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- 저자 : Masato Oda (검색결과 3 건)
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Yoshiaki Oda,Tomoyuki Takigawa,Ryo Ugawa,Yasuyuki Shiozaki,Haruo Misawa,Yoshihisa Sugimoto,Masato Tanaka,Toshifumi Ozaki 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2
Study Design: Cross sectional study. Purpose: To clarify the difference in position of the psoas muscle between adult spinal deformity (ASD) and lumbar spinal stenosis (LSS). Overview of Literature: Although it is known that the psoas major muscle deviates in ASD patients, no report is available regarding the difference in comparison with LSS patients. Methods: This study investigates 39 patients. For evaluating spinal alignment, pelvic tilt (PT), pelvic incidence (PI), sacral slope, lumbar lordosis (LL), PI–LL, Cobb angle, and the convex side, the lumbar curves were measured. For measuring the position of the psoas major at the L4/5 disk level, magnetic resonance imaging was used. The displacements of psoas major muscle were measured separately in the anterior–posterior and lateral directions. We examined the relationship between the radiographic parameters and anterior displacement (AD) and lateral displacement (LD) of the psoas major muscle. Results: AD was demonstrated in 15 cases with ASD and nine cases with LSS (p >0.05). LD was observed in 13 cases with ASD and no cases with LSS (p <0.01). The Cobb angle was significantly greater in cases with AD than in those without AD (p =0.04). PT, LL, PI– LL, and Cobb angle were significantly greater in cases with LD (p <0.05). All cases with LD had AD, but no case without AD had LD (p <0.001). The side of greater displacement at L4/5 and the convex side of the lumbar curve were consistent in all cases. Conclusions: Despite AD being observed in LSS as well, LD was observed only in the ASD group. Radiographic parameters were worse when LD was seen, rather than AD.
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Three-Dimensional Analysis of the Ideal Entry Point for Sacral Alar Iliac Screws
Watanabe Noriyuki,Takigawa Tomoyuki,Uotani Koji,Oda Yoshiaki,Misawa Haruo,Tanaka Masato,Ozaki Toshifumi 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.6
Study Design: This is a virtual three-dimensional (3D) imaging study examining computed tomography (CT) data to investigate instrumentation placement.Purpose: In this study, we aim to clarify the ideal entry point and trajectory of the sacral alar iliac (SAI) screw in relationship to the dorsal foramen at S1 and the respective nerve root.Overview of Literature: To the best of our knowledge, there is yet no detailed 3D imaging study on the ideal entry point of the SAI screw. Despite the evidence suggesting that the dorsal foramen at S1 is a landmark on the sacrum, the S1 nerve root disruption is a general concern during the insertion of SAI screws. No other study has been published examining the nerve root location at the S1and SAI screw insertions.Methods: Preoperative CT data from 26 patients pertaining to adult spinal deformities were investigated in this study. We applied a 3D image processing method for a detailed investigation. Virtual cylinders were used to mimic SAI screws. These were placed to penetrate the sacral iliac joint without violating the other cortex. We then assessed the trajectory of the longest SAI screw and the ideal entry point of SAI using a color mapping method on the surface of the sacrum. We measured the location of the nerve root at S1 in relation to the foramen at S1 and the sacral surface.Results: As per the results of our color mapping, it was determined that areas that received high scores are located medially and caudally to the dorsal foramen of S1. The mean angle between a horizontal line and a line connecting the medial edge of the foramen and nerve root at S1 was 93.5°. The mean distances from the dorsal medial edge of the foramen and sacral surface to S1 nerve root were 21.8 mm and 13.9 mm, respectively.Conclusions: The ideal entry point of the SAI screw is located medially and caudally to the S1 dorsal foramen based on 3D digital mapping. It is also shown that this entry point spares the S1 nerve root from possible iatrogenic injuries.
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