-
Hirofumi Sasaoka, Kazumori Arimura, Keiji Shiroma, Makoto Kimura, Yosh ...
1992 Volume 41 Issue 1 Pages
212-215
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We reviewed 5 cases of combine femoral fractures treated at our hospital since 1988. There were four males and one female patrent and the mean age at the time of injury was thirty nine years (range, 7-59 years). Four cases were right-sided kachires, the other one on the left. Two of five patients had intracapsular femoral neck fractures and two had extracapsular fractures. All resulted from high-energy impaction injuries. The average follow-up was 25.4 months (range, 7-44 months) with four patients achieving good results and acceptable. Ipsilateral fractures of the femoral neck and shaft should be stabilized by internal fixation as early as possible. Interlocking nailing and Knowles' pins seem to be effective in the treatment of the ipsilateral femoral neck and shaft fractures.
View full abstract
-
Takuya Tamaru, Kunio Sasaki, Atsushi Shimizu, Kouichi Watanabe, Akihir ...
1992 Volume 41 Issue 1 Pages
216-218
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Many classification systems have been developed in which trochanteric fractures are assesed as stable or unstable. However, no classification system has proven to be reliable enough for predichng the risk of unstable fracture reduction. I have fore devised the following new classification system.
The system classifies fractures into five types, based on the relation of the dislocation of the two main fragments and posterior comminution. The system was found to be superior to others, as it provided the most reliable information about prediction of the risk of unstable fracture reduction.
View full abstract
-
Shinichi Motomatsu, Mamoru Tomishige, Kenichiro Shibata, Masahiro Kina ...
1992 Volume 41 Issue 1 Pages
219-222
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Clinical examinations were performed on 25 patients over 90 years old treated operatively for femoral neck fractures. On discharge 9 patients (36%) were able to walk, and at the latest follow-up, 8 patients (32%) were alive, and 17 patients (68%) were dead. Most patients died within three years of the operation, but we believe that operative therapy produces a better prognosis than conservative therapy due to early post-operative rehabilitation.
View full abstract
-
Juji Nishi, Tetsuo Nakano, Kazuki Miyazono
1992 Volume 41 Issue 1 Pages
223-227
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Sixty four intracapsular femoral neck fractures treated with either internal fixation by multiple pinning or compression nip screw were studied. They were dassifed into four groups, using the intracapsular femoral neck fracture staging system reported by Garden: Stage I (9 fractures), stage II (7 fractures), Stage III (23 fractures) and Stage IV (15 fractures). After operation, patients were observed for periods from 6 to 69 months (mean: 20 months). Only one patient had non-union. The occurrence of late segmental collapse was rare, demonstrated in only 5 cases of Stage III and in 3 cases of Stage IV. We concluded that these therapies were more effective and less invasive than other iveament, and enabled patients to recover earier from their injury.
View full abstract
-
Takeshi Saito, Masashi Sagara, Hiroshi Inoue, Jyouji Noguchi, Iwao Yan ...
1992 Volume 41 Issue 1 Pages
228-232
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We lveated 131 cases of unstable trochantric fracture in our hospital. Of these 131 cases, 64 were treated with dynamic hip screw (group A), and 67 were treated by dynamic hip screw combined with an additional buttress plate (group B).
Telescoping of the screw more than 15mm occurred in 12.5% in group A, and 7.5% in group B. Anatomical reduction and stable fixation were achieved in group B. All patients could walk on average 2 weeks post-operatvely shortens the period requied for post-operative bed-rest.
View full abstract
-
Masao Noguchi, Hiroshi Maeda, Masatugu Suehiro, Juei-tang Chang
1992 Volume 41 Issue 1 Pages
233-236
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We treated 13 cases of subtrochanteric fracture at Kitakyushu city Yahata hospital from November 1988 to April 1991. Subjects comprised 10 males and 3 females with an average age of 42 years (range: 16-81). Fractures were classified into Type II A (3 cases), Type II B (2 cases), Type II C (1 case), Type III A (2 cases), Type III B (2 cases), Type IV (2 cases), Type V (1 case) as defined by Seinsheimer. One case treated with an AO plate did not achieve union, due to the weakness of the AO plate for subtrochanteric fracture. Two cases treated with DHS deveroped medical displasement because their Lag screws were inserted into fracture lines. But 9 cases were treated with DHS and all achieved primary healing.
View full abstract
-
Toshiaki Niimi, Ryohei Suzuki, Tokumi Nagaoka, Kenji Miyahara, Yukimas ...
1992 Volume 41 Issue 1 Pages
237-241
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Five cases of fracture and non-union of the lower extremities were treated by the Ilizarov method from August, 1989 to October, 1991.
case 1: A 45-year old female, infected non-union of a femoral supracondylar fracture
case 2: A 23-year old male, non-union of the tibia
case 3: A 72-year old male, tibia condylar fracture
case 4: A 45-year old female, tibial andylar fracture
case 5: A 13-year male, diaphyseal fracture of the tibia and fibyra having mediotorsio cruris due to fracture in the past
The complication of pin track infection occured in four cases, but all healed using antibiotics. The Ilizarov method was very useful not only various fractures, but also infected non-union.
View full abstract
-
Takashi Nakadera, Toshiaki Takahashi, Ichiro Shinohara, Yasuyuki Isobe ...
1992 Volume 41 Issue 1 Pages
242-246
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Nine fractures of long bones (three humeral, three femoral and three tibial fractures), were treated with the Ender nailing procedure. Subjects included four males and four females, with an age range from 19 to 76-years (average, 59.6). Good bone union and clinical results were obtained in all cases. Advantages of this procedure are as follow: (1) Surgical invasion is less than with other procedures (2) Callus formation is qreater and more rapid because of no damage to the external periosteal membrane and elastic fixation (3) Comminuted fractures are also a good indication. The disadvantages are as follows: (1) X-ray shower (2) Pain or contracture at nail insertion may be found; (3) Shortening or deformity may occur in unstable fractures such as comminuted fractures indication for using the Ender nad procedure.
View full abstract
-
Masatoshi Kamori, Takehiko Ogino, Tatsuo Matsuda, Hirosuke Mori, Kazuy ...
1992 Volume 41 Issue 1 Pages
247-251
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We used the May anatomical bone plate for treatment of fractures around the knee and ankle joint. Fifteen fractures included 3 in the distal part of the femur, 3 in the proximal part of the tibia, and 9 in the distal part of the tibia. Most results achieved were good or excellent and the May anatomical bone plate is an easy and effective treatment for fractures around the knee and ankle joint.
View full abstract
-
Yukimasa Nishimura, Takehisa Tsuneoka, Tadashi Watanabe, Takashi Okubo ...
1992 Volume 41 Issue 1 Pages
252-257
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We studied the mechanism of injury, treatment, and prognosis in six cases of triplane fracture of the distal tibial epiphysis. Subjects included 4 boys and 2 girls with an average age at injury of 13 years 2 months (rarge: 10-14.5 years). Athletic activity was the cause of the fracture in five cases, with a fall the cause in the other case. Four cases were treated with a cast after closed reduction. Two cases required open reduction and internal fixation. All cases showed good clinical result on follow-up. This study suggested the following: The mechanism of injury is forced plantar flexion and external rotation of the ankle. If the fracture shows more than two millimeters of displacement after closed reduction, it requires open reduction and internal fixation.
View full abstract
-
Hiroshi Nakagawa, Yoshihiro Mikawa, Kohji Hirano, Hiroshi Kondoh, Shin ...
1992 Volume 41 Issue 1 Pages
258-260
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
A rare case of subtalar anterolateral dislocation, is reported. The patient was a 62 year-old male who was injured when his car fell into a 30m deep ravine while being reversed.
There was an open wound on the innerside of the left ankle joint, and the medial tibial condyle and head of the talus were exposed. Roentgenograms showed a subtalar anterolateral dislocation and fracture of the sustentaculum tali. Open reduction was immediately performed under spinal anesthesia. The bone was fixed with Kirscher wires and a plaster cast applied postoperatively.
The Kirschner wires were removed 3 weeks postoperatively and the plaster cast was removed after 6 weeks. The patient was allowed full weight bearing 8 weeks postoperatively. One year after the accident, the patient had no pain and was doing very well.
The mechanism causing the subtalar dislocation is considered to be as follows: lateral dislocation occurred because of forsed dorsal flexion of the ankle joint and eversion of the foot. The anterior dislocation was caused by application of force posteriorly to the leg and heel. Therefore, a combination of lateral and anterior dislocation mechanism occurring at the time of the fall caused the anterolateral dislocation.
View full abstract
-
Masaaki Fujita, Kanji Akiyama, Yosimasa Ohtsubo, Kentaro Izumi, Yosiki ...
1992 Volume 41 Issue 1 Pages
261-264
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Fracture of the lateral process of the talus is an uncommon lesion and there fore this diagnosis is frequently initially overlooked.
We report one case, a 19 year-old female, who was injured in an auto accident in August, 1990. She had no clear history of severe dorsiflexion of the foot. Since initial X-rays showed a simple fracture, primary treatment was performed conservatively using a plaster cast for 3 weeks and an ankle brace for 8 weeks. However she had persistent foot pain, and excision of the osteophyte was carryed out 5 months after injury. Evaluation using Hawkins criteria showed a good result. Early diagnosis and treatment are important for avoiding prolonged disability and pain.
View full abstract
-
Shin-ichiro Takasugi, Ken Urabe, Toshihumi Shimoda, Naohisa Tayama, It ...
1992 Volume 41 Issue 1 Pages
265-267
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Isolated fracture-dislocation of the medial cuneiform bone is very rare. We report on a case that we recently experienced with this injury and review the relevant literature. We treated this patient by manual reduction and fixation of the fragments with two Kirschner wires and a satisfactory result was achieved
View full abstract
-
Yasuto Yamada, Takuya Goto, Kazunori Kamo, Yasuyuki Furukawa, Naoto Sa ...
1992 Volume 41 Issue 1 Pages
268-270
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Seven patients (six boys and one girl) with ispilateral complex fracture of the femur and tibia are reported. The mean age at the time of fracture was 7.1 years, ranging from 2 to 12 years. Follow-up period ranged from 2 years and 3 months to 6 years 11 months with a near of 3.5 years.
Six patients were injured by traffic accidents, of which five were while bicycle riding. We patients received injuries to vital organs. All patients were treated conservatively, except one patient who was operated on with Rush pinning. There was very good fracture healing with no knee contractures developing. The mean angulation after healing was 7.2 degrees in femoral fractures, and 2.3 degrees in tibial fractures. All cases had longitudinal over-growth, and this was especially remarkable after diaphyseal fractures.
View full abstract
-
Shinji Fukuoka, Hirotsugu Hagiwara, Kazuhisa Nakaie, Yoichi Kishikawa, ...
1992 Volume 41 Issue 1 Pages
271-274
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We present an unusual case of open dislocation of the knee with coronal fractures of both medial and lateral femoral condyles. The patient was a 19 year-old woman who had ipsilateral femoral shaft and patella fractures. The ACL, PCL, LCL and patellar ligament were damaged. The injury appeared to be dashboard trauma with a violent force exerted on the right front of the flexed knee.
Osteosyntheses of the femoral condyles, femoral shaft and patella, repair of the PCL and LCL, reconstruction of ACL with a Leeds-Keio artificial ligament and repair of the patellar ligament by McLaughlin's method were carried out. Early ROM exercises were emphasized, achieving a better functional result.
View full abstract
-
Shunji Matsunaga, Kousei Ijiri, Kenji Imamura, Kimiaki Koga, Kyouji Ha ...
1992 Volume 41 Issue 1 Pages
275-277
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
It is still controversial whether stimulation by electromagnetic fields is effective in the treatment of bony nonunion. We conducted experiments to study the optimal stimulation of electromagnetic fields for nonunion and used an electromagnetic fields pulse generator manufactured by the Institute of Physical and Chemical Reserch. Ten patients with nonunion (9 traumatic nonunion, one congenital pseudoarthrosis) were entered in the study. The site of nonunion was the femur in 4 patients, tibia in 3, humerus in 2, and radius in one. Results were as follows: The rate of bone union was 80%. For traumatic nonunion cases the period to union ranged from 3 to 5 months. However, it took 8 months to obtain bone union in the case of congenital pseudoarthrosis. Stimulation by electromagnetic fields is an effective method of treatment for nonunion.
View full abstract
-
Peri-shoulder trauma
Osamu Mori, Hiroshi Motoshige, Satoru Aoki, Kenshi Takada, Shinya Hori ...
1992 Volume 41 Issue 1 Pages
278-280
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We reviewed 172 cases of peri-shoulder trauma among a total of 441 cases involving cycle racers. Clavicular fracture occurred in86 cases (20%), more often involving riders in their thirties, and the left clavicle. The occurrence of lateral edge fractures was less than reported in the general population. About 40% of cases fractured again at the same site although re-fracture with displacement was noted less frequently. Time before resumption of racing was shown by questionnaire to be in the order of days and the clavicle tended to be fractured about 4 times. There were 11 scapula fractures and 9 dislocations of the acromioclavicular joint.
View full abstract
-
Hideaki Kubota, Yoshiichi Sasaki, Hiroyuki Yamamoto, Ken Arai, Naotaka ...
1992 Volume 41 Issue 1 Pages
281-284
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We report two cases of stress fracture of the ribs related to sports activities.
The first case involved fracture of the first rib caused by repeated stress from Japanese styled archery (kyudou). This is the first time such a case has been reported.
The second case, a typical stress fracture of the lower ribs and spinous process of the seventh cervical vertebra was caused by a golf swing.
View full abstract
-
Koichi Shiraishi, Tomoo Tukazaki
1992 Volume 41 Issue 1 Pages
285-288
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We report on a case of multiple stress fractures in a high school Ekiden runner, caused by overuse. We concluded that the prevention and cure of multiple stress fractures requires early detection, the diffusion of knowledge and education of relevant participants about stress fractures and maintaining communication with managers and trainers.
View full abstract
-
Hisayoshi Matsuda, Chihiro Kimura, Kouichiro Saisho, Junichi Higuchi, ...
1992 Volume 41 Issue 1 Pages
289-292
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Although bursitis is commonly seen, in rheumatoid arthritis iliopectineal bursitis is rare. We report a case of rheumatoid arthritis complicated by left iliopectineal bursitis.
The patient, a 55-year-old man had been treated for rheumatoid arthritis for 20 years. Three months previously he had noted a left groin tumor. X-rays showed his left hip joint to be in the end -stage of rheumatoid arthritis. Using ultrasonography, to you mean cystgraphy and computed tomography, we suspected that this tumor was an iliopectineal bursitis.
Total hip replacement and bursectomy were performed with no evidence of recurence.
View full abstract
-
FTA and Deformity of the Hindfoot
Katsuhiko Kamezawa, Hiroshi Nakamura, Takemasa Matsuda, Nagatoshi Yosh ...
1992 Volume 41 Issue 1 Pages
293-295
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We investigated the femoro-tibial angle (FTA) and deformity of the hindhoot radiographically in 80 knees and 80 feet of classical or definite RA patients.
Twelve knees (15%) had FTA values less than 169°, 56 knees (70.0%) had FTA values between 170° to 179° and 12 knees (15%) had FTA values qreater than 180°. There were 44 normal hindfeet (55.0%), 8 cases of flatfoot (10.0%), 15 feet with valgus deformity (18.7%) and there were no cases of varus deformity. Four of the 12 knees (33.3%) with FTA values less than 169° had valgus deformities of the hindfoot and four had planovalgus (33.3%). Seven of the 12 knees (58.3%) with FTA values qreate than 180° had normal hind feet. Feet joint with qreater than stage 3 disease were more frequently found in cases with in knees which had FTA values less than 169°. Feet joint with qreater than stage 3 disease were not found in patients with knees which had FTA values greater than 180°. This suggested that valgus deformity of the feet may cause a simular deformity of the knees.
View full abstract
-
Satoru Motokawa, Kenji Miyahara, Yasuji Mako, Masahiro Wada, Shin-ichi ...
1992 Volume 41 Issue 1 Pages
296-298
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Tsushima Island, an endemic area for ATL is known to have a high positive rate for anti-HTVL-I antibody. Recently arthropathy due HTVL-I infection has been reported. We compared the rate of HTVL-I antibody found in RA patients to that found in local inhabitants. The antibody titer of sera to HTVL-I antigen was measured by immunofluoresence. We found that 43% of RA patients in Tsushima were positive for HTLV-I antibody, which is higher than that for general inhabitants in Tsushima.
View full abstract
-
Hideaki Kira, Hiroshi Fujiki, Yoshikazu Ninomiya, Katsuya Fujimoto, Sa ...
1992 Volume 41 Issue 1 Pages
299-303
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Hand and chest X-rays of 25 classic or definite rheumatoid arthritis patients were reviewed. The mean duration of follow-up was 4.8 years, with X-rays showing advancement of the RA stages over several years.
In many cases joint destruction of the hand started at the carpal joint. Fourteen patients had signs of pulmonary disease on chest X-ray. On the basis of pulmonary function data, 5 of 23 patients were diagnosed as hawing restrictive disease, 1 patient had mixed restrictive and obstuctive disease, and 0 of 20 patients had reduced diffusing capacity.
View full abstract
-
Go Maeda, Masakazu Kondo, Norio Shinohara, Koichiro Yokoyama, Koji Naj ...
1992 Volume 41 Issue 1 Pages
304-309
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We performed a series of total knee arthroplasties (TKA), using the Kinematic stabilizer Total knee System (TKS) in rheumatoid arthritic knees, especially those with severe deformity. Since 1990, we changed from the Kinematic TKS to Kinemax TKS and now report on our follow-up study of this Kinemax stabilizer TKS. Forty five TKA with Kinemax stabilizer were performed in thirty one patients between January, 1990 and June, 1991. All cases were reviewed for this study. The follow-up period ranged from 5 to 20 months (mean 12 months). Clinical results were evaluated using the Japanese Orthopaedic Association (JOA) scoring system and rediograpic analysis was carried out. The preoperative mean JOA score was 38.6 increasing postoperatively to 78.6. Radiographic alignment data were all satisfactory. We concluded that the Kinemax stabilizer TKS was favorable for use in the severely deformed rheumatoid arthritic knee.
View full abstract
-
Tetsu Murao, Masayuki Maekawa, Hiroshi Chosa, Hiroshi Kamo, Sigeharu N ...
1992 Volume 41 Issue 1 Pages
310-314
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Osteoarthritis with pustulosis palmaris et plantaris has recently become well known, but femoral bone lesions remain very rare with only 11 cases, including our two, reported in Japan.
X-rays showed cortical bone sclerosis and expansion of the proximal half of the femur. Bone scintigraphy with
99mTc showed accumulation at the site of subjective symptoms. Blood examination results were as follows: Case 1 had a raused ESR, and Case 2 had positive CRP. These was a slight increase in serum ALP in both cases, while neither were positive for rheumatoid factor.
Histologically, femoral and vertebral body specimens showed a thickening of the trabeculae and non-specific chronic inflammation.
Conservative treatment with antibiotics and an anti-inflammatory agent and/or tonsillectomy were effective.
View full abstract
-
Kensuke Sakai, Kensei Nagata, Fujio Higuchi, Teruaki Ohhashi, Hiroshi ...
1992 Volume 41 Issue 1 Pages
315-317
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Predeposited autologous blood transfusions were used for 93 cases of spinal surgery. The success rate for avoiding the use of homologous blood was 95 percent and 100% for avoiding transfusion complications.
This method was useful for cervical laminoplasty and a combination procedure involving laminectomy and fusion of the lumbar spin.
View full abstract
-
Yasuo Ito, Shinnosuke Nakahara, Masato Tanaka, Kazuhiro Takeuchi
1992 Volume 41 Issue 1 Pages
318-320
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Fourteen cases of infectious spondylitis were evaluated with MRI. In addition, 32 cases of vertebral metastases and 25 cases of compression fractures were also evaluated to assess the possibility of differentiation from infectious spondylitis. Most infectious spondylitis showed low intensity on T1-weighted images and high intensity on T2*-weighted images from the vertebral bodies and intervertebral disc space and in all cases there was an inability to discern a margin between the disc and the adjacent vertebral body on both Ti and T2*-weighted images. In conparison half of the cases with vertebral metastases and most with benign compression fractures were isointense on both Ti and T2*-weighted images from intervertebral discs. Most cases of metastasis and fracture showed a clear margin between the disc and the vertebral body on both images. From the viewpoint of differential diagnosis, the presence of disc involvement and an unclear disc margin suggests spondylitis as compared to vertebral metastasis and benign compression fracture.
View full abstract
-
Masashi Iwasaki, Kazunori Yone, Nagatoshi Yoshikuni, Kiyoshi Uchino, N ...
1992 Volume 41 Issue 1 Pages
321-323
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
In recent years, magnetic resonance imaging (MRI) has been widely used in the diagnosis of acute spinal cord injuries. However, the association between MRI findings and histological changes remains unclear. We compared MRI results, with histological findings in 29 patients with cervical cord injury. The Subjects, 28 males and 1 female, ranged in age from 14 to 81 years. Low intensity on T2-weighted MRI images were detected in two cases immediately after spinal cord injury. Those cases showed very poor prognosis. Almost all of the cases which still had palsy at the time of follow-up, showed some MRI signal changes more than 48 hours after injury.
View full abstract
-
Using In Situ Hybridization Technique
Ei Nagai, Hirosi Tanaka, Hiroyasu Ichimoto, Tuneo Nakahara, Masayuki O ...
1992 Volume 41 Issue 1 Pages
324-326
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
BMP (bone morphogenetic protein), is a bone differentiation factor that initiates enchondral bone formation in ectopic sites. In this study, we used in situ hybridization to follow the distribution of this factor in ossification of the ligamentum flavum (OLF).
High level BMP expression was seen in chondrocytes and fibroblasts adjacent to the ossification. BMP expression was also seen at a lower level in the ossification, while it was not seen in the ligamentum. Our observations suggest that BMP is expressed in cells situated in the direction of growth before they become bone-forming cells and plays an important role in the growth of ossification.
View full abstract
-
Kiyoshi Uchino, Takashi Sakou, Nagatoshi Yoshikuni, Kazunori Yone, Hir ...
1992 Volume 41 Issue 1 Pages
327-329
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Data was collected retrospectively on 72 patients with lower cervical spine injury treated in our Institues. Fifty two patients were treated surgically and twenty treated nonsurgically. At final follow-up no significant difference in neurological recovery was noted between patients treated surgically and those treated nonsurgically. We concluded that the timing of the operation was not effective and that the type of spinal cord injury was the most important prognoshe factor in tems of neurological recovery.
View full abstract
-
Tsukasa Kondo, Takayoshi Suga
1992 Volume 41 Issue 1 Pages
330-334
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Two cases with paraparesis resulting from osteoporotic vertebral fractures were treated by an anterior operation using the Kaneda anterior spinal device. Case 1 was a 57-year-old woman with a T12 wedge compression fracture. The kyphotic deformity at T11-12 had caused the paraparesis.
Case 2 was a 65-year-old woman with a T10 compression fracture and L1 burst fracture. Spinal cord compression at L1 was evident on the myelogram, CTM and MRI.
We employed an anterior operation using the Kaneda anterior spinal device in both cases, achieving clinical improvement with no complications.
We prefer the anterior operation using the Kaneda anterior spinal device for such fractures, because this ensures a more satisfactory decompression, allows reconstruction of the anterior pillar of the vertebral column in the short fusion, and early ambulation.
View full abstract
-
Toshihiko Taguchi, Daishiro Yuge, Hiroshi Mimura, Youzi Maehara, Takas ...
1992 Volume 41 Issue 1 Pages
335-338
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We report the clinical results of Roy-Comille plate fixation for thoraco-lumbar spine fractures.
Subjects included 13 men and 3 women with an average age at operation of 52 years (range: 26 to 73 years). The average duration of follow-up was 1.4 years (range: 0.3 to 4.8 years). The most common site of injury was Th12-L1, which accounted for 69% of the injuries. Sixty-three percent of the patients had neurological improvement at the time of follw-up and no patient demonstrated a decrease in their neurologic status. Radiographs revealed an average preoperative kyphohc angle of 22°, decreasing to 7.6° post-operatively and 10° at time of follow-up. Only one complication of a screw which come out was reported. We did not observe any plate and screw breakage.
The Roy-Comille plate is a pedicle screw fixation system which has few complications and is useful for allowing early rehabilition.
View full abstract
-
Hiromichi Koga, Takuya Goto, Kazunori Kamo, Yasuyuki Furukawa, Naoto S ...
1992 Volume 41 Issue 1 Pages
339-341
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We treated 12 lower lumbar injuries out of 84 lumbar injuries in our hospital during the 5 year period since 1986. Six lower lumbar injuries were operated upon. We have recently treated 4 lower lumbar injuries with plating employing kedicle screw plates and using the. one-stage posterior approach. Pedicle screws were found to provide good strength and evaluation of neurofunchtion and by roentrography demonstirated good results.
View full abstract
-
Koichi Matsumoto, Naoya Tajima, Shigeru Kuwahara, Tadatoshi Yamaguchi
1992 Volume 41 Issue 1 Pages
342-344
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Shape-memory alloy is a new biomaterial that returns to its original shape in response to heating. Using shape-memory alloy, we devised a NiTi L-shaped rod for correction of scoliosis. In developing this instrument it was necessary to determine the biotoxicity of the alloy. Nickel levels in rabbit tissues were determined with an atomic absorption spectrometer. Shape-menory alloy rods, pure Ni powder, pure Ni rods and pure Ti rods were implanted in the paravertebral muscles of rabbits to determine the blood, urine, kidney and liver levels of Ni. The blood nickel concentration after implantation of the Ni-Ti alloy reached a twice normal level after 6 hours. After 4 weeks, the Ni concentration increased 4-fold in the kidney, 2-fold in the liver and 10-fold in the urine.
View full abstract
-
Keiji Mihara, Takayoshi Torigoshi, Hirnaki Knnisi, Masava Shiraishi
1992 Volume 41 Issue 1 Pages
345-349
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Middle-Lower lumbar and sacral spinal injuries are rare. Neurological recovery following cauda equina injury is better than after spinal cord injuries and it is possible for patients with this injury to walk. We reviewed 6 cases with cauda equina injuries. All achiewed good neurological recovery, regaining bladder-rectum function, and sensory (pain) sensation. We treated these patients by post erior decompression and fusion. Full decompression of the nerve tissues and rigid internal skeletal fixation are recommended for this type of injury.
View full abstract
-
Shuji Umeda, Yuiti Maeda, Koutaro Ohhasi, Kouji Kawakami, Takafumi Nak ...
1992 Volume 41 Issue 1 Pages
350-352
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Calcification of the intervertebral discs in chidhood has been recognized since the original descripition by Baron in 1924. We report the case of an 8-year-old girl, who complained of neck pain, limitation of neck movement and dysphagia. The neurological examination was normal. Cervical spine films showed calcification in the C6/7 intervertebral disc space. Her symptoms were theated with a cervical collar and bed rest and she became asymptomatic within a week. Six months later, the calcification was almost completely resorbed.
View full abstract
-
Haruo Takano, Kiyotsugu Maekawa, Hiroaki Sakata, Keiichirou Okajima, K ...
1992 Volume 41 Issue 1 Pages
353-357
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We report on the cervical lesions found in three cases of Athetoid Cerebral palsy.
The first case was diagnosed as having atlanto-axial subluxation on dynamic cervical spine radiography. Two other cases who complained of gait disturbances were diagnosed as having cervical spinal myelopathy on myelogram and CT-M.
Posterior spinal fusion with instrumentation was perfomed on all three cases.
Results following surgical treatment in all cases were relatively favorable and we believe that posterior spinal fusion with instrumentation is a valuable therapeutic procedure in cases with athetoid cerebral palsy.
View full abstract
-
Mitsuhiro Yanase, Hidefumi Kawaida, Toshiya Jinpo, Takashi Sakou, Eiji ...
1992 Volume 41 Issue 1 Pages
358-361
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We reviewed the contrast-enhanced MR images of 50 cases of cervical OPLL (34 males, 16 females) and 10 cases of cervical spondylosis (8 males, 2 females). Characteristic findings were as follows:
1. In 2 OPLL patients, there were correlated areas of enhancement within the spinal cord on T1-weighted images with areas of increased signal intensity on T2-weighted images.
2. Ten discs in 7 OPLL patients enhanced, however there was no disc enhancement in the cervical spondylosis group.
3. Enhancement of the epidural veins with various patterns were seen in both the OPLL and cervical spondylosis group.
4. Enhancement of the cervical posterior longitudinal ligament was not found in any OPLL patients.
View full abstract
-
Measurement by Dual-Energy X-Ray Absorptiometry
Kosei Ijiri, Eiji Taketomi, Shunji Matsunaga, Hirofumi Uehara, Katsuhi ...
1992 Volume 41 Issue 1 Pages
362-365
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Measurements of bone mineral density were carried out by Dual-Energy X-Ray Absorptiometry (DEXA) in 77 patients who were operated on for ossification of the posterior longitudinal ligament (OPLL) in the cevical spine and 60 healthy adult volunteers. There was no significant difference between OPLL and controls although some female OPLL patients did have higher bone mineral densities than the control group.
In OPLL, the subgroup with severe myelopathy had lower bone mineral density in comparison to the mild myelopathy group.
There was, however, no sighificant difference between the continuous or mixed-type group and the separate or other-type group. No significant difference was noted between ankylosing spine hyperostosis type (ASH type) and non-ASN type.
View full abstract
-
Tatsuoki Mashima, Masayoshi Oga, Yukihide Iwamoto, Youichi Sugioka, Ma ...
1992 Volume 41 Issue 1 Pages
366-372
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Three cases of dysphagia associated with ossification of the anterior longitudinal ligament (OALL) of the cervical spine have been presented. Two of the patients also had ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, but had no neurological deficits.
Retention of contrast medium in vallecula epiglottica and recess piriformis, the so called vallecular sign, was observed in the esophagogram of all cases and two showed migration of contrast medium into the trachea.
Resection of the bony mass was performed with complete relief obtained immediately after surgery.
View full abstract
-
Goichi Yoshida, Takayoshi Torigoshi, Hiroaki Konishi, Keiji Mihara, Sh ...
1992 Volume 41 Issue 1 Pages
373-376
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We studied 51 cases of cervical myelopathy to clarify the characteristics of these judged to be serious 21 cases compared with mild or moderate lesions 30 cases.
Serious cases involved a large number of elderly patients with a long duration of symptoms before surgery, narrow spinal canals, and multiple lesions of the cervical spine.
We confilmed that early diagnosis and early operation are important for the treatment of serious cervical myelopathy cases before irreversible spinal cord damage occurs.
View full abstract
-
Masao Kifune, Shinya Kawai, Kouzou Sunago, Minoru Saika, Fujio Kawakam ...
1992 Volume 41 Issue 1 Pages
377-379
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Since 1957, operative treatment has been performed on 350 cases of cervical spondylotic myelopathy (CSM) in our hospital. We achieved very good postoperative results but 23 cases did require a second operation. In to first operation, twenty-one of the 23 cases were operated anteriorly (A) and two posteriorly (P). In the second operation, sixteen patients were treated by A and seven by P. The two patients who required a third, operation, receired a posterior procedure. This report discusses several factors associated with multiply operated necks. Causes of multiple operations include recurrence at the disc level adjacent to the fused disc (9 cases), failure of decision of surgical site (4 cases), poor operative result (4 cases), mischoice of surgical procedures (3 cases), and non-union (2 cases). It is important to carefully decide the affected levels of the cervical spine with radiological and other evaluations, and give consideration to choice of operative methods.
View full abstract
-
Hidehiro Yanagi, Katumi Suzuki, Toshitaka Nakamura, Shinichi Mishima, ...
1992 Volume 41 Issue 1 Pages
380-384
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
Osteochondromas rarely compress the spinal cord or cauda equina. A case of thoracic cord compression by an osteochondroma combined with multiple osteochondromas is reported. A 21-year-old man was admitted to our hospital with a 3-month history of spastic gait and sensory disturbance. The diagnosis of osteochondroma of the 1-3rd thoracic spine was made based on histological examination, roentgenogram, myelogram and CT scan.
Right decompressive hemilaminectomy was performed at the 1-4th thoracic level. Postoperative CT scan and MR images showed no evidence of reccurence or malignancy.
View full abstract
-
Tetsuya Yara, Hitoshi Kise, Shinya Kuniyoshi, Kunio Ibaraki, Hiroaki T ...
1992 Volume 41 Issue 1 Pages
385-390
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
we experienced two cases of thoracic disc herniation associated with ossification of the yellow ligament (OYL).
Case 1 A 68-year-old male, who presented with muscle weakness of the lower limbs and gait disability was diagnosed as having Th9/10 disc herniation associated with Th9-11 OYL. Th9-11 laminectomy and transdural removal of Th9/10 disc was performed. In spite of temporary progression of muscle weakness just after surgery, he resumed full gait function.
Case 2 A 45-year-old male with gait disturbance due to Th9-12 OYL was treated with Th9-12 laminectomy. Gait function improved after surgery, but recurred one year later. MRI revealed newly-formed Th9/10 disc herniation, and anterior decompression and fusion were performed at Th9/10.
After the second operation almost full recovery of gait function was gained.
View full abstract
-
Shoichi Ikeda, Masanobu Oyama, Sinnosuke Kurose, Yasuharu Nakasima, Ke ...
1992 Volume 41 Issue 1 Pages
391-392
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
The terminal position of the caudal sac is variable. We examined the position in 100 cases who had undergone myelography. The caudal sac closed proximally to the L5/S1 disc level in 3 cases, between L5/S1 and S1/S2 disc level in 41 cases, between S1/S2 and S2/S3 disc level in 55 cases, and caudally to S2/S3 disc level in one case.
View full abstract
-
Comparison of Love's method with and without P-L Fusion
Yoshihisa Inada, Nobuyuki Ito, Masao Eto, Masayuki Egashira, Kenshiro ...
1992 Volume 41 Issue 1 Pages
393-397
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
In order to evaluate the usefulness of P-L fusion combined with Love's method for lumbar disc herniation, we studied the postoperative results, clinically and radiolodically.
We studied 32 cases, of whon 22 were treated by the Love method (Love) and 10 treated with the combined Love method and posterolateral fusion (PLF).
Pre and postoperative clinical findings, which included numbness, pain, sensory, and muscle power were evaluated. The height of the intervertebral space and instability of lumbar spine were measured by Hasegawa's and Dupuis' methods respectively.
The intervertebral disc height at the operation site decreased significantly in patents treated by the Love method. However, the preoperative intervertebral disc narrowing was not so marked in the PLF cases. PLF was also effective for treatment in cases with lumber spinal instability.
Radiological findings appeared to be superior in PLF compared to Love cases. However, clinical symptoms such as low back pain improved equally in both groups.
View full abstract
-
Masaaki Murata, Yasuo Morio, Kouji Kuranobu, Kichizou Yamamoto
1992 Volume 41 Issue 1 Pages
398-400
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We compared MRI and functional roentgenography for the evaluation of disc degeneration. There was a correlation between disc degeneration and age. There was also a correlation between disc degeneration and disc height, which decreased, as disc degeneration progressed. Segmental movement decreased, as disc degeneration severely progressed.
View full abstract
-
Hiroshi Maeda, Masao Noguchi, Masatsugu Suehiro, Hideaki Kira, Hiroshi ...
1992 Volume 41 Issue 1 Pages
401-404
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
We shudied the correlation between MRI and histopatholgical changes in seventeen discs from 7 cadaveric lumbar spines. Close comparision of MRI (T2-weighted) and the histological sections of the discs showed a high correlation between MRI and histopathological findings. The area with low intensity in the nucleus pulposus on MRI derived from an increase in collagen fibers, the area with high intensity in the annulus correlated to an area of tear. Four types of MRI were distinguished on the basis of the shape, with each type related with the pathological stage of disc degeneration.
These findings suggest that shape and intensity of MRI provides a precise evaluation of the degree of disc degeneration.
View full abstract
-
Jun Arimizu, Yasusi Asakawa, Yasusi Soejima, Hirosi Nomiyama, Toyonobu ...
1992 Volume 41 Issue 1 Pages
405-409
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
This study evaluated the morphological changes of lumbar disc extrusion seen on MRI.
The study population consisted of 4 patients who sustained lumbar extrusions, radicular pain and neurological loss, and were au who successfully treated non-operatively.
Patients were assessed pre-treatment and post-treatment by MRI with measurement of the length of extrusions in sagittal view (stenosis ratio) and the square of herniated nucleus pulposus in the axial view (occupying ratio). All cases showed a decrease in both stenosis ratio and occupying ratio. There was a median of 8.5 months between initial presentation and follow-up with a range of 6 to 15 months. Although the regression mechanism of disc extrusion is still unclear, we believe that spontaneous regression of disc extrusion in correlated to this unknown mechanism.
View full abstract
-
Naoyuki Kuga, Keiichirou Shiba, Takayoshi Ueta, Kenzou Shirasawa, Hide ...
1992 Volume 41 Issue 1 Pages
410-413
Published: November 25, 1992
Released on J-STAGE: February 25, 2010
JOURNAL
FREE ACCESS
The MRI findings in 61 subjects who were operated on for lumbar disc herniation were retrospectively studied, to diagnose rupture of the posterior longitudinal ligament(PLL). The accuracy rate of diagnosing rupture of the 66.7%. False negative cases were found in herniated discs with only a small rupture of the PLL. False positives were seen in cases with large extruded disc herniation.
View full abstract
