Hodgkin's disease of the thoracic vertebrae

BACKGROUND CONTEXT: Hodgkin's disease rarely occurs in the spine, which is usually a setting for the advanced form of the disease. PURPOSE: To describe an unusual case of isolated, primary spinal Hodgkin's disease and to draw attention to this disease as a possible diagnosis in patients with mixed inflammatory cell infiltrate lesions located in the thoracic spine. STUDY DESIGN/SETTING: A case report of a 28-year-old woman who presented with back pain and progressive weakness in the lower extremities as a result of spinal cord compression from Hodgkin's disease of the thoracic vertebrae. METHODS: We report a new case of spinal cord compression resulting from Hodgkin's disease of the thoracic vertebrae. Decompression surgery was performed in the patient, followed by antibiotic treatment. RESULTS: Antibiotic therapy temporarily improved inflammation and fever. However, magnetic resonance imaging (MRI) evaluation showed that the inflammatory reaction in the lesion was not completely resolved. The disease progressed and later investigations revealed Hodgkin's disease, which improved with a course of chemotherapy and radiation. CONCLUSIONS: Hodgkin's disease should be considered in the differential diagnosis of spinal neoplastic lesions with clinical features similar to spondylitis. Because MRI evaluation showed that the vertebral disc was maintained in this case, the presence of a tumor rather than inflammation should have been suspected.ArticleSPINE JOURNAL. 13(8):E59-E63 (2013)journal articl

Accuracy of Multilevel Registration in Image-Guided Pedicle Screw Insertion for Adolescent Idiopathic Scoliosis

This is a non-final version of an article published in final form in SPINE 35(3): 347-352, 2010.Study Design. Retrospective clinical study. Objective. To assess the accuracy of multilevel registration for skip pedicle screw placement during image-guided, computer-assisted spine surgery, in the setting of adolescent idiopathic scoliosis (AIS). Summary of Background Data. Computerized frameless stereotactic image-guidance has been used recently to improve pedicle screw placement accurately and safety during spine surgery. Because of possible intervertebral motion and usual difference in patients' position between preoperative imaging and surgery, the imaging model and the surgically exposed spine may be significantly discordant. Consequently, current protocols suggested separate registration of each spinal level (single-level registration) before respective pedicle screw placement, a time-consuming process. Moreover, although multilevel registration for lumbar spine has been reported, and that for thoracic spine has not. Methods. A total of 19 patients ( 1 male and 18 females; mean age, 13.9 years) with AIS who underwent multilevel registration for skip pedicle screw placement were included. Variables including surgical time, blood loss, preoperative and 2-year postoperative Cobb angle, correction rate, and postoperative screw position by computed tomography image were evaluated. Mean registration error after point merge and again after surface merge were recorded for each consecutive vertebra of each case. Results. Mean surgical time was 310 minutes ( range, 168-420 min). Mean blood loss 1138 g (range, 300-2300 g). Cobb angle before operation and at 2 years postoperation was 62.4 degrees (43 degrees-100 degrees) and 21.6 degrees (9 degrees-42 degrees), respectively. Mean correction rate 66.2% (39.7%-84.5%). Total 265 screws were inserted with computed tomography-based navigation system. Pedicle violation was observed in only 4 screws (1.5%). No neurovascular complication occurred. After point merge, average Mean registration error of all cases was 1.69 +/- 0.52 mm, and after surface merge was 0.51 +/- 0.16 mm. Conclusion. Multilevel registration may decrease operative time without compromising accuracy of pedicle screw placement afforded by this technique in the setting of AIS.http://journals.lww.com/spinejournal/pages/default.aspx | http://journals.lww.com/spinejournal/pages/default.aspxArticleSPINE. 35(3):347-352 (2010)journal articl

Simultaneous multi-elemental analysis by continuous flow analysis system equipped with ICP-MS

The Tenth Symposium on Polar Science/Ordinary sessions: [OM] Polar Meteorology and Glaciology, Wed. 4 Dec. / Entrance Hall (1st floor) , National Institute of Polar Researc

Computer-assisted hemivertebral resection for congenital spinal deformity

No studies have reported on osteotomies utilizing a navigation system in congenital scoliosis surgery. This study aimed to evaluate the surgical outcomes of eight patients with congenital scoliosis or kyphoscoliosis due to hemivertebrae treated by computer-assisted hemivertebral resection using only a posterior approach. Eight consecutive patients (two scoliotics and six kyphoscoliotics) managed by computer-assisted hemivertebral resection using only a posterior approach with transpedicular instrumentation were investigated retrospectively. A CT-based navigation system was used to confirm the positions of the vertebra, spinal cord and aorta in real-time when we inserted a pedicle screw and conducted the osteotomy. The mean patient age at surgery was 18 years (range 11-41 years). The mean follow-up was 46 months (range 18-84 months). Before surgery, the mean kyphotic curve was 55.8A degrees (range 26-83A degrees), and the mean scoliotic curve was 50.0A degrees (range 36-62A degrees). At the final follow-up period, the curves averaged 23.2A degrees (range 15-40A degrees) and 31.6A degrees (range 21-44A degrees), respectively, yielding kyphotic angle corrections of 32.7A degrees (range 11-58A degrees) and Cobb angle correction rates of 36.8% (range 24.1-48.3%). A total of 72 pedicle screws were inserted with the navigation system, and two screws revealed a perforating pedicle. No neurovascular complications occurred. The perforation rate was 2.8%. Hemivertebral resection via a single posterior approach is less invasive than combined anterior and posterior approaches; however, this procedure increases the risk of spinal cord and vascular injuries. Computer-assisted hemivertebral resection enables safe and accurate performance of a hemivertebral resection via a single posterior approach.ArticleJOURNAL OF ORTHOPAEDIC SCIENCE. 16(5):503-509 (2011)journal articl

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

BACKGROUND CONTEXT: The EuroQol (EQ-5D) is a widely used comprehensive measure of health-related quality of life. There has been no study that has evaluated the health-related quality of life before and after the surgical reconstruction of rheumatoid arthritis (RA) cervical spine lesions using EQ-5D. PURPOSE: The present study aimed to evaluate the improvement of quality of life before and after surgical reconstruction of rheumatoid cervical spine using EQ-5D, and the surgical outcomes of cervical spine affected by RA. STUDY DESIGN: A retrospective study of the patients who underwent surgical reconstruction of cervical disorders in RA. PATIENT SAMPLE: Twenty-five patients (seven men, 18 women, mean age 62.2 years) who underwent surgical reconstruction of cervical disorders in RA were enrolled. OUTCOME MEASURES: Japanese Orthopaedic Association (JOA) score and EQ-5D. METHODS: Clinical symptoms were evaluated before surgery and at 2 years after surgery by measuring the JOA score. We also investigated health-related quality of life before surgery and outcome at 2 years after surgery using the EQ-5D questionnaire. RESULTS: Mean observation period was 46.3 months. Mean JOA score significantly improved from 9.1 +/- 4.5 points before surgery to 12.4 +/- 2.8 at the 2 years after surgery (p=.0001). All the EQ-5D data were improved at the 2 years after surgery, compared with the data before surgery; especially, pain (p=.005), usual activity (p=.005), mobility (p=.008), and anxiety/depression (p=.02) were significantly improved. Utility weight was 0.37 +/- 0.27 before surgery and 0.56 +/- 0.26 at the 2 years after surgery, showing significant improvement at the 2 years after surgery compared to before surgery (p=.002). CONCLUSIONS: The surgical reconstruction of rheumatoid cervical spine has been demonstrated to improve patients' health-related quality of life.ArticleSPINE JOURNAL. 13(4):391-396 (2013)journal articl

Continuous CH4 measurements with the NIPR CFA system

第6回極域科学シンポジウム分野横断セッション：[IA] 急変する北極気候システム及びその全球的な影響の総合的解明―GRENE北極気候変動研究事業研究成果報告2015―11月19日（木）　国立極地研究所１階交流アトリウ