Publications by authors named "Kosei Nagata"
Background: Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement.
Methods: A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022.
Objective: To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM).
Methods: Consecutive patients with DCM were prospectively enrolled. AGEs assessed by skin autofluorescence (the AGE score) were examined at the middle fingertip in eligible patients.
Article Synopsis
- The study compares the outcomes of transforaminal interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) combined with posterior fusion (AP) regarding post-operative complications and pain management in patients.
- Results show that TLIF patients experienced shorter operative times and hospital stays compared to AP patients, but there was no significant difference in residual leg or back pain between the two approaches.
- Overall, both surgical methods had similar complication rates, except for constipation, which was more prevalent in the AP group, suggesting that the choice of surgical approach should consider these factors.
Background: Coronavirus disease 2019 (COVID-19) has resulted in substantial morbidity and mortality globally. The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) covers 99.9% of health insurance claim receipts by general practitioners.
View Article and Find Full Text PDFArticle Synopsis
- The study compares two workflows for placing cortical bone trajectory (CBT) screws during robotic-assisted spinal surgery: a traditional "Tap" three-step method and a new "No-Tap" two-step method.
- It analyzed metrics like screw-related complications, surgical time, and blood loss in 91 No-Tap and 88 Tap cases, finding that No-Tap significantly reduced robotic time without increasing the risk of complications.
- The results suggest that the No-Tap technique is a safer, more efficient alternative to the traditional tapping method in this type of surgery.
Study Design: Retrospective cohort study.
Objectives: With the aging of the Japanese population, patients with athetoid cerebral palsy (ACP) are getting older, and the rate of surgery for CSM is increasing in ACP patients. However, postoperative complications of such surgery among adult patients with ACP have not been reported yet.
Article Synopsis
- - The study examined the frequency and risk factors associated with medial breaches of the pedicle wall during robotic-assisted cortical bone trajectory (RA-CBT) screw placements in 145 adult patients from January 2019 to July 2022.
- - Out of 784 screws analyzed, 30 (3.8%) exhibited a medial breach, with a notable correlation to lower bone quality (measured by Hounsfield units), the placement of screws on the right side, and screws in the upper instrumented vertebra.
- - Despite these breaches, no patients required additional surgery for screw repositioning, and there were no significant differences in clinical outcomes between patients with or without a medial breach.
Purpose: This study aimed to investigate the impact of the severity of cervical ossification of the posterior longitudinal ligament (OPLL) on the incidence of arteriosclerosis in the carotid artery.
Methods: Patients with OPLL-induced cervical myelopathy were prospectively enrolled. The study involved analyzing patient characteristics, blood samples, computed tomography scans of the spine, and intima-media thickness (IMT) measurements of the common carotid artery.
Background: The total number of spine surgeries per year and their related deaths in Japan has not been adequately estimated in the literature.
Methods: We retrospectively reviewed the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) between April 2014 to March 2021, which covers 99.9 % of health insurance claim receipts by general practitioners.
Background: Several reports have highlighted comparable surgical outcomes between microendoscopic laminectomy (MEL) and open laminectomy (open) for lumbar spinal stenosis. However, the unilateral approach in MEL may present challenges for the upper lumbar levels, where facet joints are located deeper inside. Our objective was to compare surgical outcomes and radiographic evaluations for single-level decompression cases at L1-L2 or L2-L3 between MEL and open laminectomy.
View Article and Find Full Text PDFArticle Synopsis
- - The study is a retrospective chart review that aims to evaluate the effectiveness of direct pars repair in achieving bone healing and alleviating symptoms in patients with spondylolitic spondylolisthesis.
- - 68 patients underwent open surgical pars repair, revealing a solid union rate of 52%, with 50% reporting no postoperative pain and 15% experiencing persistent pain.
- - The study found a significant association between younger age and lower pain levels post-surgery, contributing to a complete or partial union rate of 82%.
Comparison of Bone Mineral Density in Children and Adolescents on CT Versus DEXA Scan.
Spine (Phila Pa 1976)
October 2024
Article Synopsis
- - The study aimed to explore the relationship between Hounsfield units (HU) from CT scans and bone mineral density (BMD) assessed through DEXA scans in children and adolescents, as previous research primarily focused on adults.
- - Researchers analyzed patients under 18 years who had both a lumbar spine CT scan and a DEXA scan within six months, finding a moderate correlation between DEXA Z-scores and HU values.
- - Results showed that children with a DEXA Z-score of ≤-2.0 had significantly lower HU values compared to healthy peers, indicating that HU measurements on CT scans might effectively estimate BMD in the pediatric population.
Article Synopsis
- - The study examined intraoperative screw malposition during robot-assisted cortical bone trajectory (RA-CBT) surgeries, focusing on two types of malposition: skive and shift, which occur due to instrument deflection or registration changes, respectively.
- - A total of 1344 screws were placed in 256 patients, with a malposition rate of 2.4%, linked to higher body mass index (BMI) and specific vertebral characteristics at the insertion points.
- - No screw revisions were necessary post-surgery, highlighting that while malpositions occurred, they did not require further intervention, with factors such as obesity and specific bone properties influencing the likelihood of these errors.
Article Synopsis
- Adult spinal deformity (ASD) surgery has a high complication rate due to its invasive nature and several risk factors, including age and health history.
- The article categorizes these risk factors into modifiable (like frailty and osteoporosis) and non-modifiable.
- It aims to review evidence on these risk factors and highlight recent advancements in assessing surgical risks and planning tailored approaches for patients.
Study Design: A prospective, single-center, observational study.
Objective: To explore the association between serum levels of bone turnover markers and ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine.
Summary Of Background Data: The relationship between bone turnover markers, such as N-terminal propeptide of type I procollagen (PINP) or tartrate-resistant acid phosphate 5b (TRACP-5b), and OPLL has previously been examined.
Background: The painDETECT questionnaire (PDQ) is one of the available screening tools for neuropathic pain (NeP), with a cut-off score of 13. This study aimed to investigate changes in PDQ scores in patients undergoing posterior cervical decompression surgery for degenerative cervical myelopathy (DCM).
Methods: Patients with DCM undergoing cervical laminoplasty or laminectomy with posterior fusion were recruited.
The impact of body mass index (BMI) on outcomes after lumbar spine surgery is currently unknown. Previous studies have reported conflicting evidence for patients with high BMI, while little research has been conducted on outcomes for underweight patients. This study aims to examine the impact of BMI on outcomes after lumbar spine surgery.
View Article and Find Full Text PDFStudy Design: Retrospective chart review.
Objective: To provide reference values for Hounsfield unit (HU) measured on computed tomography (CT) scans of children and adolescents.
Summary Of Background Data: Spine surgeons increasingly use HU on spine CT as a measure of bone mineral density (BMD).
Study Design: A retrospective cohort study.
Objective: To investigate whether the timing of postoperative resolution of increased signal intensity (ISI) in the spinal cord is associated with surgical outcomes.
Summary Of Background Data: It remains unclear whether changes in ISI in the early postoperative period influence surgical outcomes.
Study Design: A single-center prospective observational study.
Objective: The aim was to clarify the usefulness of assessing advanced glycation end products (AGEs) by noninvasive skin autofluorescence in patients with ossification of the posterior longitudinal ligament (OPLL).
Summary Of Background Data: AGE accumulation is associated with various systemic disorders, including aging, diabetes mellitus, and obesity.
The Runt-related transcription factor (Runx) family plays various roles in the homeostasis of cartilage. Here, we examined the role of Runx2 and Runx3 for osteoarthritis development in vivo and in vitro. Runx3-knockout mice exhibited accelerated osteoarthritis following surgical induction, accompanied by decreased expression of lubricin and aggrecan.
View Article and Find Full Text PDFBackground: The impact of the T1 slope minus cervical lordosis (T1S-CL) on surgical outcomes in patients with degenerative cervical myelopathy undergoing laminoplasty (LP) remain uncertain.
Methods: One hundred patients who underwent cervical LP were retrospectively reviewed. Radiographic measurements included C2-C7 lordosis (CL), T1 slope (T1S), and C2-C7 sagittal vertical axis (SVA).
Article Synopsis
- Ectopic endochondral ossification in tendons and ligaments results from repetitive stress or inflammation, and tendon stem/progenitor cells (TSPCs) play a role in tissue repair, with some expressing lubricin (PRG4).
- Research identified a specific cluster of TSPCs that express R-spondin 2 (RSPO2), a WNT signaling activator, which helps maintain these cells in an undifferentiated state.
- In experiments, RSPO2 overexpression reduced ectopic ossification in mouse models by inhibiting chondrogenic differentiation, and lower RSPO2 levels were found in patients with specific ligament ossification compared to those
Study Design: A prospective observational study.
Objective: To evaluate the impact on surgical outcomes of preoperative neuropathic pain (NeP) assessed by the painDETECT questionnaire (PDQ) administered to participants undergoing cervical decompression surgery for degenerative cervical myelopathy (DCM).
Methods: Participating patients were separated into the Non-NeP group (preoperative PDQ score ≤ 12), and NeP group (score ≥ 13).