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- 저자 : Shirahata Toshiyuki (검색결과 3 건)
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Rentenberger Colleen,Okano Ichiro,Salzmann Stephan N.,Shirahata Toshiyuki,Reisener Marie-Jacqueline,Shue Jennifer,Sama Andrew A.,Cammisa Frank P.,Girardi Federico P.,Hughes Alexander P. 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.2
Study Design: Retrospective clinical study. Purpose: To describe postoperative height changes and identify the predictive factors of spinal height (SH) changes among patients with adult spinal deformity (ASD) who underwent circumferential lumbar fusion with instrumentation. Overview of Literature: Postoperative height changes remain an important issue after spinal fusion surgery that affects the overall satisfaction with surgery. Previous studies of postoperative height change have focused exclusively on young patients with adolescent idiopathic scoliosis (AIS). Methods: We retrospectively reviewed the clinical and imaging data of ASD patients who underwent lumbar corrective circumferential fusion of ≥3 levels (n=106). SH was defined as the vertical distance between C2 and S1 on a standing lateral image. As potential predictors of postoperative height change, the number of lateral lumbar interbody fusion (LLIF) levels, change in spino-pelvic parameters, total number of levels fused, and pedicle subtraction osteotomies (PSO) were documented. Univariate and multivariate linear regression analyses were performed to identify the predictors of postoperative height change. Results: The mean SH change was −2.39±50.8 mm (range, −160 to 172 mm). The univariate analyses showed that the number of LLIF levels (coefficient=10.9, p =0.03), the absolute coronal vertical axis change (coefficient=0.6, p =0.01), and the absolute Cobb angle change (coefficient=−0.9, p =0.03) were significant predictors for height change. Patients with PSOs (n=14) tended to have a shorter height postoperatively (coefficient=−26.1); however, this difference was not significant (p =0.07). Multivariate analyses conducted with variables of p <0.20 showed that pelvic tilt (PT) change is an independent contributor to SH change (coefficient=−0.99, p =0.04, R2 =0.11). Conclusions: Utilizing a modified definition of SH used in previous AIS studies, we demonstrated that patients with ASD lose SH postoperatively and that PT change was an independent contributor of SH change.
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Yasukawa Taiki,Ohya Junichi,Kawamura Naohiro,Yoshida Yuichi,Onishi Yuki,Kohata Kazuhiro,Kakuta Yohei,Nagatani Satoshi,Kudo Yoshifumi,Shirahata Toshiyuki,Kunogi Junichi 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5
Study Design: Clinical case series.Purpose: This study aimed to report dynamization–posterior lumbar interbody fusion (PLIF), our surgical treatment for hemodialysisrelated spondyloarthropathy (HSA), and investigate patients’ postoperative course within 2 years.Overview of Literature: HSA often requires lumbar fusion surgery. Conventional PLIF for HSA may cause progressive destructive changes in the vertebral endplate, leading to progressive cage subsidence, pedicle screw loosening, and pseudoarthrosis. A dynamic stabilization system might be effective in patients with a poor bone quality. Thus, we performed “dynamization–PLIF” in hemodialysis patients with destructive vertebral endplate changes.Methods: We retrospectively examined patients with HSA who underwent dynamization–PLIF at our hospital between April 2010 and March 2018. The radiographic measurements included lumbar lordosis and local lordosis in the fused segment. The evaluation points were before surgery, immediately after surgery, 1 year after surgery, and 2 years after surgery. The preoperative and postoperative radiographic findings were compared using a paired t-test. A p-value of less than 0.05 was considered significant.Results: We included 50 patients (28 males, 22 females). Lumbar lordosis and local lordosis were significantly improved through dynamization– PLIF (lumbar lordosis, 28.4°–35.5°; local lordosis, 2.7°–12.8°; <i>p</i><0.01). The mean local lordosis was maintained throughout the postoperative course at 1- and 2-year follow-up (12.9°–12.8°, p=0.89 and 12.9°–11.8°, <i>p</i>=0.07, respectively). Solid fusion was achieved in 59 (89%) of 66 fused segments. Solid fusion of all fixed segments was achieved in 42 cases (84%). Within 2 years postoperatively, only six cases (12%) were reoperated (two, surgical debridement for surgical site infection; two, reoperation for pedicle screw loosening; one, laminectomy for epidural hematoma; one, additional fusion for adjacent segment disease).Conclusions: Dynamization–PLIF showed local lordosis improvement, a high solid fusion rate, and a low reoperation rate within 2 years of follow-up.
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Modified Open-Door Laminoplasty Using a Ceramic Spacer and Suture Fixation for Cervical Myelopathy
Tomoyuki Ozawa,Tomoaki Toyone,Ryutaro Shiboi,Kunimasa Inada,Yasuhiro Oikawa,Kazuhisa Takahashi,Seiji Ohtori,Gen Inoue,Masayuki Miyagi,Tetsuhiro Ishikawa,Toshiyuki Shirahata,Yoshifumi Kudo,Katsunori In 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.6
Purpose: To introduce a new simple technique using suture anchors and ceramic spacers to stabilize the elevated laminae in open-door cervical laminoplasty. Although ceramic spacers were placed in the opened laminae and fixed with nylon threads in this series, it was occasionally difficult to fix the nylon threads to the lateral mass. Materials and Methods: Study 1: A preliminary study was conducted using a suture anchor system. Sixteen consecutive patients who underwent surgery for cervical myelopathy were prospectively examined. Study 2: The second study was performed prospectivelyto evaluate the feasibility of this new technique based on the result of the preliminary study. Clinical outcomes were examined in 45 consecutive patients [cervical spondylotic myelopathy (CSM)] and 43 consecutive patients (OPLL). The Japanese Orthopedic Association scoring system (JOA score), axial neck pain, and radiological findings were analyzed. Results: 1) In one case, re-operation was necessary due to dislodgement of the ceramic spacer following rupture of the thread. 2) In all patients, postoperative CT scans showed that the anchors were securely inserted into the bone. In the CSM group, the average JOA score improved from 9.5 points preoperatively to 13.3 at follow-up (recovery 51%). In the OPLL group, the average JOA score improvedfrom 10.1 (5–14) points preoperatively to 14.4 (11–16) at follow-up (recovery 62%). There were no serious complications. Conclusion: The use of the suture anchor system made it unnecessary to create a hole in the lateral mass and enabled reliable and faster fixation of the HA spacers in open-door laminoplasty.
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