New Surgical Approach and Rehabilitation After Cemented Total Ankle Arthroplasty.

Background: According to the conventional postoperative procedure after total ankle arthroplasty (TAA) for end-stage osteoarthritis (OA) and rheumatoid arthritis (RA), mobilization and weight-bearing are currently started after completion of wound healing. Recently, an early rehabilitation program after cemented TAA with a modified anterolateral approach has been attempted because this approach could provide stable wound healing. To investigate the possibility of expediting rehabilitation, this study evaluated the feasibility, safety, and universality of an early rehabilitation program after cemented TAA using a modified anterolateral approach, even when a surgeon was completely changed.

Utility of intraoperative fluorescence imaging with indocyanine green for diagnosing spinal schwannoma: A case report.

Background: The delayed-window indocyanine green (DWICG) technique is useful for the removal of brain and spinal tumors.

Case Description: A 41-year-old female presented with lower left back and radicular pain. An magnetic resonance imaging (MRI) revealed an extramedullary L3 lesion located ventrally in the spinal canal that appeared to be a schwannoma.

Visibility of Intracranial Perforating Arteries Using Ultra-High-Resolution Photon-Counting Detector Computed Tomography (CT) Angiography.

Photon-counting detector computed tomography (PCD-CT) offers energy-resolved CT data with enhanced resolution, reduced electronic noise, and improved tissue contrast. This study aimed to evaluate the visibility of intracranial perforating arteries on ultra-high-resolution (UHR) CT angiography (CTA) on PCD-CT. A retrospective analysis of intracranial UHR PCD-CTA was performed for 30 patients.

Utility of external fixation for traumatic periprosthetic fracture after total ankle arthroplasty in patients with rheumatoid arthritis: A report of two cases.

This report describes two cases of implant-stable traumatic periprosthetic fractures after total ankle arthroplasty (TAA) in patients with rheumatoid arthritis (RA). One case with low body mass index (BMI) [14 kg/m2] achieved complete bone union with the use of an external fixator, while the other case with a high BMI [32.83 kg/m2] failed to achieve bone union with the external fixator; however, complete union was achieved utilizing secondary internal plate fixation.

Seronegative rheumatoid arthritis found in an 85-year-old woman during preoperative investigations for knee replacement surgery for osteoarthritis.

This report describes the case of an 85-year-old woman who was found to have seronegative rheumatoid arthritis during preoperative investigations for knee replacement surgery for osteoarthritis. Follow-up for knee osteoarthritis was continued for many years without any symptoms involving other joints. Before total knee arthroplasty for osteoarthritis, preoperative investigations revealed a highly inflammatory state.

Modified scarf osteotomy has a possible capability to be indicated against very severe hallux valgus deformity.

Background: Generally, scarf osteotomy is recommended for moderate-severe hallux valgus (HV) deformity. Although severe HV deformity is defined to be more than 40 degree (°), this definition of angular setting includes broad range of HV angle (HVA). Actually, very severe HV deformity such as more than 60° of the HVA is often seen.

Tethered cord syndrome in an adult with filum terminale lipoma: A case report.

Background: Filum terminale lipomas (FTLs) are congenital lumbosacral anomalies that can cause tethered cord syndrome (TCS). Most patients with TCS caused by FTL are children, and these are only rarely present in adults.

Case Description: A 64-year-old male presented with long-standing bilateral lower-limb weakness and bladder dysfunction.

Evaluation of electrical activity at the carpal tunnel area in response to median nerve elbow stimulation using magnetoneurography.

Objective: To develop a magnetic field measurement method in the carpal tunnel area in response to electrical median nerve stimulation at the elbow and evaluate its usefulness.

Methods: Five healthy subjects participated. The magnetic field recording evoked by median nerve electrical stimulation at the elbow with electrical intensity that minimized the pronator quadratus and flexor carpi radialis muscle response was measured with 132-channel superconducting quantum interference device magnetoneurography.

Mid-term outcomes of distal tibial oblique osteotomy in patients with rheumatoid arthritis: a report of three cases.

Although distal tibial oblique osteotomy (DTOO) has usually been indicated for non-inflammatory diseases such as osteoarthritis, we encountered three patients with rheumatoid arthritis (RA) who underwent DTOO. We evaluated radiographic parameters and clinical scores, including self-reported scores for the foot and ankle (SAFE-Q) and the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale. In all three cases, radiographic improvements were achieved along with improvements in SAFE-Q and JSSF scores after mid-term follow-up.

Identifying Factors for Predicting Postoperative Segmental Motor Paralysis in Patients Undergoing Anterior Cervical Spine Surgery: A Multicenter Study.

Study Design: Retrospective cohort study.

Objective: To investigate the incidence of and risk factors for segmental motor paralysis after anterior cervical spine surgery.

Summary Of Background Data: Segmental motor paralysis is a potential complication following both anterior and posterior cervical decompression procedures; however, previous studies investigating risk factors for segmental motor paralysis after anterior cervical spine surgery were limited by small sample sizes.

Preoperative dual-energy computed tomography and positron-emission tomography evaluation of lymph node metastasis in esophageal squamous cell carcinoma.

Purpose: To investigate the detectability of lymph node metastasis in patients with esophageal squamous cell carcinoma using a combination of dual-energy computed tomography (CT) and positron-emission tomography (PET) parameters.

Methods: We analyzed dual-energy CT and PET preoperative data in 27 consecutive patients with esophageal squamous cell carcinoma (23 men, 4 women; mean age, 73.7 years).

Gravitational instability in a planet-forming disk.

The canonical theory for planet formation in circumstellar disks proposes that planets are grown from initially much smaller seeds. The long-considered alternative theory proposes that giant protoplanets can be formed directly from collapsing fragments of vast spiral arms induced by gravitational instability-if the disk is gravitationally unstable. For this to be possible, the disk must be massive compared with the central star: a disk-to-star mass ratio of 1:10 is widely held as the rough threshold for triggering gravitational instability, inciting substantial non-Keplerian dynamics and generating prominent spiral arms.

A case of coexistence of multiple vascular anomalies including the absence of a left internal carotid artery, a left vertebral artery arising from the subclavian artery in a high cervical location, and a bovine arch associated with vertebral fusion.

We report a rare 16-year-old male case of Klippel-Feil anomaly associated with fetal alcohol syndrome exhibiting complex congenital vascular anomalies. The congenital vascular anomalies observed were the absence of a left internal carotid artery, a left vertebral artery arising from the subclavian artery in a very high cervical location and a bovine arch. The vascular and vertebral anomalies were evaluated using CT and MRI before cervical surgery.

Full-endoscopic discectomy utilizing an interlaminar approach for gas-containing herniation at L5-S1.

Background: Intradiscal gas is frequently observed in older patients with disc degeneration and can occasionally result in nerve root compression.

Case Description: A 79-year-old male patient presented with increasing left lower extremity sciatica. Lumbar computed tomography (CT) and magnetic resonance (MR) images revealed a left paramedian L5-S1 gas-containing disc herniation.

Arthroscopic treatment of septic arthritis of the ankle joint caused by streptococcus in patients with chronic inflammatory diseases: two case reports.

This report describes the arthroscopic treatment of septic arthritis of the ankle joint in two patients with inflammatory diseases, including rheumatoid arthritis (RA) and nail psoriasis. We treated both the ankle joints with antibiotic administration and urgent arthroscopic synovectomy and irrigation, although the procedure was performed several days (4 and 6 days) after the time at which the infection would have occurred. Fortunately, no recurrence has been seen for more than 18 and 20 months, respectively, after surgery, without antibiotic administration.

Flatfoot Surgery for Flexible Progressive Collapsing Foot Deformity With Inflammatory Joint Diseases: A Report of 3 Cases.

Case: Three cases of inflammatory joint diseases (systemic lupus erythematosus and ongoing juvenile idiopathic arthritis) with painful flexible progressive collapsing foot deformity (PCFD) underwent flatfoot surgery. All cases maintained sufficient radiological correction and achieved good clinical condition at final follow-up.

Conclusion: Although the prospect for recurrence of the deformity is not clear, even in inflammatory joint diseases, flat foot surgery such as flexor digitorum longs transfer, spring ligament reconstruction, and lateral column lengthening could have a possibility to be indicated against PCFD, as long as disease activity could be well suppressed by drug therapy, subsequently subtalar and talonavicular joints could be preserved.

Perioperative complications and cost of posterior decompression with fusion in thoracic spine for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum -a comparative study using a national inpatient database.

Background: Although posterior decompression with fusion (PDF) are effective for treating thoracic myelopathy, surgical treatment has a high risk of various complications. There is currently no information available on the perioperative complications in thoracic ossification of the longitudinal ligament (T-OPLL) and thoracic ossification of the ligamentum flavum (T-OLF). We evaluate the perioperative complication rate and cost between T-OPLL and T-OLF for patients underwent PDF.

Evaluation of Incidental Findings on Abdominopelvic CT: Potential Benefit of Photon-counting Detector CT Over Conventional Single-energy CT.

Purpose: To assese of potential benefint of photon-counting detector CT (PCD-CT) over conventional single-energy CT (CSE-CT) on accurate diagnosis of incidental findings with high clinical significance (IFHCS).

Materials And Methods: This retrospective study included 365 patients who initially underwent abdominopelvic contrast-enhanced CT (AP-CECT) without non-enhancement (PCD-CT: 187 and CSE-CT: 178). We selected IFHCS and evaluated their diagnosability using CE-CT alone.

Midterm Outcomes After Total Knee Arthroplasty With Lateral Approach for Valgus Knee Deformity in Patients With Rheumatoid Arthritis.

Background Valgus knee deformity is often seen in rheumatoid arthritis (RA) cases. Usually, the medial approach has been often utilized for total knee arthroplasty (TKA), even in valgus deformity cases; however, the medial approach is feared to induce further instability in the medial side because it could further break the soft tissue structure, including medial collateral ligament (MCL) and medial patellofemoral ligament (MPFL). Consequently, loosening of the implant, recurrence of valgus knee deformity, and pain due to instability might be induced in the early period after surgery.

Detection of Dural Defect Localization Using 4-Dimensional Dynamic Computed Tomography Myelography for Patients with Superficial Siderosis.

Background: There are cases of superficial siderosis (SS) with spinal ventral fluid-filled collection in the spinal canal. In our previous study, the balanced steady-state free precession sequence magnetic resonance imaging is useful in identifying the location of dural defects. However, because of its narrow scan area and long scan time, it cannot easily detect the defect location in some patients with small dural defect.

Comparison of Postoperative Complications and Outcomes in Anterior Cervical Spine Surgery: Ossification of the Posterior Longitudinal Ligament Versus Cervical Spondylotic Myelopathy.

Study Design: Retrospective cohort study.

Objectives: To compare the frequency of complications and outcomes between patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine and those with cervical spondylotic myelopathy (CSM) who underwent anterior surgery.

Summary Of Background Data: Anterior cervical spine surgery for OPLL is an effective surgical procedure; however, it is complex and technically demanding compared with the procedure for CSM.