127 research outputs found
MRI of Early-Stage Lumbar Spondylolysis
Purpose : To analyze extraosseous signal changes (ESCs) on magnetic resonance imaging (MRI) in pediatric patients with stress fractures occurring in the lamina. Methods : This study was a retrospective review of 69 consecutive pediatric patients with stress fractures occurring in the lamina. We analyzed MRI scans obtained at the first presentation. Results : We used mainly axial short tau inversion recovery images acquired through the pedicle of these 84 fracture sites to identify the ESCs. These were then divided into three groups: “invisible” when no ESC was detected, “periosteal” for ESC seen on only the dorsal side of the lamina, and “perimuscular” for ESC distinctly spread around / in the paravertebral muscles. In total, 78 (92.9%) fracture sites showed ESCs on the dorsal side of the lamina among which 72 ESCs were located on only the “dorsal” side, while 6 ESCs were on the ventral side against the transverse process. Conclusion : ESCs on MRI were detected in more than 90% of patients before stress fracture became apparent in the lamina, which was considered similar to findings of periosteal thickening / edema detected at the onset of stress fracture in long bone
Retrospective Cohort Study Showing Clinical Equivalence of Microendoscopic Laminotomy to Open Fenestration for Patients with Lumbar Spinal Stenosis
Objective Despite the popularity of microendoscopic disectomy, there is currently insufficient studies about microendoscopic laminotomy (MEL) for lumbar spinal stenosis. The purpose of this study was to compare the clinical and radiographic outcomes of MEL and fenestration (laminotomy in open procedure) for lumbar spinal stenosis. Methods This study included 30 patients in the MEL group and 46 patients in the open fenestration group between 2012 and 2016 (follow-up period ≥1 year). The Japanese Orthopedic Association Back Pain Evaluation Questionnaire(JOABPEQ), a visual analog scale(VAS), surgical outcomes, blood test outcomes, and radiographic parameters were studied. Results Mean age was 67 years old in the MEL group and 70 years old in the open fenestration group (p=0.1). There were no significant differences in score change of either domain of JOABPEQ between MEL and fenestration. The 95% confidence intervals of the between-group differences in score change were within clinical important difference (±20 point) in all the domains of JOABPEQ. The MEL group had significantly shorter hospital stays (9 days vs 13 days; p<0.001), smaller increase in C-reactive protein (1.7 mg/dL vs 2.9 mg/dL; p=0.009), and longer operating time (122 min vs 39 min; p<0.001) than the fenestration group. There was no significant difference in hemoglobin level, total protein, albumin, creatine kinase between the groups. The MEL group had one case of dural tear and the fenestration group had two cases(p=1.0). There was no significant differences in complication rate between the groups. There were no significant between-group differences in change of disc height or ROM. Conclusion In the treatment of lumbar spinal stenosis, the clinical effectiveness and safety of MEL was equivalent to that of fenestration, with less invasiveness
Retrospective Study of Selective Submandibular Neck Dissection versus Radical Neck Dissection for N0 or N1 Necks in Level I Patients with Oral Squamous Cell Carcinoma
Objective. To evaluate the efficacy of selective submandibular neck dissection (SMND) in patients with oral squamous cell carcinoma (OSCC) with or without nodal metastasis. Patients. From a total of 384 patients with untreated OSCC who underwent radical excision, we identified 229 with clinically N0 necks and 68 with clinically N1 necks in level I. Main Outcome Measures. The Kaplan-Meier 5-year regional control and 5-year disease specific survival (DSS) were compared for SMND, radical neck dissection (RND), and modified radical neck dissection (MRND). Results. In clinically node-negative necks, the regional control rates were 85.2% with SMND and 83.3% with MRND (P = 0.89), and 5-year DSS rates were 86.5% and 87.0%, respectively, (P = 0.94). In clinically N1 necks, the regional control rates were 81.3% with SMND and 83.0% with RND (P = 0.72), and the DSS rates were 81.3% and 80.0%, respectively, (P = 0.94). Type of neck dissection was not significantly associated with regional control or DSS on either univariate or multivariate analysis using Cox's proportional hazard model. Conclusions. SMND can be effectively applied in elective and therapeutic management to patients with OSCC that are clinically assessed as N0 or N1 to level I of the neck
<Abstract of Published Report>The Differences of Radius Bone Mineral Density among College Female Athletes and Their Life-Style.
<Abstract of Published Report>Actual Osteo Sono-assessment Index in the Calcaneus Evaluated by Ultrasound Method in Preschool Girls and its Relative Factor : Comparison with Their Mother.
<Abstract of Published Report>Comparison of the Radius Bone Density between the Right and Left Arms of Female College Badminton and Soft-tennis Players.
<Abstract of annual report>A Highly Sensitive Assay Method for Human Placental Alkaline Phosphatase Involving a Monoclonal Antibody Bound to a Paper Disk.
Orthosis stability and patient satisfaction
Purpose : To evaluate the stabilizing effects of a Fit Cure-Spine® semi-rigid thoracolumbar orthosis and wearer satisfaction after lumbar surgery. Methods : In study 1, the spinal angle, spinal motion angle, and distribution of load were measured in 8 adult male volunteers when the orthosis was worn (1) with no custom-made stay (CMS), (2) with a CMS in the prone position (P-CMS), and (3) with a CMS in the prone position and decreased lordosis (DP-CMS). In study 2, pain scale scores and responses to a questionnaire were recorded in 40 consecutive patients who underwent lumbar spinal surgery in our hospital. Results : In study 1, the mean lumbar lordosis when standing was similar to that in the prone position. When the trunk was bent forward, loads on the back support in P-CMS and DP-CMS were concentrated at the center of the CMS, unlike those for No-CMS. In study 2, there was a significant decrease in postoperative wound pain after wearing the Fit Cure-Spine orthosis for 2 weeks. Most patients who wore the orthosis were satisfied with their pain outcome. Conclusion : Adjustment to lumbar lordosis and the prone position was restricted in volunteers wearing the Fit Cure-Spine with a CMS
Clinical Study Retrospective Study of Selective Submandibular Neck Dissection versus Radical Neck Dissection for N0 or N1 Necks in Level I Patients with Oral Squamous Cell Carcinoma
Objective. To evaluate the efficacy of selective submandibular neck dissection (SMND) in patients with oral squamous cell carcinoma (OSCC) with or without nodal metastasis. Patients. From a total of 384 patients with untreated OSCC who underwent radical excision, we identified 229 with clinically N0 necks and 68 with clinically N1 necks in level I. Main Outcome Measures. The Kaplan-Meier 5-year regional control and 5-year disease specific survival (DSS) were compared for SMND, radical neck dissection (RND), and modified radical neck dissection (MRND). Results. In clinically node-negative necks, the regional control rates were 85.2% with SMND and 83.3% with MRND (P = 0.89), and 5-year DSS rates were 86.5% and 87.0%, respectively, (P = 0.94). In clinically N1 necks, the regional control rates were 81.3% with SMND and 83.0% with RND (P = 0.72), and the DSS rates were 81.3% and 80.0%, respectively, (P = 0.94). Type of neck dissection was not significantly associated with regional control or DSS on either univariate or multivariate analysis using Cox's proportional hazard model. Conclusions. SMND can be effectively applied in elective and therapeutic management to patients with OSCC that are clinically assessed as N0 or N1 to level I of the neck
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