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Koun Yamauchi,Kazunari Fushimi,Kei Miyamoto,Akira Hioki,Katsuji Shimizu,Haruhiko Akiyama 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.5
Study Design: Retrospective study. Purpose: The purpose of this study was to investigate the influence of sagittal alignment of the strut graft on graft subsidence and clinical outcomes after anterior cervical corpectomy and fusion (ACCF). Overview of Literature: ACCF is a common technique for the treatment of various cervical pathologies. Although graft subsidence sometimes occurs after ACCF, it is one cause for poor clinical results. Malalignment of the strut graft is probably one of the factors associated with graft subsidence. However, to the best of our knowledge, no prior reports have demonstrated correlations between the alignment of the strut graft and clinical outcomes. Methods: We evaluated 56 patients (33 men and 23 women; mean age, 59 years; range, 33–84 years; 45 with cervical spondylotic myelopathy and 11 with ossification of the posterior longitudinal ligament) who underwent one- or two-level ACCF with an autogenous fibular strut graft and anterior plating. The Japanese Orthopaedic Association (JOA) score recovery ratio for cervical spondylotic myelopathy was used to evaluate clinical outcomes. The JOA score and lateral radiograms were evaluated 1 week and 1 year postoperatively. Patients were divided into two groups (a straight group [group I] and an oblique group [group Z]) based on radiographic assessment of the sagittal alignment of the strut graft. Results: Group I showed a significantly greater JOA score recovery ratio (p <0.05) and a significantly lower graft subsidence than group Z (p <0.01). Conclusions: Our findings suggest that a straight alignment of the strut graft provides better clinical outcomes and lower incidence of graft subsidence after ACCF. In contrast, an oblique strut graft can lead to significantly increased strut graft subsidence and poor clinical results.
Positive Regulation of Adult Bone Formation by Osteoblast-Specific Transcription Factor Osterix
Baek, Wook-Young,Lee, Min-A,Jung, Ji Won,Kim, Shin-Yoon,Akiyama, Haruhiko,de Crombrugghe, Benoit,Kim, Jung-Eun Wiley (John WileySons) 2009 Journal of bone and mineral research Vol.24 No.6
<P>Osterix (Osx) is essential for osteoblast differentiation and bone formation, because mice lacking Osx die within 1 h of birth with a complete absence of intramembranous and endochondral bone formation. Perinatal lethality caused by the disruption of the Osx gene prevents studies of the role of Osx in bones that are growing or already formed. Here, the function of Osx was examined in adult bones using the time- and site-specific Cre/loxP system. Osx was inactivated in all osteoblasts by Col1a1-Cre with the activity of Cre recombinase under the control of the 2.3-kb collagen promoter. Even though no bone defects were observed in newborn mice, Osx inactivation with 2.3-kb Col1a1-Cre exhibited osteopenia phenotypes in growing mice. BMD and bone-forming rate were decreased in lumbar vertebra, and the cortical bone of the long bones was thinner and more porous with reduced bone length. The trabecular bones were increased, but they were immature or premature. The expression of early marker genes for osteoblast differentiation such as Runx2, osteopontin, and alkaline phosphatase was markedly increased, but the late marker gene, osteocalcin, was decreased. However, no functional defects were found in osteoclasts. In summary, Osx inactivation in growing bones delayed osteoblast maturation, causing an accumulation of immature osteoblasts and reducing osteoblast function for bone formation, without apparent defects in bone resorption. These findings suggest a significant role of Osx in positively regulating osteoblast differentiation and bone formation in adult bone.</P>
Kruppel-like factor 4 attenuates osteoblast formation, function, and cross talk with osteoclasts
Kim, Jung Ha,Kim, Kabsun,Youn, Bang Ung,Lee, Jongwon,Kim, Inyoung,Shin, Hong-In,Akiyama, Haruhiko,Choi, Yongwon,Kim, Nacksung The Rockefeller University Press 2014 The Journal of cell biology Vol.204 No.6
<P>KLF4 controls bone homeostasis by negatively regulating both osteoclast and osteoblast differentiation.</P>
Park, Min Hee,Jin, Hee Kyung,Min, Woo‐,Kie,Lee, Won Woo,Lee, Jeong Eun,Akiyama, Haruhiko,Herzog, Herbert,Enikolopov, Grigori N,Schuchman, Edward H,Bae, Jae‐,sung EMBO 2015 The EMBO journal Vol.34 No.12
<P>Many reports have revealed the importance of the sympathetic nervous system (SNS) in the control of the bone marrow environment. However, the specific role of neuropeptide Y (NPY) in this process has not been systematically studied. Here we show that NPY-deficient mice have significantly reduced hematopoietic stem cell (HSC) numbers and impaired regeneration in bone marrow due to apoptotic destruction of SNS fibers and/or endothelial cells. Furthermore, pharmacological elevation of NPY prevented bone marrow impairments in a mouse model of chemotherapy-induced SNS injury, while NPY injection into conditional knockout mice lacking the Y1 receptor in macrophages did not relieve bone marrow dysfunction. These results indicate that NPY promotes neuroprotection and restores bone marrow dysfunction from chemotherapy-induced SNS injury through the Y1 receptor in macrophages. They also reveal a new role of NPY as a regulator of the bone marrow microenvironment and highlight the potential therapeutic value of this neuropeptide.</P>
Clinical Outcomes of Surgical Treatments for Traumatic Spinal Injuries due to Snowboarding
Takahiro Masuda,Kei Miyamoto,Kazuhiko Wakahara,Kazu Matsumoto,Akira Hioki,Tetsuya Shimokawa,Katsuji Shimizu,Shinji Ogura,Haruhiko Akiyama 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1
Study Design: Retrospective study. Purpose: To assess treatment outcomes of snowboarding-related spinal and spinal cord injuries. Overview of Literature: Snowboarding-related spinal or spinal cord injury have a great impact on social and sporting activities. Methods: A retrospective review of 19 cases of surgically treated snowboard-related injury was done. Analyzed parameters included site of injury, type of fracture, peri- and postoperative complications, pre- and postoperative neurological status, activities of daily living, and participation in sports activities at the final follow-up. Results: The major site of injury was the thoracolumbar junction caused by fracture-dislocation (13/19 cases). The remaining 6 cases had cervical spine injuries. Over 60% of the patients had Frankel A and B paralysis. All patients were surgically treated by posterior fusion with instrumentation. Five underwent additional anterior fusion. Surgical outcome was restoration of ambulatory capacity in 12 patients (63.2%). Ultimately, 15 patients (78.9%) could return to work. Patients with complete paralysis upon admission showed reduced ambulatory capacity compared to those with incomplete paralysis. None of the patients again participated in any sports activities, including snowboarding. Conclusions: Snowboarding-related spinal or spinal cord injury has a great impact on social as well as sports activities. It is necessary to enhance promotion of injury prevention emphasizing the snowboarders’ responsibility code.
Shimokawa Tetsuya,Miyamoto Kei,Hioki Akira,Masuda Takahiro,Fushimi Kazunari,Ogawa Hiroyasu,Ohnishi Kazuichiro,Akiyama Haruhiko 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.2
Study Design: Cross-sectional observational study. Purpose: To examine whether pelvic rotation as a compensatory mechanism for sagittal imbalance is related to quality of life (QOL). Overview of Literature: Poor sagittal alignment is associated with compensatory pelvic retroversion and decreased QOL. Whether the compensatory pelvic tilt (PT) influences QOL is unclear. Methods: Overall, 134 subjects aged ≥20 years with lower back pain were included (104 females; mean age, 70±9.8 years). Sagittal vertical alignment (SVA) and PT were analyzed radiographically. Patients were stratified into three groups based on SVA values: good alignment (group G), intermediate alignment (group I), and poor sagittal alignment (group P). Patients in group I were further categorized into two groups: low PT and high PT. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was used for clinical assessment, and the scores were compared between groups. Results: As SVA increased, PT and lumbar lordosis (LL) increased and decreased, respectively. PT and LL differed significantly between groups G and P (p<0.01 for each comparison). Within group I, there was no significant difference in SVA between the high PT and low PT groups, suggesting that the high PT group had acquired a compensated sagittal balance. Importantly, all domains in the JOABPEQ (except for lower back pain) were significantly lower in the high PT group than in the low PT group (p<0.05 for every comparison). Conclusions: This study showed that focusing solely on SVA as a single indicator can cause important losses in QOL to be overlooked in patients with lumbar disorders. Although pelvic retroversion can compensate for sagittal balance, it is associated with a significant decrease in QOL. To improve the assessment of patients with lumbar disorders, PT should be considered besides SVA.
Core Binding Factor β of Osteoblasts Maintains Cortical Bone Mass Via Stabilization of Runx2 in Mice
Lim, Kyung-Eun,Park, Na-Rae,Che, Xiangguo,Han, Min-Su,Jeong, Jae-Hwan,Kim, Shin-Yoon,Park, Clara Yongjoo,Akiyama, Haruhiko,Kim, Jung-Eun,Ryoo, Hyun-Mo,Stein, Janet L,Lian, Jane B,Stein, Gary S,Choi, J Wiley (John WileySons) 2015 Journal of bone and mineral research Vol.30 No.10