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  • 1
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    Online Resource
    Surgical Outcomes and Limitations of Decompression Surgery for Degenerative Spondylolisthesis
    SAGE Publications ; 2018
    In:  Global Spine Journal Vol. 8, No. 7 ( 2018-10), p. 733-738
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 8, No. 7 ( 2018-10), p. 733-738
    Abstract: A retrospective study. Objectives: To investigate surgical outcomes and limitations of decompression surgery for degenerative spondylolisthesis. Methods: One hundred patients with degenerative spondylolisthesis who underwent decompression surgery alone were included in this study. The average follow-up period was 3.7 years. Radiography and magnetic resonance imaging were used for radiological assessment. Patients with a recovery rate of 〉 50% throughout the study period were classified as the control group (Group C), while those with a recovery rate of 〈 50% throughout the study period were classified as the poor group (Group P). Patients that had improved symptoms, and yet later showed neurological deterioration due to foraminal stenosis at the same level were classified as the exiting nerve root radiculopathy group (Group E), while those who showed deterioration due to slip progression at the same level were classified as the traversing nerve root radiculopathy group (Group T). Results: Patient distribution in each group was 73, 12, 7, and 8 in Groups C, P, E, and T, respectively. As for preoperative radiological features, slippage and an upper migrated disc in Group P, disc wedging and an upper migrated disc in Group E, and lamina inclination and posterior opening in Group T were evident. The cutoff value of preoperative slippage with a poor outcome was 13%. Conclusions: Surgical outcomes of decompression surgery for degenerative spondylolisthesis were successful in 73% cases. Preoperative radiological features for poor outcomes were slippage of more than 13%, an upper migrated disc, disc wedging, and lamina inclination.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568218770793
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 2
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    Online Resource
    Acceptability and feasibility of a Japanese version of STrAtegies for RelaTives (START-J): A manualized coping strategy program for family caregivers of relatives living with dementia
    SAGE Publications ; 2021
    In:  Dementia Vol. 20, No. 3 ( 2021-04), p. 985-1004
    Details
    In: Dementia, SAGE Publications, Vol. 20, No. 3 ( 2021-04), p. 985-1004
    Abstract: The rising older population in Japan is associated with a rise in cases of dementia. Support for the increased number of family caregivers of people living with dementia is crucial, as caring may negatively affect a family caregiver’s health. This study seeks to evaluate the feasibility and applicability of a recently developed Japanese version of START (STrAtegies for RelaTives). START is a psychosocial coping intervention program developed in the United Kingdom that has been shown to improve caregivers’ mood and quality of life in a randomized controlled trial. We made changes to START (e.g., idioms, linguistic nuance, and providing care insurance information suited for Japan) to make it culturally appropriate. Fourteen Japanese female family caregivers of relatives with mild dementia (n = 10) or mild cognitive impairment (n = 4) were referred to the study, but six were excluded owing to illness and busyness. This single-arm study had a before–after trial evaluating psychological outcomes including depression, anxiety, quality of life, and subjective care burden. The acceptance retention and satisfaction rate suggest the feasibility and acceptability of the START program; 8/14 ( 〉 55%) eligible, prospective participants consented and were included in this study, all (8/8) of whom completed all START sessions. The mean program satisfaction score was 30.25 (standard deviation = 2.25) out of a potential 32. The results suggest that it is feasible and acceptable to deliver START in Japanese and based on the results of analysis using a linear mixed model, there is initial indication that the intervention improved family caregivers’ quality of life, depressive symptoms, and care burden.
    Type of Medium: Online Resource
    ISSN: 1471-3012 , 1741-2684
    URL: Article
    DOI: 10.1177/1471301220919938
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2084045-7
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  • 3
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    Online Resource
    Modified Posterior Lumbar Interbody Fusion for Radiculopathy following Healed Vertebral Collapse of the Middle-Lower Lumbar Spine
    SAGE Publications ; 2014
    In:  Global Spine Journal Vol. 4, No. 4 ( 2014-12), p. 255-261
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 4, No. 4 ( 2014-12), p. 255-261
    Abstract: Retrospective study. Objectives Lumbar radiculopathy is rarely observed in patients who have achieved bony healing of vertebral fractures in the middle-lower lumbar spine. The objectives of the study were to clarify the clinical features of such radiculopathy and to evaluate the preliminary outcomes of treatment using a modified posterior lumbar interbody fusion (PLIF) procedure. Methods Fourteen patients with at least 2-year follow-up were enrolled in this study. The radiologic and clinical features of radiculopathy were retrospectively reviewed. As part of our modified PLIF procedure, a bone block was laid on chipped bone to fill the cavity of the fractured end plate and to flatten the cage–bone interface. Results The morphologic features of spinal deformity in our patients typically consisted of the intradiscal vacuum phenomenon, spondylolisthesis, and a retropulsed intervertebral disk with a vertebral rim in the damaged segment. Cranial end plate fracture resulted in radiculopathy of the traversing nerve roots due to lateral recess stenosis. On the other hand, caudal end plate fracture led to unilateral radiculopathy of the exiting nerve root due to foraminal stenosis. The mean recovery rate based on the Japanese Orthopaedic Association score was 65.0%. Solid fusion was achieved in all but one case. Conclusions Because of severe deterioration of the anterior column following end plate fracture, the foraminal zone must be decompressed in caudal end plate fractures. The modified PLIF procedure yielded satisfactory clinical outcomes due to anterior reconstruction and full decompression for both foraminal and lateral recess stenoses.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1394124
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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  • 4
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    Online Resource
    Neurogenic Shock Immediately following Posterior Lumbar Interbody Fusion: Report of Two Cases
    SAGE Publications ; 2015
    In:  Global Spine Journal Vol. 5, No. 4 ( 2015-08), p. 13-16
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 5, No. 4 ( 2015-08), p. 13-16
    Abstract: Case report. Objective To present two cases of neurogenic shock that occurred immediately following posterior lumbar interbody fusion (PLIF) and that appeared to have been caused by the vasovagal reflex after dural injury and incarceration of the cauda equina. Case Report We present two cases of neurogenic shock that occurred immediately following PLIF. One patient had bradycardia, and the other developed cardiac arrest just after closing the surgical incision and opening the drainage tube. Cardiopulmonary resuscitation was performed immediately, and the patients recovered successfully, but they showed severe motor loss after awakening. The results of laboratory data, chest X-ray, electrocardiogram, computed tomography, and echocardiography ruled out pulmonary embolism, hemorrhagic shock, and cardiogenic shock. Although the reasons for the postoperative shock were obscure, reoperation was performed to explore the cause of paralysis. At reoperation, a cerebrospinal fluid collection and the incarceration of multiple cauda equina rootlets through a small dural tear were observed. The incarcerated cauda equina rootlets were reduced, and the dural defect was closed. In both cases, the reoperation was uneventful. From the intraoperative findings at reoperation, it was thought that the pathology was neurogenic shock via the vasovagal reflex. Conclusion Incarceration of multiple cauda equina rootlets following the accidental dural tear by suction drainage caused a sudden decrease of cerebrospinal fluid pressure and traction of the cauda equina, which may have led to the vasovagal reflex.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1395422
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 5
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    Adjacent Segment Disease After Posterior Lumbar Interbody Fusion: A Case Series of 1000 Patients
    SAGE Publications ; 2018
    In:  Global Spine Journal Vol. 8, No. 7 ( 2018-10), p. 722-727
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 8, No. 7 ( 2018-10), p. 722-727
    Abstract: Retrospective study. Objective: There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD incidence and time periods by fusion length, age, and preoperative pathologies. Methods: A total of 1000 patients (average age 67 years, average follow-up 8.3 years) who underwent PLIF for degenerative lumbar disorders were reviewed. ASD was defined as a symptomatic condition in which revision surgery was required. Results: The overall ASD rate was 9.0%, and the average ASD period was 4.7 years after primary surgery. With respect to clinical features of ASD, degenerative spondylolisthesis at the cranial fusion segment was the most frequent. In terms of repeat ASD, second and third ASD incidences were 1.1% and 0.4%, respectively. As for ASD by fusion length, age, and preoperative pathologies, ASD incidence was increased by fusion length, while the time period to ASD was significantly shorter in elderly patients and those with degenerative lumbar scoliosis. Conclusions: In the present study, the overall ASD incidence was 9.0%, and the average ASD period was 4.7 years after primary operation. Second and third ASD incidences were 1.1% and 0.4%, respectively. Fusion length affected the ASD incidence, while aging factor and preoperative pathology affected the ASD time period.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568218766488
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 6
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    Lifestyle-Related Diseases Affect Surgical Outcomes after Posterior Lumbar Interbody Fusion
    SAGE Publications ; 2016
    In:  Global Spine Journal Vol. 6, No. 1 ( 2016-02), p. 2-6
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 6, No. 1 ( 2016-02), p. 2-6
    Abstract: Retrospective study. Objective Hyperlipidemia (HL) and hypertension (HT) lead to systemic atherosclerosis. Not only atherosclerosis but also bone fragility and/or low bone mineral density result from diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to examine whether these lifestyle-related diseases affected surgical outcomes after posterior lumbar interbody fusion (PLIF). Methods The subjects comprised 122 consecutive patients who underwent single-level PLIF for degenerative lumbar spinal disorders. The clinical results were assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2 years postoperatively. The fusion status was graded as union in situ, collapsed union, or nonunion at 2 years after surgery. The abdominal aorta calcification (AAC) score was assessed using preoperative lateral radiographs of the lumbar spine. Results HL did not significantly affect the JOA score recovery rate. On the other hand, HT and CKD (stage 3 to 4) had a significant adverse effect on the recovery rate. The recovery rate was also lower in the DM group than in the non-DM group, but the difference was not significant. The AAC score was negatively correlated with the JOA score recovery rate. The fusion status was not significantly affected by HL, HT, DM, or CKD; however, the AAC score was significantly higher in the collapsed union and nonunion group than in the union in situ group. Conclusions At 2 years after PLIF, the presence of HT, CKD, and AAC was associated with significantly worse clinical outcomes, and advanced AAC significantly affected fusion status.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0035-1554774
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 7
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    Online Resource
    Age-Related Surgical Outcomes of Laminoplasty for Cervical Spondylotic Myelopathy
    SAGE Publications ; 2015
    In:  Global Spine Journal Vol. 5, No. 2 ( 2015-04), p. 118-123
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 5, No. 2 ( 2015-04), p. 118-123
    Abstract: Retrospective clinical study. Objective To investigate the age-related surgical outcomes of laminoplasty. Methods One hundred patients who underwent an en bloc laminoplasty for cervical spondylotic myelopathy from 2004 to 2008 and were followed for at least 1 year were included in this study. The clinical outcomes were assessed with the Japanese Orthopaedic Association (JOA) score. Acquired points (postoperative JOA score minus preoperative JOA score) were also calculated. To investigate the age-related effect for laminoplasty, two analyses were conducted: (1) the correlation between age and clinical outcome; and (2) the clinical outcomes by decade. Patients were divided into four groups according to their age at the time of operation as follows: group 50s, 50 to 59 years old; group 60s, 60 to 69 years; group 70s, 70 to 79 years; and group 80s, 80 to 89 years. The pre- and postoperative JOA scores, acquired points, preoperative comorbidities, and postoperative complications were then compared among the groups. Results Significant correlations were detected between age and JOA scores at the preoperative ( p = 0.03), postoperative maximum ( p  〈  0.0001), and final assessments ( p  〈  0.0001). An age-related decline of JOA scores was observed over all periods. The analysis by decades showed the same results. On the other hand, the significant differences were not found for acquired points over all periods by either method. The preoperative comorbidities of hypertension and diabetes mellitus increased with age. Delirium was more common postoperatively in elderly patients. Conclusions Although an age-related decline of JOA scores was found over all periods, there were no severe sequelae and no differences in the acquired points that were age-related.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1396759
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 8
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    Online Resource
    Symptomatic Adjacent Segment Pathology after Posterior Lumbar Interbody Fusion for Adult Low-Grade Isthmic Spondylolisthesis
    SAGE Publications ; 2013
    In:  Global Spine Journal Vol. 3, No. 4 ( 2013-12), p. 219-224
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 3, No. 4 ( 2013-12), p. 219-224
    Abstract: The incidence of symptomatic adjacent segment pathology (ASP) after fusion surgery for adult low-grade isthmic spondylolisthesis (IS) has been reported to be relatively low compared with other lumbar disease entities. However, there has been no study of symptomatic ASP incidence using posterior lumbar interbody fusion (PLIF) with pedicle screw instrumentation. We investigated the incidence of symptomatic ASP after PLIF with pedicle screw instrumentation for adult low-grade IS and identified significant risk factors for symptomatic ASP. We retrospectively studied records of 40 consecutive patients who underwent PLIF with pedicle screw instrumentation at the Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Japan. The patients were followed for ≥ 4 years. Patients’ medical records were retrospectively examined for evidence of symptomatic ASP. Age at time of surgery, sex, fusion level, whole lumbar lordosis, segmental lordosis, preexisting laminar inclination angle, and facet tropism at the cranial fusion segment were analyzed to identify risk factors for symptomatic ASP. Four patients (ASP group) developed symptomatic ASP at the cranial segment adjacent to the fusion. There were no significant differences in age, sex, fusion level, lumbar lordosis, segmental lordosis, or facet tropism at the cranial segment adjacent to the fusion between the ASP and the non-ASP groups. In contrast, laminar inclination angle at the cranial vertebra adjacent to the fusion was significantly higher in the ASP group than in the non-ASP group. Four patients (10%) developed symptomatic ASP after PLIF with transpedicular fixation for adult low-grade IS. Preexisting laminar horizontalization at the cranial vertebra adjacent to the fusion was a significant risk factor for symptomatic ASP.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0033-1348088
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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