Longitudinal impact of multi-segment spinal fixation surgery on mobility status and clinical outcomes in adult spinal deformity: a multicenter retrospective study.

Purpose: To investigate changes in postoperative mobility status in patients with ASD, and the determining factors that influence these changes and their impact on clinical outcomes, including the rate of home discharge and long-term mobility.

Methods: A total of 299 patients with ASD who underwent multi-segment posterior spinal fusion were registered in a multi-center database were investigated. Patient mobility status was assessed using walking aids and classified into five levels (1: independent, 2: cane, 3: walker, 4: assisted, and 5: wheelchair) preoperatively, at discharge, and after 2 years.

Does global spinal alignment affect the use of walking aids after multi-segment spinal fixation for patients with ASD? A multicenter retrospective study.

Purpose: This study aimed to clarify the relation between global spinal alignment and the necessity of walking aid use in patients with adult spinal deformity (ASD) and to investigate the impact of spinal fixation on mobility status after surgery.

Methods: In total, 456 older patients with ASD who had multi-segment spinal fixation surgery and were registered in a multi-center database were investigated. Patients under 60 years of age and those unable to walk preoperatively were excluded.

Zonisamide ameliorates neuropathic pain partly by suppressing microglial activation in the spinal cord in a mouse model.

Neuropathic pain is caused by a lesion or a functional impairment of the sensory nervous system and allodynia is one of the frequently observed symptoms in neuropathic pain. Allodynia represents abnormal pain due to a non-noxious stimulus that does not normally provoke pain. Cellular mechanisms underlying neuropathic pain remain mostly elusive, and partial pain relief can be achieved in a limited number of patients by antidepressants, anticonvulsants topical anesthetics, and others.

Risk Factors for Neuropathic Pain in Middle-Aged and Elderly People: A Five-Year Longitudinal Cohort in the Yakumo Study.

Objective: To determine the risk factors for new neuropathic pain (NeP) after five years in healthy middle-aged and elderly volunteers.

Design: Prospective longitudinal cohort study (Yakumo study).

Setting: Clinical evaluation in a health checkup.

Association between locomotive syndrome and the Japanese version of the EQ-5D-5L in middle-aged and elderly people in Japan.

The Japanese version of the EuroQol 5 dimension, 5 level version (EQ-5D-5L) can now be used to quantitatively evaluate the health-related quality of life (QoL) in Japan. Locomotive syndrome (LS) is a concept advocated in Japan to describe a condition requiring care for musculoskeletal disorders. However, no detailed study on the relationship between this index and LS in Japanese health checkup has been reported.

A Study of Risk Factors for Early-Onset Adjacent Vertebral Fractures After Kyphoplasty.

Study Design: Retrospective study.

Objectives: To elucidate risk factors for early-onset (2 months after initial kyphoplasty) adjacent vertebral fracture (EO-AVF) after kyphoplasty.

Methods: A total of 108 vertebral bodies (95 patients) were included in this study.

Clinical Features of Thoracic Myelopathy: A Single-Center Study.

Unlabelled: Thoracic myelopathy is relatively uncommon because few degenerative changes occur as a result of the restricted range of motion surrounding the rib cage.

Methods: A retrospective study was performed in 300 consecutive surgical cases of thoracic disorders with myelopathy treated in our department from 2000 to 2015. Girdle pain, back pain, low back pain, leg numbness, leg pain, gait disturbance, leg paresis, and bowel bladder disturbance as initial and preoperative symptoms; patellar tendon reflex, ankle tendon reflex, and ankle clonus as preoperative neurologic findings; MRI and CT findings; and surgical procedure, intraoperative findings, and postoperative recovery were investigated.

Natural reduction in acute intratumoral hemorrhage of spinal schwannoma in the cauda equina.

A 58-year-old woman presented with acute pain in her back and her left leg. Magnetic resonance imaging (MRI) revealed an intradural schwannoma with an intratumoral hemorrhage between the lower L4 vertebra and L5/S1 disk level. A follow-up MRI after one month revealed that the tumor had regressed from the middle of L5 to the L5/S1 disk level.

Connection of discontinuous segments in early functional recovery from thoracic ossification of the posterior longitudinal ligament treated with posterior instrumented surgery.

Objective: The objective of this study was to investigate the relationship between morphological changes in thoracic ossification of the posterior longitudinal ligament (T-OPLL) and postoperative neurological recovery after thoracic posterior fusion surgery. Changes of OPLL morphology and postoperative recovery in cases with T-OPLL have not been examined.

Methods: In this prospective study, the authors evaluated data from 44 patients (23 male and 21 female) who underwent posterior decompression and fusion surgery with instrumentation for the treatment of T-OPLL at our hospital.

Low Bioelectrical Impedance Phase Angle Is a Significant Risk Factor for Frailty.

The phase angle, which is measured via bioelectrical impedance analysis (BIA), is a clinically important bioimpedance parameter used for nutritional assessment and evaluating the risk of various diseases, such as locomotive syndrome (LS). It remains unclear if the phase angle is associated with frailty (fragile state of physical and mental health). We therefore examined this association in a large prospective sample.

The Relationship Between Neuropathic Pain and Spinal Alignment: Independent Risk Factors for Low Quality of Life in Middle-Aged and Elderly People.

Study Design: Prospective research in middle-aged and elderly people.

Objective: To investigate low back pain (LBP) and neuropathic pain (NeP); spinal alignment and range of motion (ROM); spinal degenerative changes in plain radiography; osteoporosis; muscle strength; and physical ability as possible risk factors for poor quality of life (QOL).

Summary Of Background Data: The aging of society has led to an increase in elderly people with chronic pain, including LBP and NeP.

Postoperative Resolution of MR T2 Increased Signal Intensity in Cervical Spondylotic Myelopathy: The Impact of Signal Change Resolution on the Outcomes.

Study Design: A prospective comparative imaging study.

Objective: This study investigated whether postoperative resolution of spinal cord increased signal intensity (ISI) reflected symptom improvement and surgical outcomes in cervical spondylotic myelopathy (CSM) patients.

Summary Of Background Data: Although some CSM patients exhibit magnetic resonance imaging (MRI) ISI, its alteration and resolution have not been investigated.

Declining neck circumference is an anthropometric marker related to frailty in middle-aged and elderly women.

Neck circumference (NC) has been associated with cardiovascular disease and metabolic syndrome. However, the association between NC and frailty remains unknown. We aimed to determine the relationship between frailty and NC in middle-aged and elderly women.

Weakness of grip strength reflects future locomotive syndrome and progression of locomotive risk stage: A 10-year longitudinal cohort study.

Grip strength is a simple indicator of physical function. The goal of this retrospective study was to examine whether grip strength reflects locomotive syndrome and locomotive risk stage 10 years later. The participants were 88 Japanese adults aged >40 years who attended a health check-up in 2006.

Epidemiology and effect on physical function of osteosarcopenia in community-dwelling elderly people in Japan.

To determine the prevalence of osteosarcopenia and its relationship with physical function in elderly people in Japan. The subjects were 427 healthy volunteers over 65 years old (205 males, 222 females, average age 71.4 years) who attended health checkups in 2016 and 2017.

Shoulder pain has most impact on poor quality of life among various types of musculoskeletal pain in middle-aged and elderly people: Yakumo study.

To investigate the severity and effect on quality of life (QOL) of various types of pain in healthy volunteers.: A total of 384 subjects (male: 158, female: 226, average age: 63 years) were included in a prospective cohort study (Yakumo study). Shoulder pain, low back pain (LBP), sciatica, knee pain, and the American Shoulder and Elbow Surgeons (ASES) shoulder score were evaluated with SF-36.

Wave changes in intraoperative transcranial motor-evoked potentials during posterior decompression and dekyphotic corrective fusion with instrumentation for thoracic ossification of the posterior longitudinal ligament.

Background: A prospective clinical study of amplitudes of intraoperative transcranial motor-evoked potentials (TcMEPs) was performed in patients undergoing surgery for the posterior longitudinal ligament of thoracic spine (T-OPLL).

Objective: To investigate intraoperative TcMEPs during posterior decompression and dekyphotic corrective fusion with instrumentation for T-OPLL.

Methods: The subjects were 33 patients with an average age of 48 years at surgery who underwent posterior decompression and fusion with instrumentation under intraoperative TcMEP monitoring.

Optimal stimulation intensity for Br(E)-MsEP waveform derivation at baseline in pediatric spinal surgery.

Objectives: Br(E)-MsEP monitoring is widely used in spinal surgery for detection of spinal cord injury. However, Br(E)-MsEP waveform derivation requires high-intensity stimulation, and this raises a concern of adverse effects due to the immature corticospinal tract in pediatric patients. The purpose of this study is to determine the optimal stimulation intensity required for derivation of Br(E)-MsEP waveforms at baseline in pediatric spinal surgery.

Impact of comorbidity rates of lumbar spondylosis, knee osteoarthritis, and osteoporosis on physical QOL and risk factors for poor physical QOL in middle-aged and elderly people.

To examine effects of combined osteoporosis (P), knee osteoarthritis (K-OA), and lumbar spondylosis (L-OA) on quality of life (QOL), and identify risk factors for poor QOL. 1021 subjects (440 males, 581 females, mean age: 63.4 years) were prospectively included.

Occipitocervical or C1-C2 fusion using allograft bone in pediatric patients with Down syndrome 8 years of age or younger.

Sufficient internal fixation for occipitocervical (OC) or C1-C2 instability in pediatric patients with Down syndrome is difficult owing to small osseous structures, congenital deformities, and immature ossification. The purpose of this study was to evaluate the clinical outcomes of patients aged 8 years or younger with Down syndrome who underwent OC or C1-C2 fusion using freeze-dried allograft as bone graft substitute. The participants included seven consecutive patients aged 8 years or younger with Down syndrome who were treated for upper cervical disorders with posterior OC or C1-C2 fusion using freeze-dried allografts at our hospital between 2007 and 2016 and had a minimum follow-up of 1 year.

A comparative study of two reconstruction procedures for osteoporotic vertebral fracture with lumbar spinal stenosis: Posterior lumbar interbody fusion versus posterior and anterior and combined surgery.

Background: Optimal treatment of lumbar spinal stenosis (LSS) with neurological deficit due to osteoporotic vertebral fractures (OVFs) has been controversial. We assessed the usefulness, safety, and efficacy of posterior lumbar interbody fusion (PLIF) for LSS with neurological deficit due to OVFs and compared this procedure to posterior/anterior combined surgery (PACS).

Methods: Of 36 consecutive patients with LSS with neurological deficit due to OVFs, 15 underwent PLIF (6 males, 9 females; mean age, 74 years), and 21 underwent PACS (4 males, 17 females; mean age, 70 years).

Reduction in body cell mass as a predictor of osteoporosis: A cross-sectional study.

Improvement of nutritional status, which may help prevent osteoporosis, can be assessed using the body cell mass (BCM) index, measured by the bioelectrical impedance analysis (BIA). However, the relationship between BCM and osteoporosis is not clear. This cross-sectional study investigated the association between osteoporosis and four components of body composition, including BCM.

Computed tomography-based navigation system-assisted surgery for primary spine tumor.

Primary tumors of the spine are uncommon compared to metastases. The objective of the study was to examine the utility of O-arm navigation-assisted surgery for a primary spine tumor. A prospective study was performed in 18 consecutive patients who underwent O-arm navigation-assisted surgery for a primary spine tumor at our hospital between 2014 and 2017.