Publications by authors named "Kazuya Kitamura"

Article Synopsis
  • Spine disorders are a major global disability issue, highlighting the need for improved access to high-quality spine care to foster social inclusion and dignity for affected individuals.
  • SPINE20 outlines six recommendations for G20 countries, including providing evidence-based education for health workers, affordable spine care interventions, and investing in health policy research to support rehabilitation integration.
  • Emphasizing the importance of social equity, SPINE20 urges collaborations among healthcare providers and policymakers to ensure comprehensive access to spine care, ultimately aiming to enhance population well-being and productivity.
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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.
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The LBX1 gene is located near a single nucleotide polymorphism that is highly associated with susceptibility to adolescent idiopathic scoliosis and is considered one of the strongest candidate genes involved in the pathogenesis of this condition. We have previously found that loss of LBX1 from skeletal muscle results not only in spinal deformity but also in lean body mass, suggesting a potential role for LBX1 in energy metabolism. The purpose of the present study was to test this hypothesis by analyzing the phenotype of mice lacking LBX1 in skeletal muscle with a focus on energy metabolism.

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"Cysts of the ligamentum flavum (cysts-LF)" is the term for non-neoplastic cystic lesion involving LF. The aim of the present study was to elucidate the histopathological characteristics and pathogenesis of "cysts-LF". Herein, we defined cysts-LF as spinal cysts containing degenerative LF components.

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Study Design: A retrospective study at a single academic institution.

Purpose: This study aimed to identify imaging risk factors for stenosis in extended neck positions undetectable in preoperative neutral magnetic resonance imaging (MRI) and improving decompression strategies for cervical spine disorders.

Overview Of Literature: Cervical disorders are influenced by various dynamic factors, with spinal stenosis appearing during neck extension.

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Introduction: Leucine-rich alpha-2-glycoprotein (LRG) is a potential biomarker for disease activity and reflects mucosal healing in patients with ulcerative colitis (UC). However, only a few studies have described a detailed sensitivity analysis of LRG in predicting mucosal healing in patients. This study aimed to evaluate the association between LRG and the endoscopic activity of UC and its predictability for mucosal healing and explore the utility and clinical application of LRG.

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Article Synopsis
  • A multicenter study in Japan was conducted to evaluate adverse events (AEs) related to the tag-less PillCam patency capsule (PC) used to prevent small bowel capsule endoscope (CE) retention.
  • Out of 2578 patients, 74 AEs were identified, primarily involving residual parylene coating, small bowel obstruction, and CE retention, with a 2.37% incidence rate of AEs overall.
  • The study concluded that while the PC is generally safe, careful assessment of patient history and accurate localization of the capsule are important to mitigate risks.
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Background/aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation.

Methods: This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation.

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Article Synopsis
  • Researchers improved an AI model called RetinaNet to enhance the diagnosis of various lesions in wireless capsule endoscopy images, targeting ulcers, vascular lesions, and tumors.
  • The AI was trained on a substantial dataset from 1234 patients, using over 14 million images to ensure accurate lesion detection.
  • Evaluation results showed excellent performance metrics, with mean AUC values above 0.997 and high sensitivity and specificity for accurately identifying different types of small bowel lesions in clinical practice.
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High plantar flexor moment and limited ankle mobility are known to cause high plantar pressure under the forefoot. Stretching is an effective physical therapy for the limited ankle range of motion (ROM), and electrical stimulation is used to regulate the activity of antagonistic muscle via the action of reciprocal inhibition. Additionally, stretching paired with electrical stimulation has been reported to improve the limited ROM significantly.

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Introduction: The efficacy of minimally invasive surgeries for thoracolumbar flexion-distraction injuries (FDIs) has been reported, but those surgeries were monosegmental fusion surgeries of two adjacent vertebrae with bone grafts or temporary fixations using percutaneous pedicle screws (PPSs) that were at least bisegmental. Our idea was to fuse the fracture itself, not to fuse the fractured vertebra with an adjacent vertebra or to stabilize the fractured vertebra by bridging rostrally/caudally adjacent intact vertebrae, specifically when the displacement is minimal. This study aimed to present the surgical techniques of reduction and temporary monosegmental fixation of neurologically intact thoracolumbar bony FDIs using multiaxial PPSs, which can minimize the surgical invasiveness and preserve all motion segments, as well as report three cases treated with this procedure.

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This study aimed to evaluate the efficacy of a novel fully covered self-expandable metal stent (SEMS) with dumbbell-shaped flare ends for the palliation of distal biliary obstruction (DBO) due to unresectable pancreatic cancer (UPC). Patients with DBO due to UPC who received the novel HILZO fully covered stent (HFS), the WALLFLEX partially covered stent (WPS) or fully covered stent (WFS) were analyzed. The incidence of recurrent biliary obstruction (RBO), time to RBO (TRBO), and the incidence of complications were compared among the three SEMS groups.

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Objective: Muscle-preserving selective laminectomy (SL) is an alternative to conventional decompression surgery in patients with degenerative cervical myelopathy (DCM). It is less invasive, preserves the extensor musculature, and maintains the range of motion of the cervical spine. Therefore, the preferred treatment for DCM at the authors' institution has changed from anterior decompression and fusion (ADF), including anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF), toward SL.

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Study Design: A retrospective study at a single academic institution.

Purpose: We aimed to understand the pathogenesis of cervical spondylolisthesis by analyzing whether narrowing of the disc height stabilizes the slipped disc level according to the degenerative cascade.

Overview Of Literature: According to Kirkaldy-Willis' degenerative cascade, the narrowing of the disc height at slipped level contributes to intervertebral stability in lumbar spondylolisthesis.

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Study Design: A retrospective study conducted at a single academic institution.

Purpose: This study compared the postoperative alignment of consecutive double laminectomies according to their decompression levels and investigated the influence of the extension unit of the spinous process and its attached muscles on postoperative alignment.

Overview Of Literature: Many reports have investigated bony and soft tissue factors as the causes of postoperative cervical alignment disorders.

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Introduction: The present study aimed to understand the characteristics of adjacent segment stenosis post-surgery by examining the status of adjacent segment stenosis in patients with long-term follow-up after muscle-preserving selective laminectomy (SL).

Methods: We examined 43 patients who underwent muscle-preserving SL at a single academic institution and were followed up for >10 years. The C2-C7 angle, C2-C7 sagittal vertical axis, range of motion, and C7 slope were measured using an X-ray lateral view.

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There are few reports of degenerative atlantoaxial stenosis and new stenosis after cervical decompression. We experienced four cases of atlantoaxial stenosis after muscle-preserving selective laminectomy. We compared these four cases with no stenosis cases after long-term follow-up of selective laminectomy, as well as healthy subjects.

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We aimed to investigate the risk factors of spontaneous osseous fusion (SOF) of the atlantoaxial joint after closed reduction under general anesthesia followed by halo fixation (remodeling therapy) for chronic atlantoaxial rotatory fixation, and to elucidate the recovery mechanism of the rotatory range of motion (ROM) after halo removal. Twelve patients who underwent remodeling therapy were retrospectively reviewed. Five patients with SOF were categorized as the fusion group and seven patients without SOF as the non-fusion group.

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Introduction: Gut microbiota alterations cause inflammation in patients with ulcerative colitis (UC). Fecal microbiota transplantation (FMT) enables manipulating the microbiota's composition, but the mechanisms underlying colonization of the posttransplantation microbiota are poorly understood.

Methods: In this open-label, nonrandomized study, the FMT efficacy and changes in the gut microbiota were evaluated in 8 UC patients with mild-to-moderately active endoscopic colonic lesions.

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Objective: The purpose of our study was to investigate the risk factors of remnant tumor growth after incomplete resection (IR) of cervical dumbbell-shaped schwannomas (DS).

Methods: Twenty-one patients with IR of cervical DS with at least 2 years of follow-up were included and were divided into 2 groups: the remnant tumor growth (G) (n = 10) and no growth (NG) (n = 11) groups. The tumor location in the axial plane according to Toyama classification, the location of the remnant tumor margin, and the tumor growth rate (MIB-1 index) index were compared.

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Background Context: Frailty as a concept is not yet fully understood, and is not the same as comorbidity. It is associated with an increased risk of adverse events and mortality after surgery, which makes its preoperative assessment significant. Despite its relevance, it still remains unclear which scales are appropriate for use in patients with spinal pathology.

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Article Synopsis
  • This study is a retrospective multicenter analysis aimed at understanding how the level of stenosis in the cervical spine affects surgical outcomes for patients with cervical spondylotic myelopathy (CSM).
  • It involved 636 patients divided into two groups based on the most affected intervertebral level: upper cervical (C2/3, C3/4, C4/5) and lower cervical (C5/6, C6/7, C7/T1), and used propensity score matching to ensure fair comparisons of surgical results.
  • The findings showed no significant differences in postoperative outcomes, including JOA scores and neck pain levels, between the two groups after matching, indicating that the intervertebral level of stenosis
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Study Design: A retrospective study.

Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs.

Methods: We evaluated 379 patients with CSM after SL.

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Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome, which includes diabetes mellitus and hyperlipidemia. A fraction of NAFLD patients develop nonalcoholic steatohepatitis, leading to cirrhosis associated with various serious complications, including hepatocellular carcinoma, gastroesophageal varices, cardiovascular events, and other organ malignancy. Although the incidence of chronic viral hepatitis with associated complications has gradually decreased as highly effective antiviral therapies have been established, the number of patients with steatohepatitis has been increasing.

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