Spine Surgery and Related Research最新文献

{"title":"The Essence of Clinical Practice Guidelines for Lumbar Spinal Stenosis, 2021: 2. Diagnosis and Evaluation.","authors":"Miho Sekiguchi","doi":"10.22603/ssrr.2022-0080","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0080","url":null,"abstract":"•In the middle-aged and elderly, if pain and numbness are experienced from the buttocks to the lower limbs and the symptoms are exacerbated when walking and standing but alleviated when in the sitting and flexed positions, lumbar spinal stenosis (LSS) is very likely. Intermittent claudication is a characteristic symptom of LSS, but it is important to differentiate it from vascular intermittent claudication. •The “Diagnostic Support Tool for Lumbar Spinal Stenosis” is a convenient and useful tool for screening patients.","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/c6/2432-261X-7-0300.PMC10447202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Brace-Related Stress on Brace Compliance in Adolescent Idiopathic Scoliosis: A Single-Center Comparative Study Using Objective Compliance Measurement and Brace-Related Stress.","authors":"Tomoyuki Asada,&nbsp;Toshiaki Kotani,&nbsp;Tsuyoshi Sakuma,&nbsp;Yasushi Iijima,&nbsp;Keita Nakayama,&nbsp;Kazuhide Inage,&nbsp;Yasuhiro Shiga,&nbsp;Tsutomu Akazawa,&nbsp;Shohei Minami,&nbsp;Seiji Ohtori,&nbsp;Masao Koda,&nbsp;Masashi Yamazaki","doi":"10.22603/ssrr.2022-0246","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0246","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the brace compliance and clinical background of patients with adolescent idiopathic scoliosis (AIS) who demonstrate different degrees of psychological brace-related stress.</p><p><strong>Methods: </strong>Forty-five patients initiating brace treatment with a Cobb angle between 25° and 45° were included. Patients receiving brace treatment for AIS were administered a questionnaire for brace-related stress (i.e., the Japanese version of the Bad Sobernheim Stress Questionnaire-Brace [JBSSQ-brace]). Based on their scores, we allocated the patients into two stress groups: mild-stress (≥16 points) and below-moderate-stress (<16 points). We investigated the character of brace compliance and brace-related psychological stress in all patients and compared the demographics and brace compliance between both groups.</p><p><strong>Results: </strong>Forty-one of 45 patients completed the study. The mean JBSSQ-brace scores were 18.7±5.1, 19.1±5.2, and 18.7±5.0 points at the 1-month, 4-month, and 1-year follow-ups, respectively. There was no significant change in JBSSQ-brace scores over one year after the brace prescription (<i>P</i>=0.332). There was no difference in-brace compliance between seasons during the first month of brace prescription (<i>P</i>=0.252). Both groups' overall brace compliance was comparable (below-moderate: 17.1±7.1 h/day vs. mild: 20.4±3.0 h/day; <i>P</i>=0.078). The mild-stress group showed better compliance than the below-moderate-stress group on weekdays (below-moderate: 17.0±6.9 h/day vs. mild: 20.5±2.8 h/day; <i>P</i>=0.048) and at nighttime (below-moderate: 82.3%±27.0%/nighttime vs. mild: 93.8%±12.4%/nighttime; <i>P</i>=0.008).</p><p><strong>Conclusions: </strong>Overall, brace compliance was comparable among patients with different brace-related stress, but brace compliance during weekdays and nighttime was significantly better in the mild-stress group.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/5a/2432-261X-7-0377.PMC10447194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Essence of Clinical Practice Guidelines for Lumbar Spinal Stenosis, 2021: 5. Postoperative Prognosis.","authors":"Miho Sekiguchi","doi":"10.22603/ssrr.2022-0082","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0082","url":null,"abstract":"Preoperative numbness at rest (OR 85.6) was associated with residual leg pain/numbness, and preoperative numbness at rest (OR 4.5) and foot drop (OR 11.6, 95% CI 2.5-59.1) were associated with residual gait disturbance. The degree of symptoms after surgery was stronger in the DM group than in the non-DM group. It is necessary to explain that leg numbness and pain tend to remain when performing surgery on LSS patients with DM. The mechanism of leg cramps is complex and remains inconclusive. Therefore, it cannot be confirmed whether leg cramps are a symptom of LSS or a comorbidity. Poor Prognostic Factors for Surgical Outcomes of LSS","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/9b/2432-261X-7-0314.PMC10447196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Dislocation Fracture Complicated by a Serious Electric Shock Injury: A Case Report.","authors":"Ryosuke Hirota,&nbsp;Atsushi Teramoto,&nbsp;Mitsumasa Chiba,&nbsp;Masahiro Onuma,&nbsp;Hidetomo Narimatsu,&nbsp;Takatoshi Yotsuyanagi,&nbsp;Toshihiko Yamashita","doi":"10.22603/ssrr.2023-0007","DOIUrl":"https://doi.org/10.22603/ssrr.2023-0007","url":null,"abstract":"The patient, a 14-year-old boy, was injured after he collided with a high-voltage power line, which led to his loss of consciousness and caused him to fall from a 20-meterhigh steel tower. After being taken to a nearby hospital, he was flown by helicopter to our hospital for multidisciplinary treatment, where he was administered light sedation for pain relief. His initial measurements were 112/68-mmHg blood pressure, 118-beats/min heartbeat, respiratory rate of 15 breaths/ min, SpO2 of 100%, and body temperature of 38.0°C. His posterior neck, chest, and back were all severely burned (Fig. 1), and he had lost all motor and sensory function caudally from the Th10 level. He was diagnosed with an electric shock injury, a Th 10/11 dislocation fracture (AO type classification; type C), and a complete thoracic spinal cord injury. Concomitant injuries included Th 7.8.9.12 fractures, right hemothorax, left hemothorax, and multiple rib fractures (Fig. 2A-D). MRI revealed a complete spinal cord tear at the Th10/11 level (Fig. 2E). The paraspinal muscles showed high signals on MRI T2 weighted imaging, respectively (Fig. 2F-G). After confirming partial dislocation repair by manual traction under fluoroscopic guidance, we performed percutaneous posterior stabilization (Th5-L2) with percutaneous pedicle screws (PPS) without bone fusion. Relatively good realignment was achieved by intraoperative compression of the injured area in the supine position (Fig. 3A-D). On day 20 after injury, Th7-12 anterior intervertebral body fusion was performed via the extraperitoneal approach to reconstruct the anterior column (Fig. 3E-H). Debridement of burned skin was performed on the 5th, and skin grafting on the back was performed on the 35th day after the injury, respectively. The grafted skin survived well, and the wound healed completely on day 47 (Fig. 4). Rehabilitation, including wheelchair mobility training, could be started after two-stage spine surgery. On the 70th day after the injury, the wound was well-healed, and the patient was transferred to a nearby hospital. Electric shock injuries may be accompanied by deep tissue injury to the nerves, blood vessels, muscles, and bones. To our knowledge, this is the first report of severe electroshock injury combined with spinal cord injury. Recently, the concept of spine damage control has been reported in the field of spine trauma injuries, often accompanied by complications caused by high-energy trauma, such as iliac and pelvic ring fractures. Early stabilization of the spinal column promotes hemodynamic stability, respiratory failure, and systemic management and prevents complications. Initial stabilization with PPS and two-stage anterior strut reconstruction may be helpful in cases of high spinal instability and soft tissue damage. In this case, early surgery allowed good alignment without direct visual repair of the injured area. Electroshock wounds generally result in deep tissue damage, resulting in deep tissue necros","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/ab/2432-261X-7-0410.PMC10447183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10163405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Essence of Clinical Practice Guidelines for Lumbar Spinal Stenosis, 2021: 1. Definition, Epidemiology, and Natural History.","authors":"Miho Sekiguchi","doi":"10.22603/ssrr.2022-0079","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0079","url":null,"abstract":"Based on a historical background, LSS is not a single disease but a combination of various symptoms. At present, there is no uniform view on the definition of LSS. Disorders of the nervous and/or vascular elements are caused by the lumbar spinal canal or intervertebral foramen (anatomically not included in the spinal canal), and they induce symptoms in patients with LSS. In this edition, the diagnostic criteria (draft) of the 1 edition were revised, and the diagnostic criteria for LSS are proposed as follows: 1) presence of pain and numbness from the buttocks to the lower limbs, 2) symptoms from the buttocks to the lower limbs that appear or are exacerbated by continuous standing or walking and are alleviated with the maintenance of a forward flexion or sitting position, 3) either with or without low back pain, and 4) presence of findings of degenerative stenosis in imaging results, such as MRI, that can explain clinical findings. There is no consensus on the LSS definition as the etiology and pathological changes have not been completely elucidated.","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/cb/2432-261X-7-0298.PMC10447198.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Essence of Clinical Practice Guidelines for Lumbar Spinal Stenosis, 2021: 3. Conservative Treatment.","authors":"Katsushi Takeshita","doi":"10.22603/ssrr.2022-0081","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0081","url":null,"abstract":"The","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/66/2432-261X-7-0306.PMC10447185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to the Essence of Clinical Practice Guidelines for Lumbar Spinal Stenosis, 2021.","authors":"","doi":"10.22603/ssrr.2023-0109","DOIUrl":"https://doi.org/10.22603/ssrr.2023-0109","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447188/pdf/2432-261X-7-0297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Respiratory Dysfunction and Dysphagia in Individuals with Acute Traumatic Cervical Spinal Cord Injury.","authors":"Yuki Matsumoto,&nbsp;Tetsuo Hayashi,&nbsp;Yuichi Fujiwara,&nbsp;Kensuke Kubota,&nbsp;Muneaki Masuda,&nbsp;Osamu Kawano,&nbsp;Takeshi Maeda","doi":"10.22603/ssrr.2022-0180","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0180","url":null,"abstract":"<p><strong>Introduction: </strong>Aspiration pneumonia is one of the most frequent and fatal life-threatening complications among individuals with acute traumatic cervical spinal cord injury (CSCI). However, the mechanism of dysphagia among individuals with CSCI is not well understood. Morbidity and mortality associated with CSCI may result from the interplay between respiratory dysfunction and dysphagia. This study aimed to elucidate the effect of respiratory dysfunction on the swallowing function of individuals with acute traumatic CSCI.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving 54 individuals with acute traumatic CSCI who were admitted within 2 weeks following injury. Dysphagia was evaluated using the Dysphagia Severity Scale (DSS) and the Functional Oral Intake Scale (FOIS). Respiratory function was evaluated by measuring the cough peak flow (CPF), forced expiratory volume in 1 s (FEV_1.0), FEV_1.0/forced vital capacity (FEV_1.0%), and percent vital capacity (%VC). We recorded these parameters at weeks 2, 4, 8, and 12 following injury and analyzed pertinent changes over time and significant correlations.</p><p><strong>Results: </strong>Among 54 individuals (46 men and 8 women) recruited in this study, 48 (88.9%) had restrictive ventilatory impairment and 17 (31.5%) had severe dysphagia (DSS level 1-4) 2 weeks following injury. However, respiratory function and swallowing function significantly improved thereafter. CPF, FEV_1.0, and %VC were significantly correlated with the severity of dysphagia during each period.</p><p><strong>Conclusions: </strong>Restrictive ventilatory impairment, poor cough force, and dysphagia are closely related, and the evaluation of respiratory function plays an important role in evaluating dysphagia.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/3c/2432-261X-7-0327.PMC10447182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Spina Bifida Occulta on Bone Union in Fifth Lumbar Spondylolysis.","authors":"Hisanori Gamada,&nbsp;Masaki Tatsumura,&nbsp;Shun Okuwaki,&nbsp;Toru Funayama,&nbsp;Masashi Yamazaki","doi":"10.22603/ssrr.2022-0255","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0255","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of spina bifida occulta (SBO) on bone union in lumbar spondylolysis is controversial. The study aim was to assess the effect of SBO on bone union after conservative treatment of L5 spondylolysis, the most common level.</p><p><strong>Methods: </strong>The study included 191 lesions in 145 patients (mean age, 14.0 years) with conservatively treated L5 spondylolysis. We examined the relationships between bone union after conservative treatment and the number of SBOs, levels, and single or multilevel status. Fisher's exact probability test, chi-square test, and Welch's T test were performed.</p><p><strong>Results: </strong>The SBO incidence was 53%, with at least one SBO at any vertebral level. SBO at S1 (<i>p</i>=0.034) or S2 (<i>p</i>=0.0003), two SBOs (<i>p</i>=0.0018), and three SBOs (<i>p</i>=0.011) were associated with a lower bone union rate. The bone union rate was significantly lower for lesions with SBOs at both S1 and S2 than without (42% vs. 79%; <i>p</i><0.0001).</p><p><strong>Conclusions: </strong>The SBO incidence in L5 spondylolysis was 53%. SBO at S1 or S2 and a higher number of SBOs were associated with lower bone union rates. In particular, the bone union rate of lesions with SBOs at both S1 and S2 was <50%.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/f2/2432-261X-7-0390.PMC10447187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors for Pneumonia in the Chronic Phase of Cervical Spinal Cord Injury with Complete Motor Paralysis.","authors":"Chikara Ushiku,&nbsp;Kota Suda,&nbsp;Takehiro Michikawa,&nbsp;Satoko Matsumoto Harmon,&nbsp;Miki Komatsu,&nbsp;Osahiko Tsuji,&nbsp;Masahiko Takahata,&nbsp;Mitsuru Saito,&nbsp;Norimasa Iwasaki,&nbsp;Akio Minami","doi":"10.22603/ssrr.2022-0254","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0254","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumonia is one of the leading causes of acute- and chronic-phase mortality in patients with cervical spinal cord injury (CSCI) with quadriplegia. The risk factors for chronic-phase pneumonia recurrence in CSCI are still unknown. This study aimed to investigate the incidence of pneumonia in the chronic phase after injury and to identify its risk factors.</p><p><strong>Methods: </strong>This retrospective clinical observational study included patients with CSCI with American Spinal Injury Association Impairment Scale grades of A or B admitted to our center within 72 h of CSCI injury who started treatment and were available for follow-up for at least 90 days. The patients were assessed for incidences of pneumonia and its associations with clinical characteristics, including risk factors at the time of injury. Patients in whom pneumonia developed within 30 days postadmission and those after 30 days of hospitalization were comparatively examined using univariate and multivariate analyses.</p><p><strong>Results: </strong>Pneumonia occurred in 36% of the 69 enrolled patients throughout the study period and in 20% of all patients after 30 days of hospitalization. Multivariate analysis of risk factors for pneumonia showed that atelectasis (adjusted OR [aOR], 95% confidence interval [CI]: 4.9, 1.2-20.0), enteral feeding (aOR [95% CI]: 13.3 [3.0-58.9]), mechanical ventilation (aOR [95% CI]: 4.0 [1.0-15.0]), and tracheotomy (aOR [95% CI]: 14.6 [2.3-94.6]) within 30 days of admission were significantly associated with the occurrence of pneumonia even after 30 days of hospitalization.</p><p><strong>Conclusions: </strong>The risk factors for developing pneumonia in the chronic phase were atelectasis, enteral feeding, mechanical ventilation, and tracheotomy within 30 days of hospitalization. This study suggests that treatment of atelectasis, long-term respiratory muscle rehabilitation, and training to improve swallowing function are essential to prevent the recurrence of pneumonia after 30 days of hospitalization.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/40/2432-261X-7-0333.PMC10447191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10481871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}