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- 저자 : Hirofumi Bekki (검색결과 2 건)
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Hirofumi Bekki,Katsumi Harimaya,Yoshihiro Matsumoto,Kenichi Kawaguchi,Mitsumasa Hayashida,Seiji Okada,Toshio Doi,Yasuharu Nakashima 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Prospective cohort study. Purpose: The present study aimed to evaluate the difference in the preoperative curve fl exibility between the supine and prone positions in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature: In AIS, a side-bending view is necessary to differentiate a structural curve from a nonstructural curve using the Lenke classifi cation system. However, there are no published studies about which position, supine or prone, is more effective when evaluating preoperative curve fl exibility using side-bending X-ray images in AIS patients. Methods: Radiographs were analyzed for 32 AIS patients (26 females, six males) who underwent posterior correction and fusion of their main thoracic (MT) curves. Cobb angles of MT, proximal thoracic (PT), and thoracolumbar/lumbar (TL/L) curves were measured preoperatively using upright, supine (anteroposterior and side-bending), and prone (posteroanterior and side-bending) X-rays. Results: The average Cobb angles of PT, MT, and TL/L curves on preoperative upright/supine/prone X-rays were 29.1°/26.7°/26.6°, 60.7°/48.5°/48.2°, and 41.0°/32.6°/33.1°, respectively. The average Cobb angles of PT, MT, and TL/L curves on supine/prone sidebending X-rays were 19.2°/20.3°, 36.3°/36.4°, and 13.9°/15.7°, respectively. The fl exibility rates of PT, MT, and TL/L curves in supine/ prone positions were 35.3%/32.5%, 40.6%/40.2%, and 71.7%/68.2%, respectively. Comparing fl exibility rates in the prone position with those in the supine position in each case, the average ratios of PT, MT, and TL/L curves were found to be 1.0, 1.0, and 0.9, respectively. There were no statistically signifi cant differences between supine and prone side-bending X-ray measurements. However, the Lenke classifi cation in six of 32 patients (18.8%) differed between supine and prone positions because the TL/L curve in the supine position was slightly more fl exible than in the prone position. Conclusions: Supine side-bending fi lms may be suitable for the evaluation of preoperative curve fl exibility in AIS, especially for lumbar modifi er C.
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Diastematomyelia: A Surgical Case with Long-Term Follow-Up
Hirofumi Bekki,Yuichiro Morishita,Osamu Kawano,Keiichiro Shiba,Yukihide Iwamoto 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1
Few reports have described the involvement of syringomyelia associated with diastematomyelia in the etiology of neurological deficits. We reported a case with syringomyelia associated with diastematomyelia. A female patient with diastematomyelia was followed up clinically over 14 years. At the age of 8, she developed clubfoot deformity with neurological deterioration. Motor function of the right peroneus demonstrated grade 2 in manual muscle tests. Continuous intracanial bony septum and double cords with independent double dura were observed at upper thoracic spine. Magnetic resonance imaging revealed a tethering of the spinal cord and syringomyelia distal to the level of diastematomyelia. Extirpation of the osseum septum and duralplasty were performed surgically. She grew without neurological deterioration during 7 years postoperatively. A long-term followed up case with syringomyelia that was possibly secondary to the tethering of the spinal cord associated with diastematomyelia, and effective treatment with extirpation of the osseum septum and duralplasty was described.
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