Publications by authors named "Okano I"

Usually, coccydynia cases are caused by herniated discs, with lower back pain and sciatica as initial symptoms. However, whether lumbar disc herniation causes coccydynia without back pain remains unclear. We report a case of lumbar disc herniation diagnosed as the underlying cause of coccydynia by discoblock.

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Background/context: The assessment of disc degeneration remains a significant challenge in clinical research. Pfirrmann grade is a frequently used classification for lumbar disc degeneration on MRI. However, there has been no gold standard for cervical spine disc degeneration.

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Pyogenic spondylitis is generally managed conservatively; however, surgical intervention may be required depending on the patient's condition. In this report, we present a case of upper thoracic pyogenic spondylitis with a paravertebral abscess that was successfully treated using negative pressure wound therapy (NPWT) combined with a cranked rod construct and a minimally invasive posterior-only approach. This report was constructed based on previous medical records and imaging findings.

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Thoracolumbar (TL) burst fracture is one of the most common indications for minimally invasive percutaneous pedicle screw fixation. Although the indication for surgical treatment of neurologically intact TL fractures remains under debate, studies have demonstrated that posttraumatic malalignment may lead to a deterioration in the patient's quality of life. For burst fractures with malalignment or fragments in the spinal canal, a reduction technique using ligamentotaxis is commonly used to improve long-term outcomes.

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Article Synopsis
  • - A 13-year-old boy presented with a malunion in his small finger after a specific fracture near the PIP joint, indicated by over 2 mm of displacement and a shift in alignment.
  • - He had corrective surgery four weeks post-injury, which involved realigning the broken bone fragments and fixing the angular deformity with an extra-articular osteotomy.
  • - Eight weeks after surgery, he achieved solid bone union, showcasing that this double-level osteotomy method is effective for treating similar pediatric fractures.
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Objective This is a retrospective observational study that aims to investigate the association between disc signal intensity index (DSI2) scores and patient-reported outcome measures in patients with lumbar spine disorders. Methods We introduced DSI2 to quantitatively assess disc degeneration. MRI records of patients with lumbar spine-related pain between 2019 and 2022 were analyzed retrospectively.

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Proximal junctional kyphosis and failure is a common complication of adult spinal deformity surgery, with osteoporosis as a risk factor. This retrospective study investigated the influence of long thoracolumbar fusion with pelvic fixation on regional bone density of adjacent vertebrae (Hounsfield units on computed tomography) and evaluated the association between bone loss and the incidence of proximal junctional kyphosis and failure. Patients who underwent long thoracolumbar fusion (pelvis to T10 or above) or single-level posterior lumbar interbody fusion (control group) between 2016 and 2022 were recruited.

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Background Only a few studies have examined the impact of the coronavirus disease 2019 pandemic on spine ambulatory surgeries and changes in trends. Therefore, we investigated trends during the pre-pandemic period and three pandemic stages in patients undergoing lumbar decompression procedures in the ambulatory surgery (AMS) setting. Methodology A total of 2,670 adult patients undergoing one- or two-level lumbar decompression surgery were retrospectively reviewed.

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Aims: The localization of necrotic areas has been reported to impact the prognosis and treatment strategy for osteonecrosis of the femoral head (ONFH). Anteroposterior localization of the necrotic area after a femoral neck fracture (FNF) has not been properly investigated. We hypothesize that the change of the weight loading direction on the femoral head due to residual posterior tilt caused by malunited FNF may affect the location of ONFH.

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Introduction Advancements in bipolar hemiarthroplasty (BHA) implants in the mid-1990s contributed to favorable short-term outcomes for osteonecrosis of the femoral head (ONFH), particularly in cases without acetabular cartilage lesions. Nevertheless, long-term results remain unclear. In this study, we investigated (i) the impact of new-generation BHA implants and (ii) the effect of the preoperative stage on long-term outcomes in young patients with ONFH.

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Background: Aging is associated with muscle atrophy, as typified by sarcopenia. Loss of abdominal muscle strength can cause abdominal wall laxity. The purpose of this study was to investigate the relationship between the sacral vertebra-abdominal wall distance (SAD) and movement performance using a simple lateral spine X-ray image for measuring the SAD.

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Distal humeral fractures are among the most challenging injuries to treat. Although precise repair of the articular surface is essential during surgery, accurate reconstruction of the metaphysis contributes to the overall stability of the fracture construct. The intraosseous wiring technique has been used for small-fragment fractures.

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Article Synopsis
  • The study investigated the long-term outcomes (15 years) of the Kudo type-5 total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA), revealing significant improvement in elbow flexion and performance scores post-surgery.
  • Out of 29 elbows analyzed, complications occurred, including fractures and dislocations, with a 24.1% rate of aseptic loosening requiring revisions for five elbows.
  • The overall survival rate of the Kudo TEA was 81% at 15 years, with a notable finding that incorrect ulnar component insertion angles led to a higher risk of needing revisions.
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Purpose: The primary objective of this study is to determine if ultrasound-guided erector spinae plane blocks (ESPB) prior to thoracolumbar spinal fusion reduces opioid consumption in the first 24 hours postoperatively. Secondary objectives include ESPB effects on administration of opioids, utilization of intravenous patient-controlled analgesia (IV-PCA), pain scores, length of stay, and opioid related side effects.

Methods: A retrospective cohort analysis was performed on consecutive, adult patients undergoing primary thoracolumbar fusion procedures.

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Background: Pulsed radiofrequency (PRF) has been used for treatment of chronic pain in several body regions, including axial and radicular pain. However, a limited number of reports have specifically demonstrated the effectiveness of PRF for spine-related pain among nonsurgical patients. Therefore, we evaluated the effectiveness of PRF for lumbar spine-associated pain in patients without recent spine surgery, and identified the factors associated with clinically meaningful improvement in pain and quality of life.

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Article Synopsis
  • * It included 662 patients, of which 168 (25.4%) experienced conversion to inpatient status, with factors like female gender, low body mass index, and high postoperative pain scores being significant risk factors for longer hospital stays.
  • * The primary reason for conversion was pain management issues, affecting 80% of those who were admitted; a small percentage (1.5%) required airway management intervention.
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  • The study examined how vertebral kyphosis and abdominal circumference affect sarcopenia and fall risk in patients with osteoporosis, involving 227 patients aged 65 and older.
  • Researchers measured sarcopenia through lean body mass, grip strength, and walking speed, finding higher rates of sarcopenia in patients with an abdominal circumference less than 80 cm.
  • The results indicated that patients with a sagittal vertical axis (SVA) less than 40 mm had lower fall scores compared to those with an SVA of 40 mm or more, suggesting that SVA and abdominal circumference could help predict sarcopenia and fall risk, but further research is needed to apply these findings clinically.
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Case: A 6-year-old girl who had midshaft forearm fractures treated conservatively had volar distal radioulnar joint (DRUJ) instability caused by radial malunion at the 1-year follow-up. Corrective osteotomy was planned using computer-aided design (CAD) software based on computed tomography images. According to the analysis, the radial bone had an 8° apex volar deformation in the sagittal plane.

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Purpose: There are reports that performing lateral lumbar interbody fusion (LLIF) in a prone, single position (single-prone LLIF) can be done safely in the prone position because the retroperitoneal organs reflect anteriorly with gravity. However, only a few study has investigated the safety of single-prone LLIF and retroperitoneal organ positioning in the prone position. We aimed to investigate the positioning of retroperitoneal organs in the prone position and evaluate the safety of single-prone LLIF surgery.

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Study Design: Retrospective database analysis.

Objective: To elucidate trends in the utilization of intraoperative neurophysiological monitoring (IONM) during elective lumbar surgery procedures and to investigate the association between the use of IONM and surgical outcomes.

Background: The routine use of IONM in elective lumbar spine procedures has recently been called into question due to longer operative time, higher cost, and other substitute advanced technologies.

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  • Thoracolumbar junctional kyphosis (TLJK) from osteoporotic vertebral fractures can severely affect patient quality of life, and there's debate over the need for pelvic fixation during corrective surgeries.
  • The study assessed outcomes of major corrective surgeries for TLJK, examining various spinopelvic parameters and evaluating the risk of junctional failures.
  • Results showed that a significant portion of patients experienced distal junctional failures, particularly those with certain preoperative alignment issues, highlighting the importance of identifying candidates who may benefit from pelvic fixation during surgery.
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Study Design: A retrospective observational study.

Objective: The objective of this study was to investigate the factors associated with the conversion of patient status from ambulatory surgery (AMS) to observation service (OS) (<48 h) or inpatient (>48 h).

Summary Of Background Data: AMS is becoming increasingly common in the United States because it is associated with a similar quality of care compared with inpatient surgery, significant costs reduction, and patients' desire to recuperate at home.

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Purpose: The vertebral bone quality (VBQ) score based on magnetic resonance imaging (MRI) was introduced as a bone quality marker in the lumbar spine. Prior studies showed that it could be utilized as a predictor of osteoporotic fracture or complications after instrumented spine surgery. The objective of this study was to evaluate the correlation between VBQ scores and bone mineral density (BMD) measured by quantitative computer tomography (QCT) in the cervical spine.

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