start-ver=1.4 cd-journal=joma no-vol=156 cd-vols= no-issue= article-no= start-page=e300 end-page=e306 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210921 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparative Study of Bilateral Dual Sacral-Alar-Iliac Screws versus Bilateral Single Sacral-Alar-Iliac Screw for Adult Spine Deformities en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective
To evaluate the feasibility of O-arm navigation of bilateral dual sacral-alar-iliac (SAI) screws compared with conventional bilateral single SAI and S1 pedicle screws for pelvic anchors in cases of adult spinal deformity.
Methods
This retrospective, comparative study included 39 patients who underwent corrective fusion using SAI screws from T10 to the pelvis. Patients were divided into 2 groups according to the number of SAI screws placed during adult spinal deformity surgery: single SAI screw (group S, 17 cases) and dual SAI screws (group D, 22 cases). The incidence of rod breakage, proximal junctional kyphosis, screw loosening, reoperation, and global alignment in each group was estimated. Postoperative patient-reported outcomes were measured using the Oswestry Disability Index, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, and visual analog scale.
Results
The incidence of SAI screw loosening was significantly lower in group D than in group S (23% vs. 65%, P?= 0.011). The rod breakage incidence was 0% and 12% in groups D and S, respectively (P?= 0.17). There were no significant differences in the postoperative global alignment and clinical outcomes between the 2 groups.
Conclusions
Dual SAI screws were associated with a significantly reduced incidence of screw loosening compared with single SAI screws. The bilateral dual SAI screws technique for pelvic anchors is feasible for the treatment of patients with adult spinal deformity. en-copyright= kn-copyright= en-aut-name=UotaniKoji en-aut-sei=Uotani en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SonawaneSumeet en-aut-sei=Sonawane en-aut-mei=Sumeet kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=RuparelSameer en-aut-sei=Ruparel en-aut-mei=Sameer kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujiwaraYoshihiro en-aut-sei=Fujiwara en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamauchiTaro en-aut-sei=Yamauchi en-aut-mei=Taro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MisawaHaruo en-aut-sei=Misawa en-aut-mei=Haruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=3 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=6 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=7 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=8 en-affil=Department of Orthopaedic surgery, Okayama University Hospital kn-affil= en-keyword=dual SAI screws kn-keyword=dual SAI screws en-keyword= adult spine deformity kn-keyword= adult spine deformity en-keyword= spinopelvic fixation kn-keyword= spinopelvic fixation en-keyword=navigation surgery kn-keyword=navigation surgery END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=6 article-no= start-page=449 end-page=453 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201612 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Neurological Recovery after Posterior Spinal Surgery in Patients with Metastatic Epidural Spinal Cord Compression en-subtitle= kn-subtitle= en-abstract= kn-abstract=Metastatic epidural spinal cord compression (MESCC) is a common complication in patients with a malignant tumor, but it is difficult to decide the proper time to perform the necessary surgery. Here we analyzed the prognostic factors for postoperative walking ability. We retrospectively reviewed the cases of 112 MESCC patients treated surgically at our institute and divided them into ambulatory (n 88) and non-ambulatory (n24) groups based on their American Spinal Injury Association (ASIA) Impairment Scale grades at the final follow-up. We also classified the patients preoperatively using the revised Tokuhashi score. We assessed the correlation between preoperative or intraoperative factors and postoperative walking ability in both groups. Of the 10 patients classified preoperatively as grade A or B, 2 (20 ) were ambulatory at the final follow-up. Of the 102 patients classified preoperatively as grade C, D or E, 86 (84 ) were ambulatory at the final follow-up (p0.001). There were no significant differences between the groups in the average total Tokuhashi score. Our analysis revealed that the severity of paralysis significantly affects neurological recovery in patients with MESCC. Patients with MESCC should receive surgery before the preoperative ASIA Impairment Scale grade falls below grade C. en-copyright= kn-copyright= en-aut-name=WatanabeNoriyuki en-aut-sei=Watanabe en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MazakiTetsuro en-aut-sei=Mazaki en-aut-mei=Tetsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KataokaMasaki en-aut-sei=Kataoka en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=metastatic epidural spinal cord compression kn-keyword=metastatic epidural spinal cord compression en-keyword=American Spinal Injury Association Impairment Scale kn-keyword=American Spinal Injury Association Impairment Scale en-keyword=Tokuhashi score kn-keyword=Tokuhashi score en-keyword=walking ability kn-keyword=walking ability en-keyword=prognostic factor kn-keyword=prognostic factor END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=5 article-no= start-page=303 end-page=306 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201410 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Rare Course of Scoliosis Associated with Chiari Malformation and Syringomyelia en-subtitle= kn-subtitle= en-abstract= kn-abstract=Spinal deformity is an important clinical manifestation of Chiari I malformation (CM-I) and syringomyelia. Here we report the result of an 8-year follow-up of a 13-year-old girl with severe scoliosis associated with Chiari malformation and a large syringomyelia. The patient presented at our hospital at the age of 13 with a 68 scoliosis. Magnetic resonance imaging showed Chiari malformation and a large syringomyelia. Neurosurgical treatment involved foramen magnum decompression and partial C1 laminectomy, but the scoliosis still progressed. We present the first case report of a rare course of scoliosis in a patient with CM-I and a large syringomyelia. en-copyright= kn-copyright= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=2 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=3 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=4 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=5 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital en-keyword=Chiari I malformation kn-keyword=Chiari I malformation en-keyword=syringomyelia kn-keyword=syringomyelia en-keyword=scoliosis kn-keyword=scoliosis END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=6 article-no= start-page=385 end-page=389 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Chiari Type I Malformation Caused by Craniometaphyseal Dysplasia en-subtitle= kn-subtitle= en-abstract= kn-abstract=Craniometaphyseal dysplasia is a rare genetic condition characterized by progressive thickening of bones in the skull and metaphyseal abnormalities in the long bones. This disorder often causes progressively symptomatic cranial nerve compression, but in rare cases foramen magnum stenosis may lead to quadriplegia. Chiari I malformation with craniometaphyseal dysplasia is extremely rare. The authors report on a 25-year-old woman with myelopathy due to Chiari I malformation along with craniometaphyseal dysplasia. There are only four previous case reports of this condition. The authors present here the fifth case report of this rare condition and summarize its characteristics. en-copyright= kn-copyright= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TetsunagaTomoko en-aut-sei=Tetsunaga en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=2 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=3 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=4 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=5 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=6 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital en-keyword=craniometaphyseal dysplasia kn-keyword=craniometaphyseal dysplasia en-keyword=Chiari malformation kn-keyword=Chiari malformation en-keyword=cervicomedullary compression kn-keyword=cervicomedullary compression END