JaLCDOI 10.18926/AMO/57713
FullText URL 73_6_495.pdf
Author Masuda, Shin| Furumatsu, Takayuki| Okazaki, Yoshiki| Kamatsuki, Yusuke| Okazaki, Yuki| Kodama, Yuya| Hiranaka, Takaaki| Nakata, Eiji| Ozaki, Toshifumi|
Abstract Medial meniscus posterior root tear causes rapid knee cartilage degradation by inducing posteromedial displacement of the medial meniscus. We evaluated medial meniscus posterior extrusion before and after pullout repair for medial meniscus posterior root tear using magnetic resonance images. Twenty-eight patients with symptomatic medial meniscus posterior root tear were included. The inclusion criteria were: acute (< 3 months) or chronic (≥3 months) medial meniscus posterior root tear after painful popping events. The exclusion criteria were: other meniscus and anterior cruciate ligament injuries. We measured medial meniscus posterior extrusion and medial meniscus anteroposterior interval at knee flexion angles of 10° and 90° preoperatively and at 3 months postoperatively. The posterior extrusion at 90° knee flexion decreased from 4.42±1.38 mm preoperatively to 3.09±1.06 mm (p<0.001) postoperatively, while at 10° knee flexion it was −4.17±1.63 mm preoperatively and −3.77±1.72mm postoperatively, showing no significant change. The anteroposterior interval at 10° knee flexion increased from 19.74±4.27 mm preoperatively to 22.15±5.10 mm postoperatively (p<0.001); at 90° knee flexion, it increased from 16.81±4.51 mm preoperatively to 19.20±4.30 mm postoperatively (p<0.001). Medial meniscus posterior extrusion and movement decreased after pullout repair. Pullout repair for medial meniscus posterior root tear improves medial meniscus posterior extrusion, especially at 90° knee flexion.
Keywords medial meniscus posterior root tear pullout repair extrusion open magnetic resonance imaging
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2019-12
Volume volume73
Issue issue6
Publisher Okayama University Medical School
Start Page 495
End Page 501
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31871331
Web of Science KeyUT 000503431400004
JaLCDOI 10.18926/AMO/57714
FullText URL 73_6_503.pdf
Author Kamatsuki, Yusuke| Furumatsu, Takayuki| Miyazawa, Shinichi| Kodama, Yuya| Hino, Tomohito| Okazaki, Yoshiki| Masuda, Shin| Okazaki, Yuki| Noda, Tomoyuki| Yamakawa, Yasuaki| Tetsunaga, Tomoko| Ozaki, Toshifumi|
Abstract Clinical studies have demonstrated that transtibial pullout repair led to favorable midterm outcomes in patients with medial meniscus posterior root tears (MMPRTs) although medial meniscal extrusion (MME) continued to be present. It has been unclear whether these residual postoperative MMEs existed after the pullout repair or had progressed at the very short-term evaluation after surgery. We sought to determine which characteristics of patients with MMPRTs influence the incidence of postoperative MME. The cases of 23 patients whose date of injury was known were analyzed. All patients underwent MMPRT pullout fixation. Preoperative and 3-month postoperative magnetic resonance imaging (MRI) examinations were performed. MME was retrospectively assessed on the mid-coronal plane of MRI scans. The preoperative and postoperative MME values were 4.2±1.2 mm and 4.3±1.5 mm, respectively (p=0.559). Pullout repair surgery was performed significantly earlier after the MMPRT-specific injury in patients whose postoperative MME improved compared to the patients whose MME did not improve (p<0.001). Our findings demonstrated that an early transtibial pullout repair of an MMPRT was more effective in reducing MME than a late repair. Surgeons should not miss the optimal timing for the pullout repair of an MMPRT, considering the period from the injury and the preoperative MME.
Keywords medial meniscus posterior root tear pullout repair medial meniscus extrusion magnetic resonance imaging
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2019-12
Volume volume73
Issue issue6
Publisher Okayama University Medical School
Start Page 503
End Page 510
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31871332
Web of Science KeyUT 000503431400005
JaLCDOI 10.18926/AMO/57717
FullText URL 73_6_523.pdf
Author Hiranaka, Takaaki| Furumatsu, Takayuki| Okazaki, Yoshiki| Kamatsuki, Yusuke| Masuda, Shin| Okazaki, Yuki| Takihira, Shota| Miyazawa, Shinichi| Nakata, Eiji| Ozaki, Toshifumi|
Abstract The case of an individual with a bilateral anterior cruciate ligament (ACL) tear combined with a medial meniscus (MM) posterior root tear is described. A 34-year-old Japanese man with bilateral ACL rupture that occurred > 10 years earlier was diagnosed with bilateral ACL tear combined with MM posterior root tear (MMPRT). We performed a transtibial pullout repair of the MMPRT with ACL reconstruction. The tibial tunnels for the MM posterior root repair and ACL reconstruction were created separately. Postoperatively, a good clinical outcome and meniscal healing were obtained. Our surgical technique may thus contribute to anatomical MM posterior root repair and ACL reconstruction.
Keywords bilateral anterior cruciate ligament tear medial meniscus posterior root tear pullout repair case report
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2019-12
Volume volume73
Issue issue6
Publisher Okayama University Medical School
Start Page 523
End Page 528
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31871335
Web of Science KeyUT 000503431400008
JaLCDOI 10.18926/AMO/57947
FullText URL 74_1_7.pdf
Author Sanki, Tomoaki| Endo, Hirosuke| Tetsunaga, Tomonori| Furumatsu, Takayuki| Yamada, Kazuki| Ozaki, Toshifumi|
Abstract We investigated the relationship between the initial contact status and stress shielding in total hip arthroplasty (THA) using fit-and-fill type straight-stem implants. In addition we evaluated the clinical and radiographic outcomes. Subjects were 100 hips of 94 patients who underwent THA and were followed-up for ≥10 years. Contact areas with the femoral cortical bone were investigated according to the zonal distribution of Gruen using postoperative CT images. Depending on the number of contact areas, the patients were classified into high contact [HC], medium contact [MC], and low contact [LC] groups. Radiographic and clinical outcomes were evaluated. In the HC group (20 hips), severe stress shielding was observed in 12 hips, which was statistically significant (p=0.008). In the LC group (29 hips), mild stress shielding was observed in 27 hips which was statistically significant (p<0.001). No significant differences were observed among the 3 groups in clinical outcomes, Harris hip score (p=0.719) or Japanese Orthopedic Association (JOA) score (p=0.301). In insertion of cementless collared fit-and-fill type straight-stem implants, severe late stress shielding of the femoral bone may occur if high contact of the femoral component is achieved. However, the degree of stress shielding does not result in adverse clinical outcomes.
Keywords fit-and-fill stress shielding cementless straight stem total hip arthroplasty
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2020-02
Volume volume74
Issue issue1
Publisher Okayama University Medical School
Start Page 7
End Page 15
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 32099243
Web of Science KeyUT 000516606200002
NAID 120006795614
JaLCDOI 10.18926/AMO/57957
FullText URL 74_1_77.pdf
Author Endo, Hirosuke| Akazawa, Hirofumi| Yashiro, Masato| Yamada, Kazuki| Sanki, Tomoaki| Tetsunaga, Tomonori| Nishida, Keiichiro| Furumatsu, Takayuki| Ozaki, Toshifumi|
Abstract Idiopathic chondrolysis of the hip (ICH), a very rare disorder of unknown etiology, occurs mainly in female adolescents. Characterized by pain, limp, stiffness and radiological narrowing joint space from the rapid destruction of the articular cartilage, ICH sometimes results in ankyloses. We present the case of a 10-year-old girl diagnosed with ICH based on arthroscopic inspection and synovium biopsy. The femoral deformity appeared gradually, like a cam-type femoroacetabular impingement. She was treated with intensive rehabilitation and immunosuppressive drug. We later performed an arthroscopic bumpectomy for residual symptoms. She achieved a favorable outcome as a 15-year-old at the latest follow-up.
Keywords idiopathic chondrolysis hip joint medication bump arthroscopy
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2020-02
Volume volume74
Issue issue1
Publisher Okayama University Medical School
Start Page 77
End Page 81
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 32099253
Web of Science KeyUT 000516606200012
NAID 120006795624
JaLCDOI 10.18926/AMO/58274
FullText URL 74_2_151.pdf
Author Yamamoto, Norio| Dan’ura, Tomoyuki| Noda, Tomoyuki| Ozaki, Toshifumi|
Abstract This is the second report of an atypical peri-implant femoral fracture occurring at the distal screw after intramedullary nail fixation of a pertrochanteric fracture. A 94-year-old Japanese female with a 5-year history of alendronate intake presented with prodromal pain in her right thigh after intramedullary nail fixation. Plain radiographs showed an incomplete noncomminuted transverse fracture at the distal screw, suggesting an atypical peri-implant femoral fracture. The pathogenesis of an atypical peri-implant femoral fracture could be a combined systemic bone metabolism disorder and repetitive overloading at the screw, similar to the pathogenesis of an atypical periprosthetic femoral fracture around stem implantation.
Keywords atypical femoral fracture insufficiency fracture bisphosphonate atypical peri-implant femoral fracture, atypical periprosthetic femoral fracture
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2020-04
Volume volume74
Issue issue2
Publisher Okayama University Medical School
Start Page 151
End Page 157
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 32341590
Web of Science KeyUT 000528278500009
NAID 120006839453
JaLCDOI 10.18926/AMO/60373
FullText URL 74_4_345.pdf
Author Tanaka, Takaaki| Furumatsu, Takayuki| Hiranaka, Takaaki| Okazaki, Yuki| Masudaa, Kenji| Senoa, Noritaka| Ozaki, Toshifumi|
Abstract The aim of this study was to evaluate tunnel coalition and inter-tunnel distance by comparing the tibial tunnel position in double-bundle anterior cruciate ligament (ACL) reconstruction performed with a conventional guide versus a posterolateral (PL) divergence (PLD) guide. Subjects were 43 patients (ACL tip aimer: 20 knees; PLD guide: 23 knees) who underwent double-bundle ACL reconstruction between September 2014 and December 2017. In all cases, the tibial tunnel position, tunnel edge distance and tunnel angles were evaluated based on CT images. Clinical outcome was evaluated using the Lachman test, pivot-shift test, and Lysholm score. Tibial tunnel positions were similar between the conventional and PLD guide groups, while tibial tunnel edge distance was significantly less in the conventional group. Tunnel coalition was observed in 5 knees in the conventional and no knees in the PLD guide group. Distance between two tibial tunnel centers was 9.1 mm for the tip aimer, and 10.5 mm for the PLD guide. Creation of the PL tunnel tended to involve insertion from a more medial aspect for the PLD guide group than the conventional guide group. No differences in clinical outcomes were noted. The PLD guide can be used to create anatomically-positioned PL tunnels, and reduce the probability of occurrence of tunnel coalition.
Keywords anterior cruciate ligament reconstruction tibial tunnel position PL divergence guide tunnel coalition
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2020-08
Volume volume74
Issue issue4
Publisher Okayama University Medical School
Start Page 345
End Page 350
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2020 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 32843766
Web of Science KeyUT 000562508700010
NAID 120006880212
Author Nishida, Keiichiro| Hashizume, Kenzo| Ozawa, Masatsugu| Takeshita, Ayumu| Kaneda, Daisuke| Nakahara, Ryuichi| Nasu, Yoshihisa| Shimamura, Yasunori| Inoue, Hajime| Ozaki, Toshifumi|
Published Date 2017-02
Publication Title Acta Medica Okayama
Volume volume71
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/54824
Author Okada, Yoshiki| Abe, Nobuhiro| Hisamori, Noriyuki| Kaneeda, Toshiaki| Moriyama, Shigeaki| Ohmori, Hitoshi| Mizutani, Masayoshi| Yanai, Hiroyuki| Nakashima, Yoshio| Yokoyama, Yusuke| Ozaki, Toshifumi|
Published Date 2017-02
Publication Title Acta Medica Okayama
Volume volume71
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/54825
JaLCDOI 10.18926/AMO/61430
FullText URL 75_1_25.pdf
Author Tetsunaga, Tomonori| Tetsunaga, Tomoko| Yamada, Kazuki| Sanki, Tomoaki| Kawamura, Yoshi| Ozaki, Toshifumi|
Abstract In bipolar hemiarthroplasty (BHA), it is important to preserve soft tissue to reduce the risk of postoperative dislocation. A variety of surgical approaches for BHA are available, but extra care is needed with muscle- and tendon-preserving approaches in geriatric patients. We investigated the usefulness of BHA using a conjoined tendon-preserving posterior (CPP) approach, in which only the external obturator muscle is dissected, in geri-atric patients. We retrospectively analyzed the cases of 40 femoral neck fracture patients (10 men, 30 women) aged ≥ 80 years who underwent BHA using the CPP approach. The patients’ average age was 85.8 years (80-94 years). We examined the operation time, bleeding, preservation of short external rotator muscles, complica-tions, and stem alignment and subsidence from postoperative radiographs. Although gemellus inferior muscle injury was detected in 4 patients (10%), the hip joint stability was very excellent in all cases. There was no intraoperative fracture or postoperative dislocation. On postoperative radiographs, all femoral stems were in a neutral position. There was no stem subsidence in all 40 patients. BHA using the CPP approach appeared to be useful even in geriatric patients.
Keywords bipolar hip arthroplasty geriatric patient conjoined tendon-preserving posterior approach
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2021-02
Volume volume75
Issue issue1
Publisher Okayama University Medical School
Start Page 25
End Page 30
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 33649610
JaLCDOI 10.18926/AMO/52012
FullText URL 67_6_385.pdf
Author Tanaka, Masato| Arataki, Shinya| Sugimoto, Yoshihisa| Takigawa, Tomoyuki| Tetsunaga, Tomoko| Ozaki, Toshifumi|
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.
Keywords craniometaphyseal dysplasia Chiari malformation cervicomedullary compression
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2013-12
Volume volume67
Issue issue6
Publisher Okayama University Medical School
Start Page 385
End Page 389
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24356723
Web of Science KeyUT 000328915700007
Author Mimura, Hidefumi| Fujiwara, Hiroyasu| Hiraki, Takao| Gobara, Hideo| Shibamoto, Kentaro| Kimata, Yoshihiro| Ozaki, Toshifumi| Sasaki, Satoru| Kanazawa, Susumu|
Published Date 2010-04-01
Publication Title 岡山医学会雑誌
Volume volume122
Issue issue1
Content Type Journal Article
Author Tanaka, Masato| Sugimoto, Yoshihisa| Misawa, Haruo| Takahata, Tomohiro| Ozaki, Toshifumi|
Published Date 2010-04-01
Publication Title 岡山医学会雑誌
Volume volume122
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/61905
FullText URL 75_2_225.pdf
Author Xue, Haowei| Furumatsu, Takayuki| Okazaki, Yuki | Hiranaka, Takaaki| Kintaka, Keisuke | Zhang, Ximing| Yoshida, Aki| Ozaki, Toshifumi|
Abstract A 65-year-old man presented with a left medial meniscus (MM) posterior root tear (PRT). Unicompartmental knee arthroplasty was performed 12 months after transtibial pullout repair of the MMPRT. Repaired MM posterior root tissue was subjected to histological analysis. Immunostaining and picrosirius red staining showed sufficient deposition of type I collagen, and hematoxylin-eosin staining using a polarized microscope showed well-aligned fiber orientation in the repaired tissue. The repaired posterior root (post-transtibial pullout repair) showed mature and well-aligned ligament-like tissue. Preserving the MM posterior root remnant to mimic the original posterior root tissue might be useful when performing pullout repair.
Keywords medial meniscus posterior root tear unicompartmental knee arthroplasty histological analysis case report
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2021-04
Volume volume75
Issue issue2
Publisher Okayama University Medical School
Start Page 225
End Page 230
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 33953430
NAID 120007029882
JaLCDOI 10.18926/AMO/62817
FullText URL 75_6_751.pdf
Author Endo, Hirosuke| Yamada, Kazuki| Testunaga, Tomonori| Furumatsu, Takayuki| Mitani, Shigeru| Ozaki, Toshifumi|
Abstract The improved cemented cup technique has attained excellent long-term results in primary total hip arthroplasty. When cup revision surgery was performed, the cemented cup, which was loosened at the bone-cement interface, was easily removed. However, with a well-fixed bone-cement interface, it remains difficult to remove the cemented cup for a revision in the event of a recurring dislocation. In addition, protrusions in the cement can cause unpredictable bone defects. A new removal device was created and used successfully to remove a well-fixed cemented cup safely and efficiently. This report introduces the device and the technique used in cemented cup removal.
Keywords total hip arthroplasty revision surgery well-fixed cemented cup
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2021-12
Volume volume75
Issue issue6
Publisher Okayama University Medical School
Start Page 751
End Page 754
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2021 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 34955545
Web of Science KeyUT 000735319800003
NAID 120007180275
JaLCDOI 10.18926/AMO/63405
FullText URL 76_2_121.pdf
Author Okazaki, Yuki| Furumatsu, Takayuki| Hiranaka, Takaaki| Kamatsuki, Yusuke| Nakata, Eiji| Tetsunaga, Tomonori| Yamane, Kentaro| Ozaki, Toshifumi|
Abstract Bone marrow edema (BME) after meniscus injury and risk factors for subchondral insufficiency fracture of the knee (SIFK) have been reported. However, their association with medial meniscus posterior root tear (MMPRT) remains unknown. We investigated the association of BME volume (BME-V), posterior shinycorner lesion (PSCL), and SIFK with MMPRT to examine the correlations between BME-V and medial meniscus extrusion (MME), PSCL and duration from injury to the time of magnetic resonance imaging (duration), and SIFK and duration. Twenty-nine patients who underwent surgery for MMPRT were included (mean age, 59.2; range, 39-84). The presence of PSCL, femoral BME-V (cm3), and SIFK grade (1-4) were evaluated. Preoperative factors, such as MME (mm) and duration (weeks), were investigated using multivariate linear/ logistic regression analyses. Multivariate linear regression analysis revealed duration as a significant factor for high-grade SIFK (p<0.01). Multivariate logistic regression analysis revealed duration as a significant factor for the presence of PSCL (odds ratio=0.94, p<0.05). A long duration of MMPRT leads to severe MME and highgrade SIFK (3 and 4), often resulting in knee arthroplasty. Early diagnosis of MMPRT and pullout repair can prevent severe MME and high-grade SIFK.
Keywords medial meniscus posterior root tear subchondral insufficiency fracture bone marrow edema meniscus extrusion
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2022-04
Volume volume76
Issue issue2
Publisher Okayama University Medical School
Start Page 121
End Page 127
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2022 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 35503439
Web of Science KeyUT 000792374900003
JaLCDOI 10.18926/AMO/64364
FullText URL 77_1_71.pdf
Author Yamakawa, Yasuaki| Kamatsuki, Yusuke| Noda, Tomoyuki| Kure, Miho| Miyazawa, Shinichi| Ozaki, Toshifumi|
Abstract We report a case of ipsilateral periprosthetic fractures above and below the knee that occurred at different times due to navigation tracker pin and bone fragility. A 66-year-old Japanese woman with rheumatoid arthritis (RA) underwent a total knee arthroplasty. Four months post-surgery, a periprosthetic fracture above the knee at the navigation pin hole was detected. She underwent osteosynthesis and could walk independently, but she developed an ipsilateral tibial component fracture. Conservative treatment with a splint was followed by bone union. Patients with RA treated with oral steroids tend to develop ipsilateral periprosthetic fractures around the knee due to bone fragility.
Keywords periprosthetic fracture total knee arthroplasty navigation system bone fragility
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2023-02
Volume volume77
Issue issue1
Publisher Okayama University Medical School
Start Page 71
End Page 74
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders Copyright Ⓒ 2023 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 36849147
Web of Science KeyUT 000952992100005
Author Shimamura, Yasunori| Inoue, Madoka| Ozawa, Masatugu| Kanazawa, Tomoko| Saitou, Taiichi| Nakahara, Ryuichi| Noda, Tomoyuki| Nishida, Keiichiro| Ozaki, Toshifumi|
Published Date 2011-08-01
Publication Title 岡山医学会雑誌
Volume volume123
Issue issue2
Content Type Journal Article
Author Miyake, Yoshiaki| Furumatsu, Takayuki| Kubota, Satoshi| Kawata, Kazumi| Ozaki, Toshifumi| Takigawa, Masaharu|
Published Date 2011-06-03
Publication Title Biochemical and Biophysical Research Communications
Volume volume409
Issue issue2
Content Type Journal Article
JaLCDOI 10.18926/AMO/52007
FullText URL 67_6_343.pdf
Author Yamane, Kentaro| Takigawa, Tomoyuki| Tanaka, Masato| Osaki, Syuhei| Sugimoto, Yoshihisa| Ozaki, Toshifumi|
Abstract Cervical spinal schwannoma is benign, and outcomes after surgical resection are generally excellent. A surgical dilemma sometimes arises as to whether to perform total tumor removal, which carries a risk of sacrificing the nerve root, or subtotal removal, where the risk can be tumor recurrence. The purpose of this study was to identify factors with the potential to predict clinical impairment after surgery for cervical spinal schwannomas. Thirty cases of cervical schwannomas treated surgically in our institute were retrospectively reviewed;initial symptoms, tumor location, Eden classification, surgical method, functional outcome, and tumor recurrence were investigated. All permanent motor deficits were the result of resecting functionally relevant nerve roots (i.e., C5-8). The rate of permanent sensory deficit was 11% after C1-4 nerve root resection, and 67% after C5-8 nerve root resection. Permanent neurological deficits occurred in 14% of patients younger than 40 years and 38% of those older than 40. Dumbbell tumors were associated with the need for total or ventral nerve root transection, as well as with a high incidence of tumor recurrence. The incidence of permanent neurological deficit was significantly higher in patients undergoing C5-8 nerve root resection, and tended to be higher in those over 40.
Keywords cervical spinal schwannoma neurological deficit nerve root resection tumor resection tumor recurrence
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2013-12
Volume volume67
Issue issue6
Publisher Okayama University Medical School
Start Page 343
End Page 349
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24356718
Web of Science KeyUT 000328915700002