Publications by authors named "Shoji Seki"
Study Design: Retrospective analysis of data collected across multiple centers.
Objective: To develop machine learning models for predicting neurological outcomes one month postoperatively in patients with metastatic spinal tumors undergoing surgery, and to identify key factors influencing neurological recovery.
Summary Of Background Data: The increasing prevalence of spinal metastases has led to a growing need for surgical intervention to address mechanical instability and neurological deficits.
. Correction of thoracolumbar/lumbar curvature in adolescent idiopathic scoliosis (AIS) patients with Lenke 1-2 B and C is still controversial, with regard to extension of the caudal side to the lowest instrumented vertebra (LIV) and method of correction. We assessed the association between change in thoracolumbar/lumbar curvature after surgery with counterrotate technique (CRT) and clinical factors in 45 thoracic AIS patients.
View Article and Find Full Text PDFPurpose: Cervical spine injuries in the elderly (defined as individuals aged 65 years and older) are increasing, often resulting from falls and minor trauma. Prognosis varies widely, influenced by multiple factors. This study aimed to develop a deep-learning-based predictive model for post-injury outcomes.
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
- The study examines how the preoperative Spine Instability Neoplastic Score (SINS) relates to surgical decisions and patient outcomes in spinal metastases patients.
- The research involved 317 patients and assessed various factors like surgery type, existing conditions, and postoperative health indicators over 6 months.
- Findings revealed that SINS did not correlate with life expectancy, all patient-reported outcomes improved post-surgery, and surgical approach (especially fusion vs. non-fusion) didn't significantly impact these outcomes.
Purpose: Investigate zones where implant density should not be reduced in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) Lenke type 1A curves.
Methods: 126 consecutive patients (118 female and 8 male; mean age: 15.1 ± 2.
Study Design: Prospective multicenter study.
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.
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.
Background Context: Evaluating the gaps within the ossification of the posterior longitudinal ligament (OPLL) lesions, which may contribute to neurological symptoms, using conventional imaging techniques is challenging.
Objective: This study aimed to investigate the importance of evaluating gaps using 3-dimensional computed tomography (3D-CT) and their association with the occurrence of magnetic resonance imaging (MRI) T2 high intensity in the spinal cord.
Study Design/setting: Retrospective cohort study.
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
- The study examines the role of salt-inducible kinase 3 (SIK3) in osteoclast differentiation, which is important for maintaining bone health.
- Researchers created mice lacking SIK3 specifically in osteoclasts, finding these mice had increased bone mass and showed signs of osteopetrosis, indicating SIK3 is crucial for bone resorption.
- Treatment with the SIK3 inhibitor pterosin B suppressed osteoclast differentiation and affected metabolic pathways, suggesting SIK3 plays a key role in the molecular mechanisms of osteoclast function and bone diseases.
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.
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.
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.
Article Synopsis
- Adolescent idiopathic scoliosis (AIS) causes abnormal twisting and rotation of the spinal column, leading to uneven stress on vertebrae and increased demands on thoracic facet joints.
- The study utilized finite element analysis and surgical specimens from 13 female AIS patients to assess mechanical loading on thoracic facet joints, noting increased contact forces particularly on the concave side of the spine.
- Findings indicate that the asymmetrical load contributes to subchondral sclerosis and hypertrophy in the facet joints, enhancing the understanding of stress mechanics in AIS progression.
The apical hypokyphosis of scoliotic patients is thought to lead to decreased lung capacity and cause shortness of breath. Additionally, concave rod curve reduction is a problem in the correction of apical hypokyphosis in posterior spinal fusion surgery in adolescent idiopathic scoliosis (AIS). We investigated the contributions of rod rotation (RR) with an outrigger device, followed by differential rod contouring (DRC) with the outrigger attached to the concave rod, designed to prevent concave rod curve-flattening.
View Article and Find Full Text PDFObjective: To investigate the relationship between the severity and morphology of heterotopic ossification in the spinal ligaments including sacroiliac (SI) joints, and serum interleukin-17 (IL-17) levels in patients with ossification of the posterior longitudinal ligament (OPLL) with or without diffuse idiopathic skeletal hyperostosis (DISH), as well as a non-OPLL group.
Methods: A total of 103 patients with OPLL [DISH (-), n = 50; DISH (+), n = 53] and 53 age- and gender-matched controls were included. The serum levels of IL-17 were analysed, and the severity of ectopic ossification and the morphology of ectopic bone formation were evaluated.
Lumbar spine surgery is commonly performed worldwide for the treatment of lumbar spinal disorder, and the surgery saves many patients with lower back and lower extremity pain [...
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.*
Objective: Using segmental dynamic and static factors, we aimed to elucidate the pathogenesis and relationship between ossification of the posterior longitudinal ligament (OPLL) and the severity of cervical myelopathy.
Methods: Retrospective analysis of 163 OPLL patients' 815 segments. Imaging was used to evaluate each segmental space available for the spinal cord (SAC), OPLL diameter, type, bone space, K-line, the C2-7 Cobb angle, each segmental range of motion (ROM), and total ROM.
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.
Background: 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.