Author Kunisada, Toshiyuki| Fujiwara, Tomohiro| Hasei, Joe| Nakata, Eiji| Senda, Masuo| Ozaki, Toshifumi|
Note This fulltext will be available in Aug 2020|
Published Date 2019-08
Publication Title Clinical Orthopaedics and Related Research
Volume volume477
Issue issue8
Publisher Lippincott, Williams & Wilkins
Start Page 1892
End Page 1901
ISSN 0009-921X
NCID AA00607942
Content Type Journal Article
language 英語
OAI-PMH Set 岡山大学
File Version publisher
PubMed ID 30985613
DOI 10.1097/CORR.0000000000000764
Web of Science KeyUT 000509664400024
Related Url isVersionOf https://doi.org/10.1097/CORR.0000000000000764
JaLCDOI 10.18926/AMO/54807
FullText URL 70_6_449.pdf
Author Watanabe, Noriyuki| Sugimoto, Yoshihisa| Tanaka, Masato| Mazaki, Tetsuro| Arataki, Shinya| Takigawa, Tomoyuki| Kataoka, Masaki| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract 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.
Keywords metastatic epidural spinal cord compression American Spinal Injury Association Impairment Scale Tokuhashi score walking ability prognostic factor
Amo Type Original Article
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 449
End Page 453
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28003669
JaLCDOI 10.18926/AMO/53680
FullText URL 69_5_325.pdf
Author Okada, Yoshiki| Endo, Hirosuke| Mitani, Shigeru| Fujiwara, Kazuo| Tetsunaga, Tomonori| Kagawa, Yohei| Fujii, Yosuke| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15%, 9.0%, 6.0%, and 6.4%, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0%), minor bleeding in 2 cases (2.0%), persistent wound drainage in 3 cases (3.0%), and eruption in 1 case (1.0%). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0%) and progression of anemia in 1 case (1.0%). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.
Keywords total hip arthroplasty venous thromboembolism anticoagulant prophylaxis complications
Amo Type Erratum
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 325
End Page 325
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490031
Related Url http://doi.org/10.18926/AMO/53556
JaLCDOI 10.18926/AMO/53556
FullText URL 69_4_205.pdf
Author Okada, Yoshiki| Endo, Hirosuke| Mitani, Shigeru| Fujiwara, Kazuo| Tetsunaga, Tomonori| Kagawa, Yohei| Fujii, Yosuke| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15オ, 9.0オ, 6.0オ, and 6.4オ, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0オ), minor bleeding in 2 cases (2.0オ), persistent wound drainage in 3 cases (3.0オ), and eruption in 1 case (1.0オ). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0オ) and progression of anemia in 1 case (1.0オ). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.
Keywords total hip arthroplasty venous thromboembolism anticoagulant prophylaxis complications
Amo Type Original Article
Published Date 2015-08
Publication Title Acta Medica Okayama
Volume volume69
Issue issue4
Publisher Okayama University Medical School
Start Page 205
End Page 212
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26289911
Web of Science KeyUT 000365519100003
Related Url http://doi.org/10.18926/AMO/53680
Author Yoneda, Yasushi| Ito, Sachio| Kunisada, Toshiyuki| Morimoto, Yuki| Kanzaki, Hirotaka| Yoshida, Aki| Shimizu, Kenji| Ozaki, Toshifumi| Ouchida, Mamoru|
Published Date 2013-10-09
Publication Title PLoS ONE
Volume volume8
Issue issue10
Content Type Journal Article
Author Hasei, Joe| Sasaki, Tsuyoshi| Tazawa, Hiroshi| Osaki, Shuhei| Yamakawa, Yasuaki| Kunisada, Toshiyuki| Yoshida, Aki| Hashimoto, Yuuri| Onishi, Teppei| Uno, Futoshi| Kagawa, Shunsuke| Urata, Yasuo| Ozaki, Toshifumi| Fujiwara, Toshiyoshi|
Published Date 2013-03
Publication Title Molecular Cancer Therapeutics
Volume volume12
Issue issue3
Content Type Journal Article
JaLCDOI 10.18926/AMO/49670
FullText URL 67_2_113.pdf
Author Sugimoto, Yoshihisa| Tanaka, Masato| Gobara, Hideo| Misawa, Haruo| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract 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.
Keywords catheter embolization complication lumbar artery injury pedicle screw
Amo Type Case Report
Published Date 2013-04
Publication Title Acta Medica Okayama
Volume volume67
Issue issue2
Publisher Okayama University Medical School
Start Page 113
End Page 116
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23603928
Web of Science KeyUT 000317801700006
JaLCDOI 10.18926/AMO/49047
FullText URL 66_6_499.pdf
Author Sugimoto, Yoshihisa| Tanaka, Masato| Nakahara, Ryuichi| Misawa, Haruo| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract 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.
Keywords congenital scoliosis kyphosis navigation 3-dimensional models
Amo Type Case Report
Published Date 2012-12
Publication Title Acta Medica Okayama
Volume volume66
Issue issue6
Publisher Okayama University Medical School
Start Page 499
End Page 502
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23254585
Web of Science KeyUT 000312966100010
JaLCDOI 10.18926/AMO/48692
FullText URL 66_4_363.pdf
Author Tanaka, Masato| Sugimoto, Yoshihiro| Misawa, Haruo| Takigawa, Tomoyuki| Kunisada, Toshiyuki| Ozaki, Toshifumi|
Abstract Spinal deformity is an important clinical manifestation after surgery for spinal cord tumors. One-third of patients who receive laminectomies and irradiation of the spinal column develop scoliosis, kyphosis, or kyphoscoliosis. Recent reports indicate good results after scoliosis surgery using segmental pedicle screws and a navigation system, but these reported studies have not included surgery for post-laminectomy kyphosis. Hooks and wires are ineffective in such patients who undergo laminectomy, and there are also high perioperative risks with insertion of pedicle screws because landmarks have been lost. Here, we report on the 5-year follow-up of a 13-year-old male patient with post-laminectomy and post-irradiation thoracic kyphoscoliosis after surgical treatment of spinal astrocytoma. Posterior segmental pedicle screw fixation was performed safely using a computer-assisted technique. The authors present the first case report for treatment of this condition using a navigation system.
Keywords astrocytoma scoliosis kyphoscoliosis navigation segmental pedicle screw fixation
Amo Type Case Report
Published Date 2012-08
Publication Title Acta Medica Okayama
Volume volume66
Issue issue4
Publisher Okayama University Medical School
Start Page 363
End Page 368
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22918210
Web of Science KeyUT 000307918900010
JaLCDOI 10.18926/AMO/48560
FullText URL 66_3_213.pdf
Author Kataoka, Masaki| Kunisada, Toshiyuki| Tanaka, Masato| Takeda, Ken| Itani, Satoru| Sugimoto, Yoshihisa| Misawa, Haruo| Senda, Masuo| Nakahara, Shinnosuke| Ozaki, Toshifumi|
Abstract 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.
Keywords spine metastasis survival prognostic factor cancer
Amo Type Original Article
Published Date 2012-06
Publication Title Acta Medica Okayama
Volume volume66
Issue issue3
Publisher Okayama University Medical School
Start Page 213
End Page 219
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22729101
Web of Science KeyUT 000305669700004