fumio kasama - Academia.edu (original) (raw)

Papers by fumio kasama

Japanese Journal of Radiological Technology, 2007

$Research paper thumbnail of Equivalent values between anterior vertebral height, wedge ratio, and wedge angle in osteoporotic vertebral fractures$

Journal of Bone and Mineral Metabolism, Aug 22, 2021

Background Vertebral mobility (V-mobility) has been used to diagnose fresh osteoporotic vertebral... more Background Vertebral mobility (V-mobility) has been used to diagnose fresh osteoporotic vertebral fractures (OVFs) and determine bone union by setting cutoff values for these purposes. V-mobility is the difference in vertebral height on dynamic radiographs taken in the sitting and lateral decubitus or supine positions. The dimensions for V-mobility were presented as anterior vertebral height (Ha; mm), wedge ratio (WR; %), and wedge angle (WA; °) in previous reports. This study was performed to obtain WR and WA values equivalent to V-mobility of 1.0 mm in Ha. Methods Lateral radiographs of 284 OVFs (grade 1-3 deformed vertebrae) from T11 to L2 were obtained from 77 patients with OVF. V-mobility presented as Ha, posterior vertebral height, and WA was obtained by the difference in these dimensions on dynamic radiographs. The WR and WA values equivalent to 1.0 mm in Ha were obtained by dividing the V-mobility values for WR and WA by that for Ha. Results The mean WR values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 3.2% ± 1.4%, 3.2% ± 0.9%, and 3.4% ± 1.0%, respectively, and the corresponding value for grade 1-3 vertebrae was 3.3% ± 1.0%. The mean WA values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 1.5° ± 0.8°, 1.5° ± 0.6°, and 1.5° ± 0.8°, respectively, and the corresponding value for grade 1-3 vertebrae was 1.5° ± 0.7°. Conclusions The WR and WA values equivalent to V-mobility of 1.0 mm in Ha were 3.3% and 1.5°, respectively, in grade 1-3 vertebrae. These findings may be useful to secure a reliable value of V-mobility of OVFs using simultaneous measurements in three dimensions (Ha, WR, and WA) in clinical practice and to establish cutoff values for V-mobility to determine bone union.

Upsala Journal of Medical Sciences, 2008

Background: Post-traumatic contracture is a common complication after elbow trauma. If conservati... more Background: Post-traumatic contracture is a common complication after elbow trauma. If conservative therapy fails to restore adequate elbow motion, arthrolysis is indicated. The purposes of this study were to evaluate the clinical outcome of open arthrolysis for post-traumatic elbow contracture and to determine factors influencing the outcome. Methods: Twenty-seven patients with post-traumatic elbow contracture were followed-up after open arthrolysis for at least 12 months. Before surgery, the mean limitation in extension was 30° and the mean maximum flexion was 83°. A posterior surgical approach was used in 18 patients, and a lateral approach was employed in nine patients. Using the posterior approach, the fibrotic posterior capsule was excised and the ulnar collateral ligament was split. Both the anterior and posterior capsules were released with a lateral approach. Results: The mean flexion increased from 83° to 121°, but the mean extension improved little from-30° to-26°. The mean flexion-extension arc increased from 53° to 95°. According to the elbow evaluation score by the Japanese Orthopaedic Association, both pain and function scales improved significantly. By Hertel's subjective evaluation, the results were good in 13 patients, fair in ten patients, and poor in four patients. Twenty-three patients (85 percent) were satisfied with the results, but four were not satisfied because of residual contracture. These poor results were related to severe soft tissue trauma, residual displacement of intra-articular fragments, and recurrence of heterotopic bone formation. Conclusions: Tendon lengthening of stiff triceps, accurate reduction of intra-articular fragmens, and sharp epiperiosteal resection around the heterotopic bones are essential procedures of open arthrolysis to restore adequate motion in post-traumatic elbow contracture.

Tohoku Journal of Experimental Medicine, 2006

Thoracic myelopathy is defined as spinal cord compression in the thoracic region, leading to sens... more Thoracic myelopathy is defined as spinal cord compression in the thoracic region, leading to sensory and motor dysfunctions in the trunk and lower extremities, and can be caused by various degenerative processes of the spine. Thoracic myelopathy is rare, and there are many unsolved problems including its epidemiological and clinical features. We have established a registration system of spinal surgeries, which covered almost all surgeries in Miyagi Prefecture, and enrolled the data of 265 patients with thoracic myelopathy from 1988 to 2002. The annual rate of surgery gradually increased and averaged 0.9 per 100,000 inhabitants, which was less than 1/10 of that for cervical myelopathy. About 20 patients with thoracic myelopathy are operated on in Miyagi Prefecture each year. It frequently develops in middle-aged males. About half of the cases were caused by ossification of the ligamentum flavum, followed by ossification of the posterior longitudinal ligament, intervertebral disc herniation and posterior spur. Patients usually noticed numbness or pain in the legs and the preoperative duration was long, averaging 2 years. Its symptomatic similarities to lumbar disorders might cause difficulty in making a correct diagnosis. Since thoracic myelopathy can markedly restrict the activities of daily life, even general physicians should recognize this entity. thoracic myelopathy; epidemiological study; ossification of the ligamentum flavum; ossification of the posterior longitudinal ligament

Tohoku Journal of Experimental Medicine, 2016

Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the t... more Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the trunk and/or extremities, which could eventually disturb locomotive functions. For ensuring safe and high-quality treatment of spinal disorders, in 1987, the Tohoku University Spine Society (TUSS) was established by orthopedic departments in Tohoku University School of Medicine and its affiliated hospitals in and around Miyagi Prefecture. All spine surgeries have been enrolled in the TUSS Spine Registry since 1988. Using the data from this registration system between 1988 and 2012, we demonstrate here the longitudinal changes in surgical trends for spinal disorders in Japan that has rushed into the most advanced "aging society" in the world. In total, data on 56,744 surgeries were retrieved. The number of spinal surgeries has annually increased approximately 4-fold. There was a particular increase among patients aged ≥ 70 years and those aged ≥ 80 years, with a 20-to 90-fold increase. Nearly 90% of the spinal operations were performed for degenerative disorders, with their number increasing approximately 5-fold from 705 to 3,448. The most common disease for surgery was lumbar spinal stenosis (LSS) (35.9%), followed by lumbar disc herniation (27.7%) and cervical myelopathy (19.8%). In 2012, approximately half of the patients with LSS and cervical myelopathy were ≥ 70 years of age. In conclusion, the number of spinal operations markedly increased during the 25-year period, particularly among older patients. As Japan has a notably aged population, the present study could provide a near-future model for countries with aging population.

Spinal Cord, Nov 10, 2009

Study design: Prospective multicenter study. Objective: To clarify the significance of intramedul... more Study design: Prospective multicenter study. Objective: To clarify the significance of intramedullary Gd-DTPA enhancement in cervical myelopathy, the prevalence, morphologic features, clinical relevance and postoperative change were investigated. Setting: Four hospitals in Japan. Methods: A total of 683 patients with cervical myelopathy who underwent decompressive surgery were consecutively examined. T1, 2 and Gd-DTPA-enhanced MRI were taken before surgery. Fifty consecutive cases without intramedullary enhancement were allocated in the non-enhancement group. The following variables were investigated: prevalence of the enhancement, the morphologic feature, the relationship between the enhancement and T2 high-intensity areas, the change of the Japanese Orthopedic Association (JOA) score for cervical myelopathy and the change of the enhancement after surgery. Results: Intramedullary enhancement was observed in 50 cases (7.3%). The enhancements were observed between the most severely compressed disc and the cranial half of the lower vertebral body. On axial images, they were observed at the posterior or posterolateral periphery of the spinal cord. Enhancement areas were observed within T2 high-intensity areas and smaller than them. The preoperative JOA score was 9.8±2.8 points in the enhancement group and 9.8±3.3 points in the nonenhancement group (NS). The postoperative JOA score was 12.7 ± 2.9 points in the enhancement group and 14.2±2.4 in the non-enhancement group (P ¼ 0.006). Intramedullary enhancement disappeared in 60% of the patients 1 year after surgery. Conclusion: Intramedullary enhancement indicated not the severity of preoperative symptoms, but a sign of a worse prognosis.

Journal of Orthopaedic Science, May 1, 2023

BACKGROUND Facet cysts in the subaxial cervical spine are a relatively rare cause of neuropathy. ... more BACKGROUND Facet cysts in the subaxial cervical spine are a relatively rare cause of neuropathy. This case series aimed to investigate the radiological and histopathological features and surgical results of these lesions, and provide possible mechanisms of cyst development. METHODS Thirteen subaxial cervical facet cysts in 12 patients were diagnosed on the basis of magnetic resonance imaging and computed tomography with facet arthrography. Surgical outcomes were evaluated according to the Japanese Orthopaedic Association scores for cervical myelopathy, or Tanaka's scores for cervical radiculopathy. These results were presented in combination with a scoping review of the literature. RESULTS Seven cysts were found in the posteromedial region, and six in the posterolateral portion of the spinal canal. Computed tomography revealed degeneration of all involved facet joints. All patients underwent decompression, and the mean recovery rates of Japanese Orthopaedic Association scores and Tanaka's scores were 57.1% and 87.5%, respectively. Histopathologically, all cysts were continuous with the degenerated ligamentum flavum. In the scoping review, the patients' mean age was 65.1 years. The cysts were distributed as follows: 3.6% at C2-3, 10.7% at C3-4, 14.3% at C4-5, 5.4% at C5-6, 7.1% at C6-7, and 58.9% at C7-T1. The presenting symptoms were myelopathy (49.4%) and radiculopathy (50.0%). Radiologically, 55% and 45% of the cysts were of the posteromedial and posterolateral types. Of the patients, 76.9% underwent decompression only, and 23.1% had concomitant fusion. Cyst recurrence was not observed in the mean follow-up period of 15.1 months. CONCLUSIONS The pathogenesis of cysts is closely related to degenerative changes in the facet joint and ligamentum flavum, and rupture in degenerated ligaments can develop into a cavity, which contributes to cyst formation. The scoping review suggests that cyst resection generally results in positive outcomes without recurrence in either decompression alone or concomitant fusion.

Journal of Bone and Mineral Metabolism, Mar 1, 1989

It has been reported that 1,25-dihydroxyvitamin D3 increases serum bone Gla-protein (BGP) in a sh... more It has been reported that 1,25-dihydroxyvitamin D3 increases serum bone Gla-protein (BGP) in a short period in osteoporotic patients as well as in normal subjects. There have been, however, no reports on serum BGP in osteoporotic patients under long term treatment with la-hydroxyvitamin D3. We measured serum BGP in 11 osteoporotic women treated with la-hydroxyvitamin D3 and calcium for 5-12 years, 8.4 years on average. Bone mineral density of distal radius was assessed by single photon absorptiometry. Other biochemical parameters such as serum alkaline phosphatase, fasting urinary hydroxyproline/creatinine and calcium/creatinine were also measured. Serum BGP levels were 6.25 + 0.36ng/ml (mean_+ S.E.), being all within the normal range (6.2 +_ 3.86ng/ml). We found no significant correlation between serum BGP and other biochemical parameters. Significant correlation was found neither between serum BGP and period of treatment nor between serum BGP and bone mineral density. Our result that serum BGP is within the normal range in osteoporotic patients whose bone mineral density has been maintained by long-term treatment suggests the normal bone turnover in these patients.

$Research paper thumbnail of Equivalent values between anterior vertebral height, wedge ratio, and wedge angle for evaluating vertebral mobility and deformity in osteoporotic vertebral fractures: a conventional observational study$

Journal of Orthopaedic Surgery and Research

Journal of Orthopaedic Science, 2022

Orthopedics, 1992

The long-term effect of 1α-hydroxyvitamin D 3 and calcium lactate in osteoporotic patients was ev... more The long-term effect of 1α-hydroxyvitamin D 3 and calcium lactate in osteoporotic patients was evaluated by the bone mineral density (BMD) measured at the distal one third and one sixth of the radius and by the vertebral fracture rate. Forty-five osteoporotic patients medicated for 1 to 13 years (treated group) and 11 osteoporotic patients with no medication for 1 to 3 years (control group) were compared. The BMD of the treated group remained unchanged for the first 4 (one-third site) and 6 years (one-sixth site), followed by significant decreases, whereas that of the control group decreased significantly at the second and third year. The effect on BMD was more prominent in the patients with lower initial BMD. The vertebral fracture rate of the treated group was significantly less than that in the control group at the third year. No serious side effects were recognized. Overall, we believe 1α-hydroxyvitamin D 3 with calcium supplement can be considered a safe and effective agent for...

$Research paper thumbnail of Equivalent values between anterior vertebral height, wedge ratio, and wedge angle in osteoporotic vertebral fractures$

Journal of Bone and Mineral Metabolism, 2021

$Research paper thumbnail of Correction to: Equivalent values between anterior vertebral height, wedge ratio, and wedge angle in osteoporotic vertebral fractures$

Journal of Bone and Mineral Metabolism, 2021

Spine Surgery and Related Research, 2019

Introduction: Laminoplasty is a common surgery for cervical myelopathy. Previous studies have ana... more Introduction: Laminoplasty is a common surgery for cervical myelopathy. Previous studies have analyzed the reoperation rates in posterior decompression surgeries of the cervical spine. However, few studies have solely focused on midlinesplitting laminoplasty (MSL) using a large number of patients. This aims to analyze the reoperation rates after MSL using the survival function method. Methods: Between 1988 and 2013, 4,208 MSLs were performed as a primary operation for cervical myelopathy and enrolled in our spinal surgery registration system. The Kaplan-Meier survival function method was used to analyze the rates of reoperation. Results: Of 4,208 patients with primary MSL, 40 underwent reoperation for neurological complications. The overall reoperation rate was 0.26%, 0.64%, 0.83%, 0.93%, and 0.95% at 1, 5, 10, 20, and >20 years, respectively. The causes of reoperation were postoperative cervical radiculopathy in 10 patients, stenosis at an adjacent level in 8, stenosis due to failed "open-door" lamina in 6, instability of the cervical spine in 4, cervical disc herniation in 3, elongation of ossification of the posterior longitudinal ligament in 3, spinal cord injury in 1, fracture of the cervical spine in 1, postoperative scar formation in 1, ossification of anterior longitudinal ligament in 1, and unknown in 2. The number of patients with surgical site infection (SSI) who needed surgical debridement was 34 (0.81%). Conclusions: Excluding reoperations for SSI, the reoperation rate of MSL was approximately 1.0% at the maximum of 26 years after surgery. MSL was determined to be a reliable surgical procedure regarding postoperative complications requiring additional surgeries.

The Journal of Bone & Joint Surgery, 1991

McCance, in 1947, apparently was the first to report the case of a patient who had adult-onset vi... more McCance, in 1947, apparently was the first to report the case of a patient who had adult-onset vitamin D-resistant osteomalacia, and the features of the disease were well described by Dent and Stamp in l971 . In most reports, including that of McCance, the disease was associated with tumors2, and that variant of the disease is now classified as tumor-induced osteomalacia9’2. The disease may be diagnosed as adult-onset vitamin D-resistant osteomalacia or as adult-onset idiopathic osteomalacia because there may be a tumor that is too small to be detected; often there is a lag between the diagnosis of osteomalacia and the discovery of the tumor’2. Recently, Ryan and Reiss pointed out that tu-