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Association between Pelvic Parameters and Vaginal Delivery
Yamada Tomohiro,Yamato Yu,Hasegawa Tomohiko,Yoshida Go,Yasuda Tatsuya,Banno Tomohiro,Arima Hideyuki,Oe Shin,Mihara Yuki,Ushirozako Hiroki,Ide Koichiro,Watanabe Yuh,Hosino Hironobu,Matsuyama Yukihiro 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.2
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.
Peeled-Off Flexible Cu(In,Ga)Se2 Solar Cells and Na Diffusion Effects on Cell Performances
Adiyudha Sadono,Tomohiro Ogihara,Masashi Hino,Kenji Yamamoto,Akira Yamada 대한금속·재료학회 2016 ELECTRONIC MATERIALS LETTERS Vol.12 No.4
Na diffusion on Cu(In,Ga)Se2 (CIGS) solar cells fabricated ontop of polyimide-coated soda-lime glass (SLG) substrate wereinvestigated. Polyimide-coated SLG that can be used assubstrate for fabricating flexible solar cells by peeled-offprocess, shown to have the same efficiency with SLG referencewhich is around 12%, indicating diffusion of almost sameamount of Na from the substrates into the CIGS. Additional Naincorporation by NaF post-deposition treatment (PDT) wereapplied to CIGS deposited on substrates with different Naquantity to understand the Na diffusion effect prior and postCIGS deposition. Improvement of cells performance wereobserved for CIGS deposited on both substrates with or withoutNa diffusion. Final conversion efficiency of 15% was achievedafter PDT for CIGS deposited on Na-contained substratessuggesting that PDT can be used even for CIGS with Nadiffusion from the substrate.
Yamato Yu,Hasegawa Tomohiko,Yoshida Go,Banno Tomohiro,Oe Shin,Arima Hideyuki,Mihara Yuki,Ushirozako Hiroki,Yamada Tomohiro,Watanabe Yuh,Ide Koichiro,Nakai Keiichi,Kurosu Kenta,Matsuyama Yukihiro 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5
Study Design: Single-center retrospective case series.Purpose: We aimed to evaluate the clinical results of revision surgery for a rod fracture using a posterior-only approach and determine the best procedure to prevent refracture in patients with adult spinal deformity (ASD).Overview of Literature: ASD affects the thoracolumbar spine and often requires surgical correction. However, surgery for extensive spinal fusion causes rod fracture, a major mechanical complication. Few studies have described the treatment methods for rod fractures. Furthermore, the clinical outcomes of revision surgery for rod fractures in patients with ASD are currently unclear.Methods: We retrospectively reviewed the medical records of 404 patients who underwent corrective fusion surgery for ASD with a minimum 2-year follow-up. We studied cases of reoperation for postoperative rod fractures and investigated surgical procedure, intraoperative findings, clinical course, and rod refracture following revision surgery.Results: Rod fracture was observed in 88 patients (21.8%). Fifty-three patients (average age, 68.3 years; average blood loss, 502.2 mL [% estimated blood volume=16.4%]; and operation time, 203.3 minutes) who suffered from a rod fracture at an average of 28.3 months after the primary operation underwent reoperation. Surgical invasiveness had no significant differences in total or partial rod replacement; however, the procedures with and without an anterior bone graft significantly differed. The replaced rod refractured at an average of 35.3 months after the revision surgery of five patients. The rod also refractured at a level outside multiple rods in two patients and with traumatic episodes in three patients. Three patients had bone grafts in the anterior column.Conclusions: Revision surgery involving a multirod with a posterior-only approach for a rod fracture that occurred after ASD was performed successfully. Bone grafting in the anterior column is unnecessary for patients without massive bone defects.
Sharma, Aditi,Paeng, Jun-Young,Yamada, Tomohiro,Kwon, Tae-Geon Korean Association of Maxillofacial Plastic and Re 2016 Maxillofacial Plastic Reconstructive Surgery Vol.38 No.-
Background: Temporomandibular joint (TMJ) ankylosis can be accompanied by various degrees of functional and esthetic problems. Adequate mouth opening, occlusal stability, and harmonious facial form are the main goals of treatment for ankylosis. Distraction osteogenesis has proven to be an excellent treatment for lengthening the ramus-condyle unit. However, various timings for distraction have been suggested, and there is no consensus on selection criteria for performing the procedure in stages or simultaneously with other treatments. Case presentation: In this case report, concomitant intraoral distraction and gap arthroplasty was planned to treat TMJ ankylosis and associated facial asymmetry. After gap arthroplasty and 23 mm of distraction, the ramus-condyle segment was successfully lengthened and mouth opening range was significantly increased. The resultant interocclusal space was stably maintained with an occlusal splint for 4 months after distraction. Finally, good occlusion was achieved after prosthetic treatment. The remaining mandibular asymmetry was corrected with osseous contouring and augmentation surgery. The mouth-opening range was maintained at 35 mm 24 months after treatment. Conclusion: Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.
Magcalas Ken Jeffrey,Oe Shin,Yamato Yu,Hasegawa Tomohiko,Yoshida Go,Banno Tomohiro,Arima Hideyuki,Mihara Yuki,Ushirozako Hiroki,Yamada Tomohiro,Ide Koichiro,Watanabe Yuh,Matsuyama Yukihiro 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: Cohort study.Purpose: There is currently no published study that focuses on the spinal corrective surgery effects with cranial parameters in adult spinal deformity (ASD) patients. It is an important factor to measure since it plays a critical role in maintaining the line of sight. The objective is to determine the change in cranial parameters using the slope of McGregor’s line (McGS) after ASD surgery after 2 years of follow-up.Overview of Literature: A study concluded that cervical spine alignment (C2–C7 lordosis) is strongly affected by thoracic kyphosis (TK). Another study showed that patients with ascending gaze had significantly more thoracolumbar malalignment.Methods: This retrospective study includes 295 corrective surgery patients with ASD. Subjects were divided into two groups after propensity age matching analysis: cranial malalignment (McGS <−8 or >13) and normal cranial alignment (−8≤ McGS ≤13). Lumbar lordosis (LL), pelvic tilt (PT), TK, cervical lordosis (CL), and sagittal vertical axis (SVA) were evaluated between the two groups.Results: SVA (95–56 mm) and PT (34°–25°) decreased and LL (19°–41°) increased 2 years after surgery (p <0.05), but McGS (−1.1° to −0.5°) and CL (21°–19°) did not change. Conversely, in the group with cranial malalignment, SVA (120–64 mm), PT (35°–26°), and LL (12°–41°) showed similar results to the normal cranial parameter group 2 years after surgery, but in contrast, McGS (−13° to −2°) and CL (24°–18°) improved significantly.Conclusions: Severe ASD adversely affects to maintain horizontal gaze but can be improved by spinal corrective surgery.
Yoshida Go,Ushirozako Hiroki,Hasegawa Tomohiko,Yamato Yu,Yasuda Tatsuya,Banno Tomohiro,Arima Hideyuki,Oe Shin,Mihara Yuki,Yamada Tomohiro,Ide Koichiro,Watanabe Yuh,Ushio Takasuke,Matsuyama Yukihiro 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.3
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.
Hasegawa Tomohiko,Ushirozako Hiroki,Yamato Yu,Yoshida Go,Yasuda Tatsuya,Banno Tomohiro,Arima Hideyuki,Oe Shin,Yamada Tomohiro,Ide Koichiro,Watanabe Yuh,Matsuyama Yukihiro 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.4
Study DesignCombination of retrospective and prospective study.PurposeWe 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 LiteratureThe 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.MethodsWe 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.ResultsIn 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).ConclusionsFor 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.