-rod construct is useful for preventing rod fracture in ASD surgery. However, limited information is available regarding the incidence of iliac screw loosening after corrective fusion surgery using a multi-rod construct., Methods: Total 106 patients with ASD (24 men and 82 women; mean age, 68 years) who underwent corrective fusion surgery using bilateral iliac screws and were followed up for at least 1 year were reviewed. The following variables were compared between patients who underwent surgery with a two-rod and multi-rod construct: age, sex, bone mineral density (BMD), fusion level, high-grade osteotomy, L5/S interbody fusion, screw loosening (upper instrumented vertebra [UIV], S1, and iliac), rod fracture, proximal junctional kyphosis, spinopelvic parameters, and Oswestry Disability Index (ODI) score. We also compared patients with and without iliac screw loosening in the multi-rod construct group., Results: Of the 106 patients, 55 underwent surgery with a conventional two-rod construct and 51 with a multi-rod construct (three rods in 16, four rods in 35). Iliac and UIV screw loosening was observed in 24 patients (21%) and 35 patients (33%), respectively. The multi-rod group showed significantly higher incidence of iliac and UIV screw loosening and lower incidence of rod fracture. Patients with iliac screw loosening had a lower BMD than those without screw loosening; however, no significant differences were observed in the spinopelvic parameters or the ODI score., Conclusions: The use of multi-rod constructs led to a higher incidence of junctional screw loosening than the use of conventional two-rod constructs, especially in patients with osteoporosis. Iliac screw loosening did not affect sagittal alignment or clinical outcome in the short term. more...
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- 2019
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9. Minimum Clinically Important Differences in Oswestry Disability Index Domains and Their Impact on Adult Spinal Deformity Surgery.
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Yoshida G, Hasegawa T, Yamato Y, Kobayashi S, Shin O, Banno T, Mihara Y, Arima H, Ushirozako H, Yasuda T, Togawa D, and Matsuyama Y
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Study Design: Retrospective study., Purpose: To calculate the minimum clinically important difference (MCID) for total and individual domains of the Oswestry Disability Index (ODI) and assess score distribution and changes over time in surgically treated adult spinal deformity (ASD) patients., Overview of Literature: Despite the common use of ODI for assessing ASD, there are no robust studies defining MCID values for this index., Methods: This study included 240 consecutive ASD patients with a minimum of 2 years of follow-up. We calculated MCID values for total and individual ODI domains using all or part of the Scoliosis Research Society-22R questionnaire as anchors. Using current MCID values, we measured the acquisition rates in patients who acquired MCID at follow-up in both total and individual ODI domains. Differences in pathology, age, and locations of the upper and lower instrumented vertebrae were analyzed., Results: MCID of the total ODI score was 11%, with an area under the curve of 0.737. Each domain ranged from 0 to 2, with 1 being the most common value. In the pain and standing domains, >60% of the patients acquired MCID, although acquisition rates of the personal care, lifting, sleep, and sexual activity domains were relatively low (20%-35%). Patients with MCID had more radiographic improvement in lumbar lordosis, sagittal vertical axis, and T1 pelvic angle than those without MCID (p<0.05)., Conclusions: To our knowledge, this is the first study to describe MCID of ODI (11%) after ASD surgery. In the pain and standing domains, most patients acquired MCID although the rates of acquisition of MCID in the personal care, lifting, sleep, and sexual activity domains were low. Spine surgeons should counsel their patients regarding the benefits and setbacks of ASD surgery. more...
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- 2019
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10. Transcranial Motor Evoked Potential Monitoring for the Detection of Nerve Root Injury during Adult Spinal Deformity Surgery.
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Ushirozako H, Yoshida G, Kobayashi S, Hasegawa T, Yamato Y, Yasuda T, Banno T, Arima H, Oe S, Mihara Y, Togawa D, and Matsuyama Y
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Study Design: Retrospective study., Purpose: We aimed to determine the utility of transcranial motor evoked potential (TcMEP) monitoring for the detection of intraoperative nerve root injury., Overview of Literature: Intraoperative neuromonitoring is important for the prediction of neurological injuries or postoperative paralysis. Nerve root injury can develop as a complication of adult spinal deformity (ASD) surgery., Methods: We analyzed 295 patients who underwent ASD surgery using multi-channel TcMEP monitoring between 2010 and 2016 (58 men, 237 women; median age, 68 years; follow-up period ≥1 year). We defined the alarm point as a TcMEP amplitude <30% of that at baseline, and nerve root injury as meeting the focal TcMEP alerts shortly following surgical procedures with the presence of postoperative motor deficits in the selected muscles. Patients were classified into two groups, as those with nerve root injury and those with true-negatives., Results: Seven patients (2.4%) exhibited neurological events related to nerve root injury, comprising six true-positive and one falsenegative cases. TcMEP monitoring from multiple myotomes was effective in detecting nerve root injury. Compared to the 248 truenegative cases, the seven cases of nerve root injury were associated with significantly different preoperative pelvic tilt (PT) values, sacral slope values, and degree of change in PT. The cutoff for the degree of change in PT for predicting nerve root injury, with the best sensitivity and specificity, was 17.5°. Multivariate logistic analyses revealed that a change of >17.5° in PT (odds ratio, 17.5; 95% confidence interval, 1.994-153.560; p =0.010) was independently associated with intraoperative nerve root injury., Conclusions: Multi-channel TcMEP monitoring may be useful for detecting nerve root injuries. A change in PT of >17.5° may be a significant risk factor for neurological events related to intraoperative nerve root injury. more...
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- 2018
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11. Difference in Spinal Sagittal Alignment and Health-Related Quality of Life between Males and Females with Cervical Deformity.
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Oe S, Togawa D, Yoshida G, Hasegawa T, Yamato Y, Kobayashi S, Yasuda T, Banno T, Mihara Y, and Matsuyama Y
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Study Design: Large cohort study., Purpose: To clarify spinal sagittal alignment and health-related quality of life (HRQOL) according to sex in volunteers aged >50 years with cervical deformity (CD)., Overview of Literature: Adult spinal deformities, especially those associated with lumbosacral lesions, are more frequent in females; however, CD is observed to a greater extent in males., Methods: We divided 656 volunteers (263 males, 393 females; age, 50-89 years [mean, 73 years]) as follows: males with CD (CDM; 82 patients); males without CD (NCDM, 181); females with CD (CDF, 36); and females without CD (NCDF, 357). CD was defined as C2-7 sagittal vertical axis (SVA) ≥40 mm. We measured pelvic tilt (PT), pelvic incidence minus lumbar lordosis (PI-LL), thoracic kyphosis, T1 slope, cervical lordosis, C7 SVA, and C2-7 SVA. HRQOL was evaluated using EuroQOL five dimensions questionnaire (EQ-5D)., Results: In CDM, NCDM, CDF, and NCDF groups, the respective parameters were as follows: PT: 15°, 14°, 26°, and 21°; PI-LL: 7°, 5°, 16°, and 10°; C2-7 SVA: 49, 24, 46, and 20 mm; C7 SVA: 61, 40, 75, and 47 mm; and EQ-5D: 0.82, 0.88, 0.78, and 0.81. PT and PI-LL were significantly greater in the CDF group than in the NCDF group ( p <0.05) but were not significantly different between CDM and NCDM groups. The CDF group already showed deterioration of spinopelvic alignment, although it was maintained in the CDM group. EQ-5D in showed significantly greater deterioration the CDM group than in the NCDM group; deterioration of lumbopelvic parameters had less influence in males ( p <0.05)., Conclusions: Sagittal spinal deformity may have different mechanisms in males and females. The deterioration of spinal sagittal alignment in males may originate from the cervical spine, and CD may be associated with HRQOL., Competing Interests: Conflict of Interest: Shin Oe and Daisuke Togawa belong to donated fund laboratory called Division of Geriatric Musculoskeletal Health. more...
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- 2017
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12. Novel Measurement Technique for the Sagittal Vertical Axis and Its Clinical Application in Adult Spinal Deformity.
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Yoshida G, Kurosu K, Yamato Y, Hasegawa T, Yasuda T, Togawa D, and Matsuyama Y
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Study Design: Prospective physical measurement of the sagittal vertical axis (SVA)., Purpose: To evaluate a simple method for measuring SVA by analyzing its relationship with radiographic measurements and clinical appearance., Overview of Literature: No studies have examined physical measurements using the cranial center of gravity (CCG) in a relaxed standing position., Methods: The physical measurement of the horizontal distance between CCG and spina iliaca posterior superior (CCG-SIPS) was measured using a straight ruler in 252 healthy volunteers and 56 patients with adult spinal deformity. Health-related quality of life (HRQOL) was evaluated using the Oswestry disability index (ODI), and clinical symptoms were assessed according to standing status and the presence of gastroesophageal reflux disease (GERD)., Results: CCG-SIPS increased with age in the volunteer group and strongly correlated with radiographic SVA in the patient group ( r =0.984). Differences increased between CCG-SIPS in patients in the relaxed position and radiographic SVA with an increase in sagittal malalignment ( r =0.692, p <0.001). ODI with high sagittal malalignment (CCG-SIPS>120 mm) was significantly larger in the patient group than in the group with low sagittal malalignment (59.9±18.8 vs. 45.1±17.0; p =0.004); these patients (CCG-SIPS>120 mm) needed crutches or walkers for standing. The patient group with GERD had significantly larger sagittal malalignment than the group without GERD (160.3 mm vs. 81.0 mm)., Conclusions: The CCG-SIPS correlated with age and strongly reflected radiographic SVA and HRQOL in the patients. Moreover, it reflects a relaxed posture without a backward shift in the radiographic position even in patients with severe sagittal malalignment. The critical limit of CCG-SIPS can be relevant to clinical appearance, including standing assistance (>120 mm) and the existence of GERD (>150 mm). Thus, it will be a useful predictor of true SVA in clinical practice before radiographic evaluation., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported. more...
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- 2017
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13. Relationship between Spinal Hemangioblastoma Location and Age.
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Yasuda T, Hasegawa T, Yamato Y, Kobayashi S, Togawa D, Banno T, Arima H, Oe S, and Matsuyama Y
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Study Design: Retrospective case series., Purpose: To investigate the relationship between tumor location and clinical characteristics., Overview of Literature: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma's location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI., Methods: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma. Using T1 contrast axial MRI data, the cases were divided into three groups (intramedullary, intramedullary+extramedullary, and extramedullary). Patient demographics, MRI findings, and preoperative neurological status were analyzed and compared for each group., Results: The average age of patients with intramedullary, intramedullary+extramedullary, and extramedullary hemangioblastoma was 34.0, 64.4, and 67.5 years, respectively. Patients in the intramedullary hemangioblastoma group were younger than the other groups. Extramedullary cases had a smaller syrinx compared to the other groups., Conclusions: Age may play an important role in the hemangioblastoma tumor location and the subsequent diagnosis by an MRI. more...
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- 2016
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14. Preoperative and Postoperative Pulmonary Function in Elderly Patients with Thoracolumbar Kyphoscoliosis.
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Yasuda T, Hasegawa T, Yamato Y, Kobayashi S, Togawa D, and Matsuyama Y
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Study Design: Case series., Purpose: The objective of this study was to investigate the change in pulmonary function in adult patients with a spinal deformity who underwent spinal corrective surgery., Overview of Literature: Degenerative lumbar and/or thoraco-lumbar deformities are is often prominent in adult spinal deformity cases, whereas a thoracic deformity involving the chest wall is inconspicuous. A lumbar spine deformity could affect the pulmonary function; however, few reports have investigated pulmonary function in adult patients with a spinal deformity., Methods: This study included 14 adult patients with a spinal deformity who underwent posterior corrective fusion (3 males, 11 females; mean age, 67.4 years). We measured percent vital capacity (%VC) and percent forced expiratory volume in 1 second (%FEV1) before surgery and six months after surgery. We investigated the change in pulmonary function after corrective surgery and the correlation between radiographic parameters and pulmonary function., Results: Mean preoperative %VC and %FEV1 values were 99.9% and 79.3%, respectively. Two cases were diagnosed with restrictive impairment, and two cases were diagnosed with obstructive impairment before surgery. %VC improved in the restrictive impairment cases six months after surgery. However, %FEV1 did not improve significantly after surgery in the obstructive impairment cases., Conclusions: Restrictive impairment was improved in adult patients with a spinal deformity by corrective spinal surgery. However, spinal surgery did not improve obstructive impairment. more...
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- 2015
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15. Optimal Timing of Preoperative Skin Preparation with Povidone-Iodine for Spine Surgery: A Prospective, Randomized Controlled Study.
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Yasuda T, Hasegawa T, Yamato Y, Kobayashi S, Togawa D, Arima H, and Matsuyama Y
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Study Design: A prospective, randomized, controlled study., Purpose: The objective of this study was to evaluate the effectiveness of two techniques of skin preparation with povidone-iodine., Overview of Literature: Preoperative skin preparation is important for preventing surgical site infection by reducing the bacteria in the surgical area. Povidone-iodine is a commonly used agent for preoperative skin preparation, and further decrease in surgical site infections can be expected by understanding how to apply it more effectively., Methods: Eighty-nine spine surgery patients were randomly allocated to two groups. In group A, povidone-iodine was applied to the surgical site just before starting the operation; in group B, povidone-iodine was applied several minutes prior to starting the operation and was allowed to dry. We collected samples from the wound edge before suturing, and we compared the rates of positive culture between the two groups., Results: The rate of positive culture was 30.2% (13 out of 43 patients) in group A, and 6.5% (3 out of 46 patients) in group B. This indicates that there was a significant difference in postoperative infection rates between group A and group B., Conclusions: Because bacteria on the skin appeared significantly reduced by allowing povidone-iodine to dry for several minutes prior to surgery, we recommend this approach to reduce the incidence of postoperative infections. more...
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- 2015
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16. Hypoglossal nerve palsy as a complication of an anterior approach for cervical spine surgery.
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Yasuda T, Togawa D, Hasegawa T, Yamato Y, Kobayashi S, Arima H, and Matsuyama Y
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A recurrent laryngeal nerve injury is known as a complication referring to an anterior cervical spine surgery. However, hypoglossal nerve injury is not well known yet. Herein we report a rare case of a 39-years-old male with a hypoglossal nerve injury after C3/4 osteophyte resection with Smith-Robinson approach. In this case there appeared difficulties of articulation and tongue movement with deviation of the tongue to the left side after the surgery and we diagnosed a hypoglossal nerve injury due to retraction against the nerve during the operation. During the operative approach to the upper cervical spine we had to retract the internal carotid artery and the soft tissue to reach the vertebrae. This retract was the cause of the hypoglossal nerve injury. A gently traction and intermittent release is important to avoid a hypoglossal nerve damage. more...
- Published
- 2015
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