Publications by authors named "Haruki Funao"
Article Synopsis
- * Out of 451 patients over 65 years with cervical fractures, 69% had mid-cervical injuries while 31% had lower-cervical injuries, with lower-cervical injuries being linked to more high-energy trauma cases.
- * Although lower-cervical injuries resulted in fewer muscle weaknesses compared to mid-cervical injuries, many patients still experienced neurological deficits and similar overall complication rates after treatment, such as respiratory issues but no significant differences in mortality or mobility outcomes.
Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.
View Article and Find Full Text PDFObjective: Instrumentation surgery in combination with radiotherapy (RT) is one of the key management strategies for patients with spinal metastases. However, the use of materials can affect the RT dose delivered to the tumor site and surrounding tissues, as well as hinder optimal postoperative tumor evaluation. The association of the preoperative Spine Instability Neoplastic Score (SINS) with the need for spinal stabilization and life expectancy are unclear.
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- This study analyzed 389 patients aged 65 and older with cervical spinal cord injury (CSCI) but no bone injury to assess the effects of diabetes on neurological recovery.
- The research found that there were no significant differences in neurological outcomes between diabetic patients and those without diabetes at 6 months post-injury.
- Additionally, moderate-severe diabetes did not adversely impact recovery, suggesting that diabetic patients had similar improvements in neurological function as their nondiabetic counterparts.
Study Design: Prospective multicenter study.
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.
Article Synopsis
- Dysphagia, a serious swallowing disorder, affects older adults post-spinal cord injury, particularly those with cervical injuries, though its risk factors are not well understood.
- A study involving 707 patients aged 65 and older identified male sex, low nutritional status (GNRI <92), dementia, fractures, complete paralysis, anterior surgery, and tracheostomy as significant risk factors for dysphagia.
- The findings suggest that a low geriatric nutritional risk index (GNRI) is a key indicator of dysphagia risk, implying that nutritional health is critical for recovery in elderly patients with cervical spinal injuries.
Article Synopsis
- A retrospective multicenter study was conducted in Japan to assess the influence of preoperative neck pain on clinical outcomes after posterior decompression surgery for cervical ossification of the posterior longitudinal ligament (OPLL).
- The study involved 90 patients followed for at least two years, who were grouped based on the presence or absence of preoperative neck pain, but the two groups showed no significant demographic or outcome differences.
- Both groups improved post-surgery according to the Japanese orthopedic association (JOA) scores, but lower JOA scores and larger cervical angles in the no preoperative pain group were linked to higher chances of developing postoperative neck pain.
Article Synopsis
- The study investigated the postoperative outcomes for patients with spinal metastases from prostate cancer, focusing on improvements in their quality of life and other patient-oriented assessments.
- Conducted across 35 centers, the research assessed 413 patients, with 41 specifically having prostate cancer, and followed them for at least a year following surgery using various evaluation methods.
- Results showed significant improvements in neurological function, quality of life, and patient motivation post-surgery, indicating that surgical intervention is beneficial for these patients.
Article Synopsis
- A newly established hospital in rural Japan conducted a three-year study to evaluate osteoporosis care for patients with non-vertebral fragility fractures following surgery, focusing on proximal humerus, distal radius, and proximal femoral fractures.
- Out of 115 surgical cases, a significant portion of patients were newly diagnosed with osteoporosis post-surgery, with nearly half receiving new osteoporosis treatments based on Japanese guidelines, which surpassed previous intervention rates in the country.
- The study found differences in bone density and some biochemical markers between patient groups, highlighting variations in osteoporosis characteristics related to different types of fractures, while complications like secondary fractures were minimal during the observation period.
Article Synopsis
- Tranexamic acid (TXA) is increasingly used in spinal surgery for its potential to minimize blood loss, but there are ongoing concerns about its safety and effectiveness.
- A systematic review analyzed thirteen studies with over 1,200 participants, finding TXA significantly reduced both intraoperative and total estimated blood loss, as well as the need for blood transfusions.
- While TXA did not increase the risk of thrombotic complications, further research is necessary due to the variability among studies and to assess any long-term safety concerns.
Article Synopsis
- The study aimed to determine minimal clinically important differences (MCIDs) for patients undergoing surgery for spinal metastases to improve patient care by linking quality of life assessments with clinical outcomes.
- A total of 171 patients were evaluated pre- and post-surgery using various scales, leading to the identification of specific MCID values for different quality of life aspects based on their treatment outcomes.
- The study successfully established both anchor-based and distribution-based MCIDs for surgical interventions, which can help in assessing patient progress and overall treatment effectiveness.
Corrective spine surgery for spinal deformities, such as adolescent idiopathic scoliosis (AIS) and adult spinal deformity (ASD), aims to enhance the quality of life by addressing physical impairments. However, the extent of patient satisfaction after surgery, which includes pain management, functional recovery, and psychological contentment, exhibits considerable variation across different cultural and geographical landscapes. This review describes the influence of cultural and regional disparities on postoperative satisfaction in AIS and ASD surgery with a particular emphasis on the disparities between the US and Japan.
View Article and Find Full Text PDFThis retrospective cohort study established malnutrition's impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk.
View Article and Find Full Text PDFStudy Design: Retrospective cohort study.
Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C).
Settings: Multi-institutions in Japan.
Study Design: Retrospective multicenter study.
Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear.
Background: Although the surgical release of the sternocleidomastoid muscle (SCM) is required for residual congenital muscular torticollis (CMT), the surgical outcomes between bipolar and unipolar SCM release remained unclear. The purpose of the present study was to assess surgical outcomes after bipolar and unipolar release of SCM in adolescent/adult patients with neglected CMT.
Methods: Twenty-one consecutive adolescent/adult patients with neglected CMT who underwent surgical treatment were enrolled.
This study aimed to determine whether a trunk orthosis with joints providing resistive force (TORF) modifies sagittal malalignment during level walking in patients with lumbar spinal stenosis (LSS). Fifteen patients, 6 months after undergoing surgery for LSS, performed level walking at a self-selected speed while wearing a TORF. Dynamic sagittal alignment, including sagittal vertical axis, lumbar lordosis, and pelvic tilt, and spatiotemporal data as well as lower limb kinematic and kinetic data were recorded using a three-dimensional motion analysis system and six force plates.
View Article and Find Full Text PDFAdult spinal deformity (ASD) surgery aims to correct abnormal spinal curvature in adults, leading to improved functionality and reduced pain. However, this surgery is associated with various complications, one of which is proximal junctional failure (PJF). PJF can have a significant impact on a patient's quality of life, necessitating a comprehensive understanding of its causes and the development of effective management strategies.
View Article and Find Full Text PDFBackground: The radiographic outcomes of nonoperative treatment of dropped head syndrome are still unknown. The purpose of the present study was to assess the change in sagittal spinopelvic radiographic parameters after the short and intensive rehabilitation (SHAiR) program in patients with dropped head syndrome.
Methods: This study included 48 consecutive patients with dropped head syndrome who presented with an inability to maintain horizontal gaze and who underwent the SHAiR program during the period of 2018 to 2019.
: Thoracic ossification of the ligamentum flavum (OLF) often causes myelopathy and/or radiculopathy. The disease is frequently observed in East Asian populations. Although thoracic OLF in young athletes who have underwent decompression surgery has been reported, the removal of posterior spinal bony elements and ligamentous complex may often cause postoperative thoracolumbar instability.
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- AI and machine learning are becoming essential in modern healthcare, particularly in spinal care, improving diagnosis, treatment, and patient outcome prediction.
- They enhance spinal imaging techniques and help create predictive models for personalized treatment plans.
- Despite their potential, integrating these technologies into clinical practice faces challenges like data quality, security, and ethical issues that need to be resolved for effective use.
Article Synopsis
- The study is a retrospective multicenter analysis comparing elderly patients with cervical diffuse idiopathic skeletal hyperostosis (cDISH) injuries to matched controls, focusing on those with and without fractures.
- It involved 140 patients aged 65 and older, revealing that those with fractures had similar complication rates and ambulation outcomes as controls, while nonambulatory patients without fractures had significantly poorer ambulation.
- Logistic regression highlighted complete paralysis and age as major risk factors for early mortality, with 14 patients passing away within three months of the injury.*
Purpose: To investigate the impact of early post-injury respiratory dysfunction for neurological and ambulatory ability recovery in patients with cervical spinal cord injury (SCI) and/or fractures.
Methods: We included 1,353 elderly patients with SCI and/or fractures from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were included in the respiratory dysfunction group, which was further classified into mild and severe respiratory groups based on respiratory weaning management.
Background: Despite the increasing prevalence of cervical odontoid fractures in older adults, the treatment strategy is controversial. The objectives of the current study are to investigate the prognosis and complications of cervical odontoid fractures in elderly patients and to identify factors associated with worsening of ambulation after 6 months.
Methods: This multicenter, retrospective study included 167 patients aged 65 years or older with odontoid fractures.
Patients with cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament have been considered to be prone to falls due to lower extremity dysfunction and gait instability. Anticipatory postural adjustments (APAs) are unconscious muscular activities to counterbalance perturbation. To date, there are no reports on APAs in cervical myelopathy patients, and quantification of postural control remains difficult.
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