Publications by authors named "Ryosuke Hirota"
Spinal cord injury (SCI) disrupts the blood-spinal cord barrier (BSCB) exacerbating damage by allowing harmful substances and immune cells to infiltrate spinal neural tissues from the vasculature. This leads to inflammation, oxidative stress, and impaired axonal regeneration. The BSCB, essential for maintaining spinal cord homeostasis, is structurally similar to the blood-brain barrier.
View Article and Find Full Text PDFArticle 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 PDFArticle Synopsis
- 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.
Article Synopsis
- * Seven patients received autologous MSCs without any serious side effects, showing no tumors or neurological decline throughout the process.
- * Notable functional improvements and enhanced quality of life were reported 90 and 180 days after the infusion, indicating that this treatment could be beneficial for chronic SCI, though further large-scale studies are required for conclusive results.
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease that predominantly affects children and adolescents. Currently, CRMO diagnoses are based on a combination of clinical, radiological, pathological, and longitudinal findings. However, distinguishing CRMO from malignant bone tumors using imaging is occasionally challenging.
View Article and Find Full Text PDFArticle 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
- The study investigated the postoperative outcomes for patients with spinal metastases from prostate cancer, focusing on improvements in their quality of life and other patient-oriented assessments.
- Conducted across 35 centers, the research assessed 413 patients, with 41 specifically having prostate cancer, and followed them for at least a year following surgery using various evaluation methods.
- Results showed significant improvements in neurological function, quality of life, and patient motivation post-surgery, indicating that surgical intervention is beneficial for these patients.
Article Synopsis
- This study conducted a retrospective analysis to evaluate the atrophy and fatty degeneration of cervical spinal muscles in patients with proximal cervical spondylotic amyotrophy (PCSA), aiming to predict postoperative improvements in neurological function.
- The analysis included 18 patients who underwent specific surgical procedures, correlating the cross-sectional area and fatty degeneration of the paraspinal muscles with their neurological function before and after surgery.
- Findings showed that greater fatty degeneration, particularly in the trapezius muscle, was linked to lower preoperative muscle strength, and this degeneration may serve as a significant indicator of likely postoperative outcomes.
Article Synopsis
- The study aimed to determine minimal clinically important differences (MCIDs) for patients undergoing surgery for spinal metastases to improve patient care by linking quality of life assessments with clinical outcomes.
- A total of 171 patients were evaluated pre- and post-surgery using various scales, leading to the identification of specific MCID values for different quality of life aspects based on their treatment outcomes.
- The study successfully established both anchor-based and distribution-based MCIDs for surgical interventions, which can help in assessing patient progress and overall treatment effectiveness.
This retrospective cohort study established malnutrition's impact on mortality and neurological recovery of older patients with cervical spinal cord injury (SCI). It included patients aged ≥ 65 years with traumatic cervical SCI treated conservatively or surgically. The Geriatric Nutritional Risk Index was calculated to assess nutritional-related risk.
View Article and Find Full Text PDFStudy Design: Retrospective cohort study.
Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C).
Settings: Multi-institutions in Japan.
Study 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.
Background: We investigated whether non-enhancement MRI features, including measurement of the heterogeneity of the tumor with MR T2 imaging by calculating coefficient of variation (CV) values, were associated with the prognosis of non-metastatic malignant peripheral nerve sheath tumors (MPNST).
Methods: This retrospective study included 42 patients with MPNST who had undergone surgical resection (mean age, 50 years ± 21; 20 male participants). Non-enhancement MR images were evaluated for signal intensity heterogeneity on T1- and T2-weighted imaging, tumor margin definition on T1- and T2-weighted imaging, peritumoral edema on T2-weight imaging, and CV.
Since the 1990s, our group has been conducting basic research on regenerative medicine using various cell types to treat several central nervous system diseases, including spinal cord injury (SCI). We have reported many positive effects of the intravenous administration of mesenchymal stem cells (MSCs) derived from the bone marrow. In the current study, MSCs were administered intravenously to a rat model of severe SCI (crush injury) during the acute to subacute stages-considerable motor function recovery was observed.
View Article and Find Full Text PDFDiffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory spondyloarthropathy characterized by ectopic calcification of spinal cord tissue. Its etiology is possibly polygenic. However, its pathogenesis and systemic effects remain unclear.
View Article and Find Full Text PDFSpinal cord injury (SCI) can cause paralysis with a high disease burden with limited treatment options. A single intravenous infusion of mesenchymal stem cells (MSCs) improves motor function in rat SCI models, possibly through the induction of axonal sprouting and remyelination. Repeated infusions (thrice at weekly intervals) of MSCs were administered to rats with chronic SCI to determine if multiple-dosing regimens enhance motor improvement.
View Article and Find Full Text PDFArticle Synopsis
- 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.
Purpose: To evaluate segmental mobility with degenerative lumbar spondylolisthesis (DLS), upright lateral flexion-extension radiographs (FE) are widely used. However, some authors have described that a combination of lateral radiographs in the standing position and supine sagittal image (SS) reveal more segmental mobility than FE. The purpose of this study was to investigate the optimal method for evaluating segmental mobility with DLS.
View Article and Find Full Text PDFStudy Design: Prospective single-center observational study.
Objective: To investigate the effects and limitations of self-motor-control exercise in patients with chronic low back pain.
Summary Of Background Data: Although exercise therapy and physical therapy have been shown to be effective in treating chronic low back pain, these therapies are often discontinued due to patients' non-compliance, and their effectiveness cannot be fully demonstrated.
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.
Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010-2020.
View Article and Find Full Text PDF