Publications by authors named "Kenichi Kawaguchi"
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 PDF: Data on the differences in functional recovery between inpatient rehabilitation for total hip arthroplasty (THA) and total knee arthroplasty (TKA) are lacking, and the factors influencing the improvement of short-term functional mobility remain unknown. In this study, we compared the short-term functional outcomes of both procedures and identified early postoperative predictors of physical function gain during post-acute rehabilitation. : A total of 435 patients who underwent THA and TKA were included.
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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: Retrospective study of prospectively collected data.
Objective: To investigate the influence of cartilaginous endplates (CEs) in herniated discs on clinical symptoms and postoperative outcomes in patients with lumbar disc herniation (LDH) in different age groups.
Summary Of Background Data: LDH involving CEs, which are hard and less resorptive, is frequently observed with increasing age and appears to affect the natural course and clinical outcomes following discectomy.
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
- Some patients who undergo total hip arthroplasty (THA) for hip osteoarthritis may still exhibit a Trendelenburg gait, which involves a specific pattern of muscle contractions during walking.
- The study analyzed 89 patients with a focus on hip muscle performance and pelvis movement to identify factors contributing to this gait, finding that 27% displayed the Trendelenburg gait.
- Key findings suggest that poor performance in hip abductor and extensor muscles during early to mid-stance phases of walking is linked to difficulty in stabilizing the hip, highlighting the importance of these muscle functions after surgery.
Article Synopsis
- The study looked at what causes some people with ankylosing spondylitis (AS) to have serious back fractures that need surgery.
- They checked 60 patients and found that most were middle-aged men who had AS for a long time.
- Higher levels of a certain protein (CRP) in the blood were linked to a greater chance of needing surgery for back fractures, suggesting that treating inflammation could help prevent these fractures.
Article Synopsis
- This study examined how malnutrition affects older patients (65+) with cervical spinal cord injuries and their outcomes after treatment.
- Among 789 patients, 6% had major nutritional risks at the start, which impacted their survival and recovery.
- Results showed that those with major nutritional risks had a significantly higher death rate, shorter lifespan, less neurological improvement, and greater difficulty with daily activities a year after their injury compared to matched controls.
Article Synopsis
- The study investigated the prognosis and factors predicting neurological improvement in older patients (65+) with incomplete spinal cord injuries classified as AIS-C.
- Significant differences in age, body mass index, pre-traumatic activities of daily living, and serum albumin concentrations were found among groups based on their final neurological status.
- Approximately 64.2% of patients improved to AIS-D, with only 7.1% achieving AIS-E, indicating that while many showed some improvement, complete recovery was rare and linked to higher serum albumin levels and independent pre-injury ADL.
Background: Spinal metastases can impair mobility, worsening the Karnofsky Performance Status (KPS). Surgery for spinal metastases has the potential to improve KPS and extend prognosis, but it is crucial to recognize the elevated risk of perioperative complications. Therefore, the development of a new scoring system to accurately predict perioperative complications in spinal metastatic surgery is essential.
View Article and Find Full Text PDFStudy 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.
Study Design: Retrospective study.
Objective: To investigate the characteristics of newly developing Modic changes following discectomy and their impact on residual low back pain (LBP) in the early postoperative stage of lumbar disc herniation.
Methods: We included 96 patients who underwent microscopic discectomy.
Background: Spinal cord injury (SCI) is a devastating disease that results in permanent paralysis. Currently, there is no effective treatment for SCI, and it is important to identify factors that can provide therapeutic intervention during the course of the disease. Zinc, an essential trace element, has attracted attention as a regulator of inflammatory responses.
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- Meningiomas can recur and need careful surgical removal; the study focused on a new technique for dural reconstruction using artificial dura mater after their resection.
- The Fenestrated Durotomy with Oversized Graft (FDOG) method was tested on 8 patients, who underwent tumor removal and had larger-than-normal grafts inserted to repair the dural defects.
- Results showed successful dural expansion and no complications for the patients, indicating that this technique is a safe and effective option for dural repair in complex cases.
Article Synopsis
- This study focused on car usage and comfort in patients who underwent Total Hip Arthroplasty (THA), assessing factors like car entry and exit comfort levels based on muscle strength.
- Out of 172 surveyed patients, most used cars post-surgery, with 114 feeling comfortable and 47 experiencing discomfort, particularly noted when using the contralateral side door.
- The research concluded that lacking strength in the contralateral hip abductor muscle predicted discomfort, suggesting that strengthening this area might enhance overall comfort for patients post-THA.
Background: Progression of kyphosis after laminoplasty sometimes results in the recurrence of myelopathy with lamina closure. However, only a few case reports have been published on the reoperation of double-door laminoplasty using the suture method. This study investigated the incidence and clinical features of reoperation cases caused by the recurrence of myelopathy with lamina closure after double-door laminoplasty using a modified Kirita-Miyazaki suture method.
View Article and Find Full Text PDFNeonatal spinal cord injury (SCI) shows better functional outcomes than adult SCI. Although the regenerative capability in the neonatal spinal cord may have cues in the treatment of adult SCI, the mechanism underlying neonatal spinal cord regeneration after SCI is unclear. We previously reported age-dependent variation in the pathogenesis of inflammation after SCI.
View Article and Find Full Text PDFAfter spinal cord injury (SCI), inflammatory cells such as macrophages infiltrate the injured area, and astrocytes migrate, forming a glial scar around macrophages. The glial scar inhibits axonal regeneration, resulting in significant permanent disability. However, the mechanism through which glial scar-forming astrocytes migrate to the injury site has not been clarified.
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- 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.
Systems combining superconductors with topological insulators offer a platform for the study of Majorana bound states and a possible route to realize fault tolerant topological quantum computation. Among the systems being considered in this field, monolayers of tungsten ditelluride (WTe ) have a rare combination of properties. Notably, it has been demonstrated to be a quantum spin Hall insulator (QSHI) and can easily be gated into a superconducting state.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- - The study focuses on the increasing elderly population at high risk for delirium due to cervical trauma, aiming to create a risk score to predict delirium in patients with cervical spinal cord injury or fracture regardless of their treatment type.
- - A total of 1,512 elderly patients (aged 65+) were analyzed, and significant risk factors for delirium were identified through multivariate logistic regression, leading to a delirium risk score based on six important variables.
- - The newly developed risk score can help healthcare providers make informed decisions regarding treatment strategies, despite needing further validation with additional data, having shown a prediction accuracy area under the curve of 0.66.
Article Synopsis
- - The study analyzed 1512 patients aged 65 and older with cervical spine injuries, revealing that 6.3% of them had dementia, which was more common in older, mainly female patients with lower body mass index and higher frailty.
- - Patients with dementia showed worse short-term outcomes, including lower functional ability in activities of daily living (ADLs) and a higher rate of dysphagia compared to those without dementia.
- - Mortality rates were significantly higher in patients with dementia following their injuries, highlighting the adverse effects of dementia on recovery and survival in this demographic.