JaLCDOI 10.18926/AMO/54980
フルテキストURL 71_2_119.pdf
著者 Oda, Yoshiaki| Takigawa, Tomoyuki| Sugimoto, Yoshihisa| Tanaka, Masato| Akazawa, Hirofumi| Ozaki, Toshifumi|
抄録 Patients with cerebral palsy (CP) frequently present with scoliosis; however, the pattern of curve progression is difficult to predict. We aimed to clarify the natural course of the progression of scoliosis and to identify scoliosis predictors. This was a retrospective, single-center, observational study. Total of 92 CP patients from Asahikawasou Ryouiku Iryou Center in Okayama, Japan were retrospectively analyzed. Cobb angle, presence of hip dislocation and pelvic obliquity, and Gross Motor Function Classification System (GMFCS) were investigated. Severe CP was defined as GMFCS level IV or V. The mean observation period was 10.7 years. Thirtyfour severe CP patients presented with scoliosis and were divided into 3 groups based on their clinical courses: severe, moderate and mild. The mean Cobb angles at the final follow-up were 129°, 53°, and 13° in the severe, moderate, and mild groups, respectively. The average progressions from 18 to 25 years were 2.7°/year, 0.7°/year, and 0.1°/year in the severe, moderate, and mild curve groups, respectively. We observed the natural course of scoliosis and identified 3 courses based on the Cobb angle at 15 and 18 years of age. This method of classification may help clinicians predict the patients’ disease progression.
キーワード severe cerebral palsy scoliosis natural course Cobb angle progression
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 119
終了ページ 126
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420893
JaLCDOI 10.18926/AMO/54807
フルテキストURL 70_6_449.pdf
著者 Watanabe, Noriyuki| Sugimoto, Yoshihisa| Tanaka, Masato| Mazaki, Tetsuro| Arataki, Shinya| Takigawa, Tomoyuki| Kataoka, Masaki| Kunisada, Toshiyuki| Ozaki, Toshifumi|
抄録 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 (n=24) 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 (p<0.001). 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.
キーワード metastatic epidural spinal cord compression American Spinal Injury Association Impairment Scale Tokuhashi score walking ability prognostic factor
Amo Type Original Article
発行日 2016-12
出版物タイトル Acta Medica Okayama
70巻
6号
出版者 Okayama University Medical School
開始ページ 449
終了ページ 453
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28003669
JaLCDOI 10.18926/AMO/52901
フルテキストURL 68_5_313.pdf
著者 Yamane, Kentaro| Tanaka, Masato| Sugimoto, Yoshihisa| Ichimura, Kouichi| Ozaki, Toshifumi|
抄録 Ossified meningioma is classified histologically as a phenotype of metaplastic meningioma, and it is extremely rare. There are only 12 cases involving ossified spinal meningiomas in the literature. We present the case of a 61-year-old female with a primary tumor within the ventral spinal canal at T12. Although we performed a total tumor excision using an ultrasonic bone aspirator, a temporary deterioration of motor evoked potentials (MEPs) was observed during curettage with a Kerrison rongeur. The neurologic findings worsened immediately after surgery. Histologically, the tumor was diagnosed as a metaplastic meningioma with osseous differentiation. In order to avoid spinal cord injury, great care must be taken when removing an ossified meningioma located on the ventral spinal cord.
キーワード spinal metaplastic meningioma osseous differentiation ossified meningioma ultrasonic bone aspirator post-operative course
Amo Type Case Report
発行日 2014-10
出版物タイトル Acta Medica Okayama
68巻
5号
出版者 Okayama University Medical School
開始ページ 313
終了ページ 316
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25338489
Web of Sience KeyUT 000343269300009
JaLCDOI 10.18926/AMO/52899
フルテキストURL 68_5_303.pdf
著者 Tanaka, Masato| Sugimoto, Yoshihisa| Arataki, Shinya| Takigawa, Tomoyuki| Ozaki, Toshifumi|
抄録 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.
キーワード Chiari I malformation syringomyelia scoliosis
Amo Type Case Report
発行日 2014-10
出版物タイトル Acta Medica Okayama
68巻
5号
出版者 Okayama University Medical School
開始ページ 303
終了ページ 306
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25338487
Web of Sience KeyUT 000343269300007
JaLCDOI 10.18926/AMO/52012
フルテキストURL 67_6_385.pdf
著者 Tanaka, Masato| Arataki, Shinya| Sugimoto, Yoshihisa| Takigawa, Tomoyuki| Tetsunaga, Tomoko| Ozaki, Toshifumi|
抄録 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.
キーワード craniometaphyseal dysplasia Chiari malformation cervicomedullary compression
Amo Type Case Report
発行日 2013-12
出版物タイトル Acta Medica Okayama
67巻
6号
出版者 Okayama University Medical School
開始ページ 385
終了ページ 389
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24356723
Web of Sience KeyUT 000328915700007
JaLCDOI 10.18926/AMO/52007
フルテキストURL 67_6_343.pdf
著者 Yamane, Kentaro| Takigawa, Tomoyuki| Tanaka, Masato| Osaki, Syuhei| Sugimoto, Yoshihisa| Ozaki, Toshifumi|
抄録 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.
キーワード cervical spinal schwannoma neurological deficit nerve root resection tumor resection tumor recurrence
Amo Type Original Article
発行日 2013-12
出版物タイトル Acta Medica Okayama
67巻
6号
出版者 Okayama University Medical School
開始ページ 343
終了ページ 349
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24356718
Web of Sience KeyUT 000328915700002
JaLCDOI 10.18926/AMO/49670
フルテキストURL 67_2_113.pdf
著者 Sugimoto, Yoshihisa| Tanaka, Masato| Gobara, Hideo| Misawa, Haruo| Kunisada, Toshiyuki| Ozaki, Toshifumi|
抄録 We report on 2 patients who experienced injury to one of their lumbar arteries related to pedicle screw misplacement. In this report, the lumbar pedicle screw holes were made laterally with resultant injury to the lumbar artery. During surgery, arterial bleeding was controlled with pressure and gauze; however, the patients experienced vital shock after surgery. Vital shock ensued and they were rescued by catheter embolization. If patients receiving lumbar instrumentation surgery experience severe anemia or vital shock postoperatively, the surgeon should assume lumbar artery injury as a differential diagnosis.
キーワード catheter embolization complication lumbar artery injury pedicle screw
Amo Type Case Report
発行日 2013-04
出版物タイトル Acta Medica Okayama
67巻
2号
出版者 Okayama University Medical School
開始ページ 113
終了ページ 116
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23603928
Web of Sience KeyUT 000317801700006
JaLCDOI 10.18926/AMO/49047
フルテキストURL 66_6_499.pdf
著者 Sugimoto, Yoshihisa| Tanaka, Masato| Nakahara, Ryuichi| Misawa, Haruo| Kunisada, Toshiyuki| Ozaki, Toshifumi|
抄録 An 11 year-old girl had 66 degrees of kyphosis in the thoracolumbar junction. For the purpose of planning for kyphosis correction, we created a 3-D, full-scale model of the spine and consulted spinal navigation. Three-dimensional models are generally used as tactile guides to verify the surgical approach and portray the anatomic relations specific to a given patient. We performed posterior fusion from Th10 to L3, and vertebral column resection of Th12 and L1. Screw entry points, directions, lengths and diameters were determined by reference to navigation. Both tools were useful in the bone resection. We could easily detect the posterior element to be resected using the 3D model. During the anterior bony resection, navigation helped us to check the disc level and anterior wall of the vertebrae, which were otherwise difficult to detect due to their depth in the surgical field. Thus, the combination of navigation and 3D models helped us to safely perform surgery for a patient with complex spinal deformity.
キーワード congenital scoliosis kyphosis navigation 3-dimensional models
Amo Type Case Report
発行日 2012-12
出版物タイトル Acta Medica Okayama
66巻
6号
出版者 Okayama University Medical School
開始ページ 499
終了ページ 502
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23254585
Web of Sience KeyUT 000312966100010
JaLCDOI 10.18926/AMO/49043
フルテキストURL 66_6_469.pdf
著者 Shiozaki, Yasuyuki| Ito, Yasuo| Sugimoto, Yoshihisa| Tomioka, Masao| Shimokawa, Tetsuya| Mazaki, Tetsuro| Koshimune, Koichiro| Tanaka, Masato| Ozaki, Toshifumi|
抄録 In this study, we studied the relationship between fracture patterns and motor function recovery in 70 consecutive patients with cervical spinal cord injury. Fractures were categorized into 6 fracture types and subdivided into stages according to the Allen-Ferguson classification system:compressive flexion (CF), distractive flexion (DF), compressive extension (CE), distractive extension (DE), vertical compression (VC) and lateral flexion (LF). Paralysis was evaluated using the American Spinal Injury Association (ASIA) impairment scale at the time of injury and 3 months afterwards. The residual rate of complete motor palsy (ASIA grade A or B) at the final examination was higher in those patients with DE fractures than those with CF, DF or CE. The final outcomes were as follows. Of the 14 patients who were classified with CF fractures, residual palsy was frequently seen in patients who had stage 5 injury. Of the 27 patients with DF fractures, residual palsy occurred in about half of the patients who had stage 4 or 5 injury. Of the 18 patients with CE fractures, residual palsy occurred in half of the patients with stage 3 injury or higher. Finally, of the 7 patients with DE fractures, the rate of residual palsy was high even for the stage 1 and 2 cases;indeed, all DE patients who had complete motor palsy at the first examination had residual palsy at the final examination. Accordingly, we conclude that motor recovery may be related to fracture pattern.
キーワード cervical spinal cord injury motor function recovery fracture patterns
Amo Type Original Article
発行日 2012-12
出版物タイトル Acta Medica Okayama
66巻
6号
出版者 Okayama University Medical School
開始ページ 469
終了ページ 473
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23254581
Web of Sience KeyUT 000312966100006
JaLCDOI 10.18926/AMO/48560
フルテキストURL 66_3_213.pdf
著者 Kataoka, Masaki| Kunisada, Toshiyuki| Tanaka, Masato| Takeda, Ken| Itani, Satoru| Sugimoto, Yoshihisa| Misawa, Haruo| Senda, Masuo| Nakahara, Shinnosuke| Ozaki, Toshifumi|
抄録 There are a variety of treatment options for patients with spinal metastasis, and predicting prognosis is essential for selecting the proper treatment. The purpose of the present study was to identify the significant prognostic factors for the survival of patients with spinal metastasis. We retrospectively reviewed 143 patients with spinal metastasis. The median age was 61 years. Eleven factors reported previously were analyzed using the Cox proportional hazards model:gender, age, performance status, neurological deficits, pain, type of primary tumor, metastasis to major organs, previous chemotherapy, disease-free interval before spinal metastasis, multiple spinal metastases, and extra-spinal bone metastasis. The average survival of study patients after the first visit to our clinic was 22 months. Multivariate survival analysis demonstrated that type of primary tumor (hazard ratio [HR]=6.80, p<0.001), metastasis to major organs (HR=2.01, p=0.005), disease-free interval before spinal metastasis (HR=1.77, p=0.028), and extra-spinal bone metastasis (HR=1.75, p=0.017) were significant prognostic factors. Type of primary tumor was the most powerful prognostic factor. Other prognostic factors may differ among the types of primary tumor and may also be closely associated with primary disease activity. Further analysis of factors predicting prognosis should be conducted with respect to each type of primary tumor to help accurately predict prognosis.
キーワード spine metastasis survival prognostic factor cancer
Amo Type Original Article
発行日 2012-06
出版物タイトル Acta Medica Okayama
66巻
3号
出版者 Okayama University Medical School
開始ページ 213
終了ページ 219
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 22729101
Web of Sience KeyUT 000305669700004