Journal of Orthopaedic Science最新文献

{"title":"Reliability of the Risser+ grade for assessment of bone maturity in pediatric scoliosis cases: Investigation using standing and supine whole-spine radiograph","authors":"Takahiro Mui,&nbsp;Hideki Shigematsu,&nbsp;Masaki Ikejiri,&nbsp;Sachiko Kawasaki,&nbsp;Yasuhito Tanaka","doi":"10.1016/j.jos.2023.12.007","DOIUrl":"10.1016/j.jos.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Although several radiography-based systems for assessing skeletal maturity are available to clinicians, the classical Risser grading system remains a clinical gold standard. For scoliosis follow-up, a standing whole-spine radiograph is usually used. However, in our clinical practice, we have occasionally encountered cases in which ossification of the iliac crest is seen differently in the standing and supine whole-spine radiography. Here, we aimed to clarify the reliability of the Risser+ grading system for supine versus standing position radiographs.</div></div><div><h3>Methods</h3><div>This study recruited patients with all types of scoliosis who had been radiographed in both the standing and supine positions. We retrospectively evaluated the Risser+ grade of standing and supine whole-spine radiographs taken consecutively. Kappa statistics were computed to investigate the agreement between standing and supine Risser+ grades for this study.</div></div><div><h3>Results</h3><div>We evaluated 111 patients (age: 12.6 ± 2.0; male-to-female = 23:88). The Kappa value for the standing and supine Risser+ grade systems was 0.74. The degree of agreement between the two positions for each Risser+ grade revealed high agreement for grades 0 and 5 in all cases, whereas grades 2 and 3 had low agreement.</div></div><div><h3>Conclusions</h3><div>Overall, there was substantial agreement between the Risser+ grades assigned to standing and supine position radiographs. However, disagreement was observed between standing and supine position radiographs assigned Risser+ grades of 2 or 3. Therefore, we have found a wide range in the visibility of iliac apophysis ossification of the iliac depending on the posture, and there are limitations in assessing bone maturity using the Risser+ grade alone. Clinicians should use other evaluation systems, in addition to the Risser+ system, to achieve a more accurate bone maturity assessment, especially for cases with standing position radiographs assigned Risser grades of 2 or 3.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 73-77"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a compression staple on correction of varus deformity during arthroscopic ankle arthrodesis","authors":"Tomoyuki Nakasa ,&nbsp;Yasunari Ikuta ,&nbsp;Shingo Kawabata ,&nbsp;Satoru Sakurai ,&nbsp;Dan Moriwaki ,&nbsp;Nobuo Adachi","doi":"10.1016/j.jos.2024.03.003","DOIUrl":"10.1016/j.jos.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic ankle arthrodesis (AAA) has become popular because of its higher rate of bone union, lower invasiveness, and shorter hospital stays compared to those of open arthrodesis. However, postoperative malalignment is often observed for severe varus deformity, which can cause nonunion, pain, and adjacent joint arthrosis. A compression staple can provide a persistent, strong compressive force on the bone surface. This study aimed to clarify the difference in alignment correction in AAA by comparing a compression staple and screws fixation with screws-only fixation pre- and postoperatively.</div></div><div><h3>Methods</h3><div>Seventy ankles in 67 patients undergoing AAA were retrospectively reviewed. AAA with three screws through the distal tibia was performed in 53 ankles, and 17 ankles underwent AAA with a compression staple and two screws. After the preparation of the joint surface arthroscopically, patients in the S group had three canulated cancellous screws inserted through the medial tibia. Patients in the CS group had a compression staple placed at the lateral aspect of the tibiotalar joint and two screws inserted through the medial side. Clinical scores and pre-and postoperative alignment on plain radiographs were compared between the two procedures.</div></div><div><h3>Results</h3><div>There were no significant differences in the pre-and postoperative Japanese Society for Surgery of the Foot scale. One ankle in the S group exhibited nonunion. There were no significant differences in talar tilt and tibiotalar angles between the groups. The tibial plafond angle in the CS group was significantly lower than that in the S group (p &lt; 0.05). Postoperatively, talar tilt and tibiotalar angles on the coronal image, and the lateral tibiotalar angle in the CS group were significantly lower than those in the S group (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>AAA with a compression staple and two-screw fixations could obtain more optimal alignments than AAA with screw-only fixation, even in cases with severe varus deformity.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 113-118"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definitive internal fracture fixation followed by staged free flap coverage (“fix followed by flap” protocol) for open Gustilo type IIIB fractures","authors":"Masahiro Nishida ,&nbsp;Satoru Kamekura ,&nbsp;Izumi Nakada ,&nbsp;Manami Kiriyama ,&nbsp;Chihiro Maeda ,&nbsp;Ei Ozone ,&nbsp;Takahiro Goto","doi":"10.1016/j.jos.2024.03.006","DOIUrl":"10.1016/j.jos.2024.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Although the concept of the “fix and flap” approach, in which definitive fracture fixation and flap coverage are completed in a single procedure at the earliest opportunity may seem ideal for the treatment of Gustilo type IIIB open fractures, the individual circumstances of patients, such as polytrauma or multiple fracture cases may not allow for the immediate fracture fixation and flap coverage (“fix and flap” approach). In our hospital, patients with Gustilo type IIIB open fractures are treated with definitive internal fixation of the fracture followed by staged flap coverage (“fix followed by flap” protocol) when the “fix and flap” approach was not feasible due to the patient's condition or difficulty in coordinating surgery schedules. The “fix followed by flap” protocol provides benefits in terms of flexibility in adjusting the surgical timetable, simplifying the planning of flap coverage following fracture fixation, and minimizing individual surgical invasion.</div></div><div><h3>Methods</h3><div>We reviewed 10 cases of severe open fractures treated with the “fix followed by flap” protocol and evaluated their outcomes. All surgical procedures, including wound debridement, fracture fixation, and flap coverage, were performed by orthoplastic surgeons specializing in both fracture surgery and microsurgery including soft tissue reconstruction.</div></div><div><h3>Results</h3><div>All free flaps survived, and no partial necrosis was observed. None of the patients developed postoperative deep infection up to the last follow-up. Fracture union was achieved in all patients with or without autologous bone grafts. The median time for union was 9.4 months (range, 4–12 months).</div></div><div><h3>Conclusions</h3><div>This study presents favorable outcomes of treatment for Gustilo type IIIB open fractures with fracture fixation followed by staged flap coverage (“fix followed by flap” protocol). Despite a delay in flap coverage, the consistency of treatment provided by orthoplastic surgeons may have contributed to the favorable outcomes in this study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 142-146"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between restricted outings and geriatric locomotive function scale score in the general elderly population during the COVID-19 pandemic","authors":"Masashi Uehara ,&nbsp;Jun Takahashi ,&nbsp;Shota Ikegami ,&nbsp;Ryosuke Tokida ,&nbsp;Hikaru Nishimura ,&nbsp;Noriko Sakai ,&nbsp;Etsuo Chosa","doi":"10.1016/j.jos.2024.01.001","DOIUrl":"10.1016/j.jos.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Restrictions in daily activities due to coronavirus infection countermeasures reduced opportunities for physical activity and social participation in people of all ages. This study investigated the associations of restricted outings on locomotive function during the COVID-19 pandemic using a cohort of middle-aged and elderly community-dwelling residents.</div></div><div><h3>Methods</h3><div>Registered citizens of 50–89 years old were targeted for this investigation. We established 8 groups based on age (50's, 60's, 70's, and 80's) and gender (male and female) after random sampling from the basic resident registry of Obuse town in 2014. All participants were surveyed by a 25-question geriatric locomotive function scale (GLFS-25) at the time of checkup before the COVID-19 pandemic. Then, in 2021 and 2022 after government restrictions on outings were lifted for COVID-19 pandemic, all participants were mailed questionnaires including the GLFS-25. A total of 296 (143 male and 153 female) participants who responded at least once were included. We evaluated the changes in opportunities to go out between pre- and post-pandemic time points and the impact on GLFS-25 scores.</div></div><div><h3>Results</h3><div>In total, 128 (43.2%) respondents had fewer opportunities to go out than the previous year. Pre- and post-pandemic GLFS-25 scores in the decreased outing (+) group were significantly worse than in the decreased outing (−) group (both p &lt; 0.01). The final multivariate model revealed GLFS-25 score worsening beta coefficient of 0.27 for age (+10 years), 3.97 for male, 4.54 for decreased outings, and 4.46 for spinal canal stenosis.</div></div><div><h3>Conclusions</h3><div>In this randomly sampled Japanese cohort based on a resident registry, restricted outings during the COVID-19 pandemic was a significant independent factor associated with lower locomotive function.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 180-184"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and functional outcomes of varus displaced proximal humerus fractures","authors":"Sung Weon Jung,&nbsp;Jong Min Jeon,&nbsp;Chul Ho Lee","doi":"10.1016/j.jos.2024.02.005","DOIUrl":"10.1016/j.jos.2024.02.005","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to compare fracture characteristics and functional outcomes between patients with proximal humerus fractures with and without initial varus displacement.</div></div><div><h3>Methods</h3><div>A retrospective review of 325 patients with proximal humerus fractures was performed. Patients with initial varus displacement were placed in Varus cohort and were age- and sex-matched 1:1 with a second cohort presenting proximal humerus fractures without varus displacement, referred to as Fracture cohort. Varus fracture displacement was defined when the most proximal aspect of humeral head was below the most proximal aspect of greater tuberosity on initial radiographs, and the head shaft angle was &lt;130°.</div></div><div><h3>Results</h3><div>There were 60 patients in V cohort and 60 patients in F cohort. Statistical analysis revealed that there were significant differences in initial horizontal offset (38.8 vs. 45.9 mm), initial anterior angulation angle (36.5° vs. 16.4°), postoperative head shaft angle (132.2° vs. 141.3°), last head shaft angle (122.2° vs. 138.5°), difference for head shaft angles (10.0° vs. 2.7°), postoperative horizontal offset (43.4 vs. 45.3 mm), last horizontal offset (38.4 vs. 42.8 mm), difference for offsets (4.9 vs. 2.5 mm), complications (15 vs. 7 cases), and revision surgery (7 vs. 1 case) between two cohorts. Overall satisfactory results were achieved in most patients regardless of varus displacement, pain-VAS and Constant scores in V cohort were inferior to the scores in F cohort. The cut-off value of postoperative head shaft angle for good/excellent outcomes was 135.5° using receiver operating characteristic curve analyses.</div></div><div><h3>Conclusion</h3><div>Varus displaced proximal humerus fractures were accompanied by decreased horizontal offset and increased anterior angulation angle, and had a course of more varization and horizontal shortening compared with those without initial varus displacement. Patients with varus displaced fractures were associated with worse functional outcomes, and these factors might affect functional outcomes.</div></div><div><h3>Level of evidence</h3><div>Prognostic, cohort study, Level III.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 152-158"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of ulnar collateral ligament injury in baseball athletes: An online survey in Japanese surgeons","authors":"Shota Hoshika ,&nbsp;Kazunari Tomita ,&nbsp;Keisuke Matsuki ,&nbsp;Hiroshi Kusano ,&nbsp;Jun Yamakawa ,&nbsp;Shogo Yonekawa","doi":"10.1016/j.jos.2024.03.001","DOIUrl":"10.1016/j.jos.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div>The management of ulnar collateral ligament (UCL) injuries widely varies among surgeons. Although various treatment options have been proposed including surgical and conservative treatments, no golden standard treatment strategy has been established of yet. The American survey reported an overall experienced and well-trained cohort of surgeons often reached consensus opinions on how to approach UCL injury. However, the consensus among Japanese surgeons on the treatment of UCL injuries remains unclear. The purpose of this study was to survey current trends among Japanese orthopaedic surgeons in the treatment of UCL injuries in baseball players.</div></div><div><h3>Methods</h3><div>An online survey was distributed to the active members of the Japanese doctor's network for baseball injury prevention, which was formed by partial members of the medical committee in the Japan Baseball Council. The survey was composed of three sections: demographics of the surveyees, preferred operative and nonoperative management of UCL injuries, and five fictional clinical case scenarios of baseball players with a UCL injury.</div></div><div><h3>Results</h3><div>The 131 e-mailed invitations to society members yielded 78 completed online surveys with a participation rate of 60%. Sixty-four respondents (82%) reported &gt;15 years of clinical experience. Sixty-five respondents (83%) performed ≤5 UCL reconstructions per year. As nonsurgical management of UCL injuries, seventy-four surgeons (95%) preferred physiotherapy followed by intraarticular injection (46%). For surgical management, seventy-three surgeons (93%) preferred UCL reconstruction. Of the five case scenarios, a consensus was reached in three cases: to perform surgery on the patient with full-thickness UCL tear. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction.</div></div><div><h3>Conclusion</h3><div>Japanese doctors involved in the treatment of baseball injuries reached a consensus to indicate high-level athletes with a full-thickness UCL tear for surgery. When operative management was the preferred option, a consensus was reached to perform UCL reconstruction. These results may contribute to the decision-making for managing UCL injuries.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 96-100"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deap-seated infection and nonunion following internal fixation for Charcot foot deformity correction. A proportional meta-analysis of level 4 evidence","authors":"Konstantinos Tsikopoulos ,&nbsp;Konstantinos Sidiropoulos ,&nbsp;Gabriele Meroni ,&nbsp;Savvas Christofilos ,&nbsp;Konstantinos Kazamias ,&nbsp;Kirellos Said Abbas ,&nbsp;Periklis Papaioannou ,&nbsp;Dimitris Mavridis ,&nbsp;Venu Kavarthapu ,&nbsp;Panagiotis Givissis","doi":"10.1016/j.jos.2024.03.004","DOIUrl":"10.1016/j.jos.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Given the paucity of literature on the management of infected metalwork and nonunion in neuropathic diabetic patients, a meta-analysis was designed to investigate the two major complications following Charcot reconstruction performed by means of internal fixation methods.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus and CENTRAL until the 17^th of May 2022 for completed studies investigating outcomes following midfoot and/or hindfoot and/or ankle diabetic Charcot reconstruction. For a paper to qualify for inclusion, an internal fixation element should have been considered. Random effects meta-analysis of proportion was performed to calculate the rate of post-operative deep-seated infections with the associated amputation rate and nonunions by using Open Meta-analyst software. Sub-analysis linked to anatomical location of reconstruction was performed and the quality of the included studies was appraised using the Moga tool.</div></div><div><h3>Results</h3><div>Thirty studies with 492 eligible reconstructions were considered. Of those, deep-seated infections were diagnosed in 46 cases (Estimated proportion was 6.7%, 95% CI [4.2%–9.2%]). Debridement and antibiotic administration with or without metalwork removal were considered in the majority of the participants with successful clinical outcomes. Amputation was performed in 15 patients due to unmanageable post-operative infection and nonunion was reported in 17 studies (Estimated rates were 36.6%, 95% CI [18.4%–56.3%]; and 11.9%, 95%CI [6.6%–18.1%]; respectively).</div></div><div><h3>Conclusions</h3><div>Meta-analysis showed that although the overall risk of infection development is less than 10%, just below one third of the infected cases undergo late amputation. Moreover, internal fixation reconstructions carry a nonunion risk of just above 10%.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 119-125"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic nutrition index as a predictive factor for overall survival in trabectedin-treated advanced soft tissue sarcoma","authors":"Hideaki Sabe ,&nbsp;Satoshi Takenaka ,&nbsp;Shigeki Kakunaga ,&nbsp;Hironari Tamiya ,&nbsp;Toru Wakamatsu ,&nbsp;Sho Nakai ,&nbsp;Haruna Takami ,&nbsp;Yoshiki Yamada ,&nbsp;Seiji Okada","doi":"10.1016/j.jos.2024.02.004","DOIUrl":"10.1016/j.jos.2024.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Trabectedin binds covalently to the DNA minor groove and causes DNA to bend toward the main groove, then trabectedin regulates the transcription of the involved genes in cell proliferation or acts on the mononuclear phagocyte system in tumors, which contributes to its antitumor effects. Several clinical trials confirmed the efficacy of trabectedin for patients with advanced soft tissue sarcoma (STS) although clinically useful biomarkers remained unidentified. This study aimed to identify prognostic factors of trabectedin treatment, especially focusing on the systemic inflammatory, immune response, and nutritional status.</div></div><div><h3>Methods</h3><div>This study included 44 patients with advanced STS treated with trabectedin from January 2018 to August 2022. We evaluated the associations of clinical factors that influence the efficacy of trabectedin treatment with progression-free survival (PFS) and overall survival (OS), focusing on systemic inflammatory, immune response, and nutritional status represented by the absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), prognostic nutrition index (PNI), and C-reactive protein (CRP) using the Kaplan–Meier method and the log–rank test.</div></div><div><h3>Results</h3><div>ALC, LMR, PNI, NLR, PLR, and SIRI demonstrated no association with PFS. Patients with CRP of ≥0.3 had a significantly shorter PFS than those with CRP of &lt;0.3 (median PFS: 863 vs. 105 days, <em>P</em> = 0.045). PNI of ≥44 (median: 757 days vs. 232 days, <em>P</em> = 0.021) and CRP of &lt;0.3 (median: 877 days vs. 297 days, <em>P</em> = 0.043) were significantly good prognostic factors in terms of OS.</div></div><div><h3>Conclusions</h3><div>The study results indicate pretreatment PNI and CRP levels as prognostic factors for trabectedin treatment in advanced STS.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 171-179"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated number of spine surgeries and related deaths in Japan from 2014 to 2020","authors":"Kosei Nagata ,&nbsp;Chang Chang ,&nbsp;Mitsuhiro Nishizawa ,&nbsp;Koji Yamada","doi":"10.1016/j.jos.2023.12.006","DOIUrl":"10.1016/j.jos.2023.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The total number of spine surgeries per year and their related deaths in Japan has not been adequately estimated in the literature.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) between April 2014 to March 2021, which covers 99.9 % of health insurance claim receipts by general practitioners. The annual number of surgeries was counted using K codes, a procedure classification unique to Japan, and classified into the following six categories; percutaneous vertebroplasty, endoscopic surgery, open discectomy, laminoplasty/laminectomy, instrumentation surgery, and others. The data distribution was also summarized by sex and age. Additionally, by reviewing DPC database-related papers for evaluation of the mortality rate after spine surgery in Japan, the number of spine surgery-related deaths was calculated.</div></div><div><h3>Results</h3><div>The NDB showed that the number of spine surgeries analyzed in this study increased from 170,081 in 2014 to 193,903 in 2019, with a slight decrease in 2020. The ratio of instrumentation surgery increased from 33.0 % in 2014 to 37.9 % in 2020. The rate of patients aged 75 or older increased 31.6 % to 39.6 %. Combining these findings with DPC data showing a mortality rate of 0.1 % to 0.4 % revealed that the estimated number of deaths related to spine surgery in Japan ranged from 200 to 800 per year.</div></div><div><h3>Conclusions</h3><div>Approximately 200,000 spine surgeries and 200 to 800 spine surgery-related inpatient deaths were estimated to have occurred in Japan around 2020.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 32-38"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of multi-rod reinforcement on rod fractures in adult spinal deformity: A retrospective case series with a minimum follow up of 5 years","authors":"Yu Yamato ,&nbsp;Tomohiko Hasegawa ,&nbsp;Go Yoshida ,&nbsp;Tomohiro Banno ,&nbsp;Shin Oe ,&nbsp;Hideyuki Arima ,&nbsp;Koichiro Ide ,&nbsp;Tomohiro Yamada ,&nbsp;Kenta Kurosu ,&nbsp;Keiichi Nakai ,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jos.2024.01.010","DOIUrl":"10.1016/j.jos.2024.01.010","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the impact of the multi-rod construct on rod fractures over a minimum follow-up period of five years in comparison to that with the conventional two-rod construct using the same technique, rod composition, and rod reinforcement method.</div></div><div><h3>Methods</h3><div>Data were retrospectively retrieved from a prospectively collected, single-center database. Consecutive patients &gt;50 years of age who underwent thoracopelvic corrective fusion with planned two-stage anterior-posterior surgery and were followed up for at least five years were included in this study. The incidence of rod fracture in the conventional two-rod and multi-rod groups was investigated.</div></div><div><h3>Results</h3><div>A total of 58 patients (mean age, 68.9 years) were included in this study (follow-up rate, 73.4 %). Rod fracture was identified in 25 patients (43.1 %), within an average period of 25.1 months. The incidence of rod fracture in the multi-rod group was significantly lower than that in the two-rod group. However, there was no significant difference in the time to rod fracture between the two groups. Reinforcement of the multi-rod to the distal portion of the connector of the iliac screw had the lowest fracture rate and no cases of reoperation.</div></div><div><h3>Conclusions</h3><div>The incidence of rod fracture was significantly lower using multi-rod reinforcement, but the timing of rod fracture did not differ, compared to that with the two-rod construct using the same surgical technique and rod material. Multi-rod reinforcement covering the distal portion of the iliac screw is recommended to reduce the risk of fracture and reoperation.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"30 1","pages":"Pages 51-57"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}