Publications by authors named "Yasushi Oshima"
Article 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 PDFObjective: 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 explores how the brain processes stopping behaviors when faced with external signals, focusing on the pathways involved in this response inhibition.
- - Researchers utilized neuroimaging techniques and brain stimulation to map out a four-step processing pathway that starts from the visual cortex and moves through various brain regions before reaching motor control areas.
- - Findings highlight the crucial roles of specific areas within the insular and prefrontal cortices, revealing how these regions communicate to efficiently inhibit responses, establishing a linked circuit: V1→daINS→vpIFC/aIFC→BG/M1.
Article Synopsis
- The study compares microendoscopic laminectomy (MEL) and open laminectomy in patients with multi-level lumbar spinal canal stenosis (LSCS), focusing on patient outcomes and complications.
- It involved 882 patients from eight spine centers, analyzing factors like blood loss, operation time, complications, and patient-reported outcomes over a one-year follow-up.
- Results showed that MEL had lower blood loss and a significantly reduced rate of surgical site infections compared to open laminectomy, with comparable complication rates overall.
Article Synopsis
- The study compares two techniques—Range-of-Motion (ROM) and Akagi's line—for aligning the tibial component in total knee arthroplasty (TKA) to see how differently they align the tibia.
- Results showed that the ROM technique generally led to a tibial component aligned 2.5° more externally than Akagi's line, particularly in knees with a smaller preoperative medial proximal tibial angle.
- Overall, while the techniques produced different alignment values, they didn’t significantly differ in terms of tibial rotational movement during the procedure.
Article 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.
Background Context: Low back pain (LBP) frequently occurs in patients with lumbar disc herniation (LDH), however the extent to which discectomy ameliorates it and how preoperative LBP influences postoperative outcomes remains unclear.
Purpose: To evaluate the improvement in LBP and its impact on postoperative patient-reported outcome measures (PROMs).
Study Design/setting: Multicenter retrospective observational study.
Objective: Facet joint destruction causes postoperative spinal instability, resulting in poor clinical outcomes after lumbar decompression surgery. However, the effect of facet joint destruction on radiographic and clinical outcomes after microendoscopic laminectomy (MEL) is unknown. Therefore, the current study aimed to examine the effect of facet joint resection on radiographic and clinical outcomes after single-level MEL surgery.
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- 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
- Incidental dural tears (DTs) during cervical spine surgery are a serious concern, yet their effects on patient-reported outcomes (PROs) one year post-surgery are not well understood.
- The study investigated patients who had elective cervical spine surgeries, examining pre- and postoperative PROs in relation to the occurrence of DTs, identifying complications and differences between patients with and without DTs.
- Results showed that out of 2,704 patients, 3.6% had DTs, leading to higher rates of complications and more severe neck and pain outcomes in those affected compared to those without DTs.
Full-endoscopic Spine Surgery for the Treatment of Lumbar Ligamentous Flavum Hematoma.
Neurol Med Chir (Tokyo)
November 2024
Lumbar ligamentous flavum hematoma (LFH) is a relatively rare pathology, and it is difficult to differentiate it from other cystic lesions. Full-endoscopic spine surgery (FESS), an excellent approach for clear and magnified operative visual field since it allows saline irrigation and minimizes destruction of surrounding tissues, has been applied to the treatment. This study aims to present a case series of patients with lumbar LFH treated by FESS.
View Article and Find Full Text PDFBackground: Spinal, pelvic, and lower extremity alignment is crucial for maintaining a healthy body posture. However, with aging, this posture becomes challenging to maintain due to muscle weakness and skeletal degeneration. Osteoarthritis (OA) of the hip and knee can also lead to abnormal posture, known as hip-spine and knee-spine syndrome.
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- Cervical radiculopathy impacts finger movement and dexterity, and a study analyzed 359 patients who underwent surgery for this condition, comparing those with C8 radiculopathy to those with C5-7 radiculopathy.
- The study found that while arm pain decreased significantly after surgery, patients with C8 radiculopathy experienced worse post-surgery neck disability index (NDI) scores and higher levels of upper back pain and numbness compared to the C5-7 group.
- Overall, the findings suggest that despite relief from arm pain after surgery, C8 radiculopathy patients had a less favorable clinical outcome compared to those with C5-7 radiculopathy.
Introduction: The association between postoperative patient-reported outcomes (PROs) and patient satisfaction remains poorly defined in patients undergoing surgery for thoracic myelopathy. This study aimed to investigate PROs and patient satisfaction following surgical intervention for thoracic myelopathy.
Methods: A prospective cohort of 133 patients who underwent surgery for thoracic myelopathy at 13 hospitals between April 2017 and August 2021 was enrolled.
Background: Distal femur fractures (DFFs) following total knee arthroplasty (TKA) in older patients often require prolonged non-weight-bearing, thereby decreasing their activities of daily living (ADL) and increasing mortality. This report clarifies early weight-bearing safety and utility by using double-plate fixation on medial and lateral sides (LM180 double-plate fixation) for DFFs following TKA.
Case Presentation: Three cases of Su Type III periprosthetic, interprosthetic, and interimplant DFFs following TKA, where bone stock was limited, were treated with LM180 double-plate fixation using locking plates through medial and lateral incisions on the distal femur.
Simple radiography is the most frequently and widely available technology to examine bone pathologies. Computed tomography (CT) can evaluate pathologies more accurately in multiple planes and three dimensions; however, radiation exposure is much higher than with simple radiography. In addition, diagnostic ability is decreased for both technologies when metal devices are present.
View Article and Find Full Text PDFPurpose: Adult spinal deformity (ASD) is associated with a combination of back and leg pain of various intensities. The objective of the present study was to investigate the diverse reaction of pain profiles following ASD surgery as well as post-operative patient satisfaction.
Methods: Multicenter surveillance collected data for patients ≥ 19 years old who underwent primary thoracolumbar fusion surgery at > 5 spinal levels for ASD.
Study Design: A prospective study.
Objective: To measure 3-dimensional cervical range of motion (ROM) by noninvasive optical tracking-based motion-capture technology in patients undergoing laminoplasty, and to elucidate the postoperative effects of laminoplasty on cervical mobility.
Summary Of Background Data: Cervical laminoplasty is a motion-sparing decompression surgery for degenerative cervical myelopathy.
Article Synopsis
- Sacral fractures can lead to lower urinary tract symptoms (LUTS) due to damage to the cauda equina, and there's limited understanding of how LUTS differs between high-energy and fragility fractures.
- This study analyzed eight patients with LUTS resulting from low-energy sacral fractures, comparing surgical and conservative treatment methods, and tracking their recovery.
- Results showed that most patients improved LUTS, with conservative treatment recommended as the first option, highlighting that surgical intervention may still be necessary if symptoms persist for several weeks.
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.
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 PDFBackground: We previously compared the operative outcomes of microendoscopic laminectomy (MEL) and full-endoscopic laminectomy (FEL) for single-level lumbar spinal canal stenosis (LSCS). In this initial report, the operative outcomes of FEL were not inferior to those of MEL.
Objective: The purpose of this study is to compare the outcomes of MEL and FEL for single-level LSCS on a large scale using widely used multiple evaluation methods.