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谷口 博信, 桑原 茂, 田島 直也
1993 年 42 巻 1 号 p.
1-5
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
A standard experimental fracture was produced in rats using a simple apparatus, a cast spreader fitted with a dull-edged copper blade with stopper.
Without the aid of internal splintage, a total of 100 fractures were made in the tibial shaft using this apparatus, and their healing process was examined radiologically. More than 80% were satisfactory fractures, a closed and transverse fracture made in the mid-shaft with minimal displacement and not complicated by fibular fracture. The fracture fragments almost turned to be impacted and stable by the end of the 1st week.
These results indicate that the expermental fracture made using this method is especially useful in histological studies concerning the formation of internal callus.
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林 協司, 吉国 長利, 岸本 浩, 酒匂 崇
1993 年 42 巻 1 号 p.
6-8
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We experienced 6 cases of traumatic spondylolisthesis of the axis,
so-called hamgmas's fracture, over a six year Period. This fracture is usually considered to be caused by an exten sion injury, however, two of our cases appeared, to be due to a flexion injury. The mechaninsm of injury needs to be taken into consideration when deciding on the type of treatment, although, in general this fracture is treated conservatively. According to Levine's classification, type I and type II fractures can be treated by skeletal traction. However traction is contraindicated for type IIa fractures, and these should be treated by the application of an extensive-compressive force using a halo vest. Such cases as type III fractures and any remaining remarkable kyphosis or instability, require operative treatment.
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中村 雅洋, 今給黎 尚典, 長野 芳幸, 藤井 晴朗, 新門 裕三, 酒匂 崇, 武富 栄二, 松永 俊二
1993 年 42 巻 1 号 p.
9-11
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
A rare case of paraplegia due to thoracic ossification of the yellow ligament and thoracic vertebral compression fracture is reported. A 70-year-old female with thoracic ossification of yellow ligament developed severe spinal cord symptoms after mild trauma. Radiographic evaluation showed spinal cord compression caused by an anterior bone fragment and posterior ossification of the the yellow ligament. The patient was treated surgically with posterior decompression and fusion using Dick's transpedicular screw system. Good alignment of the spine was shown on the postoperative X-ray. Although the follow up period is only eight months, the patient has had no neurological deterioration. Spinal fusion combined with decompression should be indicated to prevent neurological deterioration due to kyphosis after laminectomy.
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前川 清継, 坂田 浩章, 岡嶋 啓一郎, 家入 浩一, 佐々木 彰, 高野 晴夫
1993 年 42 巻 1 号 p.
12-15
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We have treated Luguerod lumbar canal stenosis (LCS) using or in elderly patients since 1987.
We have carried out root decopression for the lateral type of LCS without spinal instrumentation (7 reported cases). The patients' main complaints were intermittent claudication without neurological defici.
The exact diagnosis was made using root block nd angiography.
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今村 健志, 酒匂 崇, 米 和徳
1993 年 42 巻 1 号 p.
16-18
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We performed fenestration on 22 patients with lumbar canal stenosis.
The average follow-up period was 18 months, ranging from 6 to 41 months.
We evaluated the postoperative results according to the criteria for lumbar disorder of the Japanese Orthopaedic Association (JOA score).
The average preoperative JOA score was 13. After operation, symptoms were reduced in many patients, with an average JOA score of 22.8 and an improvement rate of 55%.
Fenestration is a useful procedure for degenerative and combined type of lumbar canal stenosis.
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橋本 卓, 新宮 彦助, 木村 功, 那須 吉朗, 塩谷 彰秀, 大浜 満, 立木 豊和, 山下 優嗣
1993 年 42 巻 1 号 p.
19-23
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Clinical, radiological and surgical studies have been made of 57 farmers who were operated upon for degenerative lumbar canal stenosis (Group A) and degenerative spondylolisthesis (Group B). The improvement rate was excellent in both groups.(Group A: 75.6%, Group B: 71.7%). The improvement rate in abdominal and back muscle strength was lower in cases with postoperative kyphosis than in those with postoperative lordosis. Cases with a slip angle of less than 0 degrees postoperatively showed less improvement and a lower abdomminal and back muscle strength than those with an angle of 0 degrees or more. Disappearance of lumbar lordosis, local kyphotic alignment, low strength of abdominal and back muscles are unfavourable factors influencing return to farm work.
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寺井 祐司, 今井 健, 越宗 陽平, 角南 義文
1993 年 42 巻 1 号 p.
24-26
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Eighteen cases of lumbar disc herniation (LDH) and thirty two cases of lumbar canal stenosis (LCS) with foot drop were reviewed. The average age at the time of operation was 40.4 years (LDH), and was 59.2 years (LCS). Follow-up period after the operation averaged 30.6 months (LDH), and 31.9 months (LCS).
We devised two types of classification according to neurological symptoms, namely cauda equina or nerve root type with operative methods selected for each type. Love's method was mainly performed for LDH, laminectomy for cauda equina lesions, and fenestration for neve root lesions.
Operative results were assesed using the JOA score and Hirabayashi's method. Average recovery rate was 84.6% for LDH, and 61.9% for LCS. The main factors influencing the prognosis were morbidity period, bladder bowel disturbance, and the strength of the tibial anterior muscle. Three cases of LDH and nine cases of LCS remained with foot drop postoperatively.
Surgery was not as effective for the recovery of foot drop, but was useful for treatment of intermittent claudication and lower extremity pain. Because the symptoms are progressive, the operation should be done as soon as possible even with elderly patients.
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米 和徳, 酒匂 崇, 増田 明敏, 上原 裕史, 川内 義久, 中川 雅裕
1993 年 42 巻 1 号 p.
27-29
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Thirteen patients treated with percutaneous discectomy for relapse of lumbar disc herniation were evaluated. All patients had been treated by partial laminectomy and herniotomy in the first operation.
The period between the first operation and percutaneous discectomy ranged from 4 to 204 months, mean 76 months. The observation period after the second operation ranged from 12 to 39 months' mean 25 months.
According to MacNab's criteria, the results of surgry were excellent in 1 patient, good in 11 patients, and poor in 1 patient.
Percutaneous discectomy is simple, safe and only slightly invasive since it causes no direct damage to the dura or nerve roots. Since 1989 we have performed this operation on 363 patients with lumbar disc herniation, with no serious surgical complications encountered.
The study of our series suggests that this techique is a useful preocedure for treating relapse of lumbar disc herniation.
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中川 雅裕, 酒匂 崇, 増田 明敏, 寺田 歩, 川内 義久, 簗瀬 光宏, 西村 謙一
1993 年 42 巻 1 号 p.
30-32
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We investigated MRI and X-ray changes in operated discs in patients following percutaneous discectomy.
Sixty-six patients were examined by MRI pre and post operatively, and the degree of the herniated disc was measured in sagittal imaging. Reduction of the herniated disc was seen in 49 disc levels (67.1%)
The X-rays of forty patients available for follow-up showed disc space narrowing in twenty (42.6%) and four with unstable an intervertebral space (8.5%).
However these changes were not well correlated with the clinical results.
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松本 治之, 槙坪 宏之, 宮下 裕行, 下垣 浩一, 藤本 英作, 横田 和典
1993 年 42 巻 1 号 p.
33-37
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Lumbar disc herniation with bone erosion is rare. We report a case of a 53-year-old male with a migrated disc fragment which caused bone erosion in his L3 vertebra. On admission the patient complained of pain and hypesthesia of his left thigh anterior region. Myelography was not able to detect the presence of the migrated disc fragment. Myelo-CT, discography, disco-CT and MRI detected the migrated disc fragment which had moved in a superior direction subligamentally from the L3/L4 disc. We did a partial laminectory and removed the migrated disc fragment and postoperatively the patient was free from pain.
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新門 裕三, 今給黎 尚典, 野尻 良基, 酒匂 崇, 武富 栄二, 井尻 幸成
1993 年 42 巻 1 号 p.
38-40
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
There is a great controversy as to the anatomy of the lumbar nerve roots at the intra and extraforaminal zones. We report the anatomical study of the relationship between lumbar nerve roots and intervertebral discs and vertebral bodies at intra and extraforaminal zone.
Eight human cadavers, aged 49-90 years (average 73.1 years) were studied. Laminectomy and facetectomy were performed at L1 to L5 vertebral levels to observe the lumbar nerve roots. Myelography, radiculography and CT scan were performed to confirm the anatomy of the nerve root. At the outlet of the foramen, 81.2% of nerve roots were located on the inferior edge of the vertebral body.
As for extraforaminal lumbar disc herniation, nerve roots were impaired by lateral and superior sequestrated herniation.
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transpedicular fixation 使用・非使用の比較
久我 尚之, 芝 啓一郎, 植田 尊善, 白澤 建蔵, 大田 秀樹, 森 英治, 力丸 俊一, 檜田 伸一, 達城 大, 小原 伸夫
1993 年 42 巻 1 号 p.
41-44
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Posterolateral lumbar fusion is a useful method for stabilization of unstable lumbar spine segments. We reviewed 139 patients who were operated on with posterolateral lumbar fusion and 72 patients with transpedicular fixation. The success rate of posterolateral fusion was studied using postoperative X-rays with a comparison made between the group that received tranpedicular fixation and the group that didn't. Diagnosis of solid fusion was made by the absence of motion with no more than three degrees between vertebrae on lateral bending films. 75.0% of patients with transpedicular fixation were assessed as success, compared to 63.2% without transpedicular fixation. Single level fusion achieved a higher rate of fusion than multilevel fusion. The complication rate was 16.7%, most of which were failure of instruments for multilevel fusion.
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原 真一郎, 櫛田 学, 濱里 雄次郎, 宮原 健次, 瀬良 敬祐
1993 年 42 巻 1 号 p.
45-47
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Since 1983, We have used the Hokudai System Lumbar Posterior Instrumentation for healment of lumber spinal disorders.
Clinical and radiographic evaluation has been carried out in 25 patients who have used this device with PLF.
In conclusion, this device can be recommended as a useful instrumentation to achieve a higher union rate of spine fusion.
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松本 光司, 秋山 徹, 西田 民夫, 上野山 和秀
1993 年 42 巻 1 号 p.
48-51
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Fifteen patients were treated by posterior lumbar interbody fusion using the Steffee VSP system for degenerative lumbar spine lesions. They were evaluated independently with an average follow-up of 1 year. Fusion rates were 94% (15/16). Anterior slipping was well reduced and the alignment was corrected. Acceptable clinical results were seen in most of the patients with low back and leg pain. However, several problems remain in the reduction and alignment-corrertion of lateral slip of the lumbar spine. In addition, treatment of patients with osteoporosis or long term hemodialysis required careful surgical technique and extensive external fixation.
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山城 健一, 田中 智香, 川口 英二, 坂本 公宣, 赤崎 幸二, 絹原 寛士, 園田 英器, 友田 邦彦, 武内 晴明, 大塚 豊
1993 年 42 巻 1 号 p.
52-57
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Inflamatory spondylitis in children is a rare infectious disease and often misleading thus resulting in a delayed diagnosis. We reported the clinical course and X-ray change of three cases. Antibiotics were administered in all three cases until the erythrocyte sedimentation rate recovered to the standard value. All patients were cured.
X-ray revealed the affected disc space narrowing and vertebral body condenstion. Following control of the disease. disc space narrowing and vertebral body condensation improved. In one case, the affected vertebral bodies over-grew 7 years after disease onset.
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原 雄人
1993 年 42 巻 1 号 p.
58-59
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We used the Lipo-PGE1 for post decompressed myelopathy patients who continued to have various symptoms post operatively and evaluated the effect for numbness and intermittent claudication.
We used the Lipo PGE1 in a total of ten patients, seven with spinal canal stenosis of the lumbar region and three with lumbar hernia nuclei pulposi. Lipo PGE1 relieved numbness and prolonged the distance before developing intermittent claudication. All patients reduced the numbless and prolonged of gait distance. Using the Lipo PGE1 for who had continued symptoms of post decompmession of myelopathy were usefull.
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加藤 清信, 木田 浩隆, 花村 達夫, 後藤 俊介, 中村 宏, 三原 隆
1993 年 42 巻 1 号 p.
60-63
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
The advantages and limitations of the ultrasonic surgical system in spinal surgery are disccused in this report.
We used SUMISONIC ME-24000, which transmits ultrasonic vibrations (maximum vibration 2400times/sec, maximum amplitude 200μm) to the horn tip. Since the horn tip is very thin, accurate, precise cutting and resection of hard tissue is possible using a light touch.
Cool water is discharged by the horn tip, minimizing heat gererated from cutting, and also washs away dissolved tissue.
It was very useful in spinal surgery, especially in surgical decompression of spinal cord of OPLL and OYL.
The risk of damage to soft tissue appears to be very low, in comparison with surgiairtome.
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佐々木 彰, 前川 清継, 坂田 浩章, 岡嶋 啓一郎, 家人 浩一, 高野 晴夫
1993 年 42 巻 1 号 p.
64-66
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) were prospectively measured after uncomplicated spinal operation. The three types of operations included lumbar anterior spinal fusion (
n=11), cervical spinal fusion (
n=8-, and laminectomy with posterior fusion (
n=7), In all patients CRP and WBC reached peak levels on the first day, while the peak level was reached on the 7th day. CRP values did not reach 10mg/dl after 7 days in any patients. CRP appears to be more valuable that WBC or ESR for ealy detection of postoperative infection.
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簗瀬 光宏, 川井田 秀文, 川内 義久, 西村 謙一, 酒匂 崇, 武富 栄二, 米 和徳, 大久保 幸一
1993 年 42 巻 1 号 p.
67-69
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed contrast-enhanced MR images of 71 patients with OPLL (50 cervical OPLL, 13 thoracic OPLL and 8 lumbar OPLL).
In 2 cases of cervical OPLL, there were areas of enhancement within the spinal cord on T1 weighted images which correlated with areas of increased signal intenity on T2 weighted images. But there was no area of enhancement within the spinal cord on T1 weighted images in the cases with thoracic and lumbar OPLL. Enhancement of the discs were present in 10 discs of 7 cervical OPLL patients. However there was no disc enhancement in cases with thoracic and lumbar OPLL. Enhancement of the hypertrophic posterior longitudinal ligament was not found in any OPLL patients.
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國東 芳顕, 有薗 剛, 大賀 正義, 真島 龍興, 杉岡 洋一
1993 年 42 巻 1 号 p.
70-73
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Magnetic resonance imaging has been increasingly used in recent years. Vertebral compression fractures in elderly patient are a common occurrence, and although most vertebral compression fractures are due to senile osteoporosis, the radiologist is often consulted by his colleagues to identify pathologic fracture due to an underlying malignancy.
In this study, we evaluated MRI for differentiating benign from pathologic compression fractures.
Both benign and malignant fractures produced mixed signal intensities on the MR images. It seems to be difficult to differentiate benign compression fractures of vertebral bodies from pathologic fractures which are associated with tumor.
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吉村 豊暢, 高岸 宏, 諫山 照刃, 浅川 康司, 有水 淳
1993 年 42 巻 1 号 p.
74-77
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Twenty female pahents (averaging 75.5years) with compression fractures associated with spinal osteoporosis were examined by magnetic resonance (MR) imaging, Newly diagnosed cases presented low and high signals in T1-and T2-weighted images, respectively. Image normalization was noted from peribody (especially posterior margin)after 1-3months of treatment, gradually leading to iso-luminance in mixed presence of high and low signals. Seven cases showed no roentgenographic euidence of fractures, but did show signal changes in MRI. Two cases also developed such changes in the adjacent vertebral bodies in the course of treatment, showing the need for diagnostic care.
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岩本 幸英, 國東 芳顕, 大賀 正義, 中馬 広一, 小田 義直, 田仲 和宏, 岩熊 智雄, 杉岡 洋一, 大宮 克弘, 森永 政博
1993 年 42 巻 1 号 p.
78-81
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
The transoral approach is the most popular method for exposure of the upper cervical spine. However, since only a small area of exposure can be achieved with this approach, we have used the mandibular-tongue splitting approach, for removal of an upper cervical spine chordoma. Splitting of the soft palate, tongue and lower mandible were performed following tracheotomy and intubation. The entire surface of the tumor was then exposed by incision of the pharangeal mucosa. The tumor was resected and then anterior spinal fusion from the atlas to the fourth cervdcal vertebra was performed. Symptoms such as severe cervical pain, upper limb weakness and urinary dysfunction rapidly improved following surgery. Posterior stabilization from occiput to seventh cervical vertebra using Hartshill-Ransford loop was added two and a half months after the initial surgery.
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土井口 祐一, 伊藤 信之, 衛藤 正雄, 岩崎 勝郎
1993 年 42 巻 1 号 p.
82-86
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of atlantoaxial dislocation associated with von Recklinghausen's disease which developed after anterior cervical spinal fusion.
Anterior spinal fusion was performed from C
3 to C
7 to prevent the progression of marked kyphosis (125 degrees) found in a 22-year-old man with von Recklinghausen's disease. Spondylosis was well established, and no further increase in kyphosis was seen. However three years after the operation, he complained of lower extremity tingling and had a spastic gait. Radiological instability of C
1-C
2 was then confirmed.
The earlier anterior cervical spinal fusion was considered to be potentially involved in the pathogenesis of this patient's atlantoaxial dislocation.
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鳥取部 光司, 田島 直也, 桑原 茂, 平川 俊一, 松本 宏一
1993 年 42 巻 1 号 p.
87-91
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Since 1984, cervical spinal canal enlargement has been performed in 33 patients with cervical myelopathy (21 with cervical ossification of the posterior longitudinal ligament and 12 with cervical spondylosis). In expansive open-door laminoplasty, the average age at surgery was 57.5 years and the average follow-up period was 4 years and 5 months. In double door laminoplasty, the average age at surgery was 65.3 years and the average follow-up period was 1 year and 2 months. Clinical results were evaluated using JOA score for cervical myelopathy and recovery rates using Hirabayashi's method. In expansive open-door laminoplasty the preoperative average score was 8.7 points, and this improved to 12.2 points postoperatively. The average recovery rate was 42.2%, In double door laminoplasty the average preoperarve score was 8.1 increasing to 11.6 postoperatively The average recovery rate was 39.3%. Radiologically, cervical alignment showed a tendency to be straight, and postoperative cervical antero-posterior movement decreased. Cervical laminoplasty is a useful procedure for treatment of cervical myelopathy.
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頚椎症性脊髄症例について
立木 豊和, 新宮 彦助, 木村 功, 那須 吉郎, 塩谷 彰秀, 大濱 満, 橋本 卓, 山下 優嗣
1993 年 42 巻 1 号 p.
92-96
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We evaluated the clinical results and cervical alignment in 26 cases of cervical spondylotic myelopathy. All patients had had a cervical laminopasty at least a year previously. At follow-up kyphotic and S-shaped type cases did not achieve such good clindcal results. Group A cases refained alignment of lordosis and this straight-type achieved good clinical results. Group B cases which changed to other types had a fair response. Group A kept their curvature index compared to Group B. Cases which maintained their curvature index within 5* achieved better clinical results than those over 5 and this difference was significant (p<0.05).
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村田 雅明, 森尾 泰夫, 倉信 耕爾, 山本 吉蔵
1993 年 42 巻 1 号 p.
97-102
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
(6 cases of cervical spondylotic myelopathy and 8 cases of OPLL).
The fusion rate of PLF was 67.3% Cervical spine motion and cervical lordosis decreased significantly after operation. Segmental motion angle and listhesis also decreased significantly, therefore, the stabilizing effect of PLF was recognized. However the segmental motion angle of the level above the fused segment increased significantly.
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副島 康, 浅川 康司, 竹下 満, 有水 淳, 緒方 公介
1993 年 42 巻 1 号 p.
103-106
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
In 3 patients cervical radiculopathy occurred after posterior decompression of the cervical spinal cord. In the postoperative radiculopathy group the average backward movement of the spinal cord was 4mm on the C5 level and 5mm on the C6 level. In the nonradiculopathy group the average backeward movement of the spinal cord was 2mm at the C5 and C6 level. We recommend wide laminoplastic enlargment of the cervical canal.
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三原 圭司, 鳥越 雄喜, 小西 宏昭, 吉田 伍一
1993 年 42 巻 1 号 p.
107-112
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Five cases of cervical myelopathy caused by calcification of the yellow ligament were reported. Patients included two male and three female, aged 57, 74, 53, 73, and 78 years old. The authors performed laminoplastic spinal canal enlargement in all cases. The average improvement rate, evaluated using the J. O. A score was 44.4% (range: Se 30-58%) 40%. CT scanning after myelogram is avalable for the diagnosis of CYL rather than X-ray, tomogram, and MRI. Early and adequate decompression of the spinal cord is necessary.
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有村 一盛, 城間 啓治, 笹岡 博文, 馴松 義啓, 越智 龍弥, 木村 真
1993 年 42 巻 1 号 p.
113-118
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
A case of multiple thoracic disc herniation is reported because of the rarity of the condition.
A patient is presented with cord compression due to herniation of the T
2-3 T
3-4 and T
4-5 discs.
We selected the extrapleural approach because of simplified postoperative care with minimum surgical interferance with respiratory function.
Surgical decompression was successful via this approach.
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谷口 育秀, 江川 正, 朝長 圀夫, 植松 伸久, 矢部 嘉浩, 奥村 正彦
1993 年 42 巻 1 号 p.
119-121
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
A seventy-year old female with symptomatic thoracic disc herniation between T2 and T3 was reported. This patient was severely disabled and nonambulant preoperatively. Following posterolateral costotransversectomy she showed marked improvement in symptoms and signs.
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朝長 匡, 鳥越 雄喜, 小西 宏昭, 三原 圭司, 白石 雅也
1993 年 42 巻 1 号 p.
122-125
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Postoperative results were evaluated in 7 patients (5 males and 2 females) with ossification of the ligamentum flavum. The mean follow-up period was 2 years. Age at the time of operation ranged from 41 to 74 years with a mean of 57 years.
Mean recovery rate using Hirabayashi's method was 43.1%. In this series, the factors influencing the postoperative results were unclear. CTM findings correlated with preoperative severity.
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井上 貴雄, 槌田 典平, 中原 進之介
1993 年 42 巻 1 号 p.
126-129
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
A case of paraplegia caused by calcification of the thoracic spinal yellow ligament is presented. A 77-year-old Japanese woman had lumbago, muscle weakness of her lower extremity and hypoesthesia of right lower extremity as incipient symptoms. Radiological examination of the thoracic spine showed scoliosis, spondylotic deformity and abnormal opacity posteriorly in the spinal canal.
Myelography, CT scan and MRI demonstrated spinal canal stenosis due to calcification of the yellow ligament in the T10-11 region. Decompression following laminectomy was performed from T9 to T12. Postoperatively, paraplegia gradually improved and she could walk without walking aids three months later.
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佐々木 邦雄, 清水 敦, 田丸 卓弥, 渡辺 浩一, 西井 章裕, 松浦 恒明, 赤木 慶三
1993 年 42 巻 1 号 p.
130-133
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
The Isola spinal system was developed in 1985 in the USA and is based on principles and designs conceived by Paul R. Harrington. We discussed the advantage of this system from our own experience. Using this system we operated on 15 cases each of which had a different pathology. The Isola system provided excellent results for managing deformity and instability of the thoracolumbar spine.
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大橋 輝明, 永田 見生, 今里 博司, 後藤 昌史, 橋本 彰二, 井上 明生
1993 年 42 巻 1 号 p.
134-137
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Thirty seven cases of pyogenic spondylitis were treated between 1984 and 1991. Eighteen of these cases were treated conservatively and 19 treated suraically. Of the 19 surgical cases, percutaneous suction aspiration and drainage was carried out in 4. The technique was easy, and materials obtained provided adequate samples for histologic examination and culture. In follow-up studies, both conservative treatment and surgery produced good clinical results. We conclude that percutaneous suction aspiration and drainage as a minimally invasive technique is useful in the case of early stage pyogenic spondylitis.
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田縁 竜一, 高下 光弘, 大賀 正義, 真島 龍興, 杉岡 洋一
1993 年 42 巻 1 号 p.
138-141
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Eleven cases of spinal tuberculosis were operated with posterior spinal instrumentation in our hospital from 1979 to 1991. In ten of these, anterior fusion was also used in cases with destruction involving more than two vertebral bodies and marked kyphosis, anterior and posterior fusion should be carried out in combination. This treatment can shorten the period of bed rest with no failure in long-term union and no progression of kyphosis. There was no evidence to show deteriorahon in the infection.
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小原 伸夫, 芝 啓一郎, 植田 尊善, 白澤 建蔵, 大田 秀樹, 森 英治, 力丸 俊一, 檜田 伸一, 久我 尚之, 達城 大
1993 年 42 巻 1 号 p.
142-145
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed ten cases of tuberculous spondylitis with kyphotic deformity with special reference to the cause of paraplegia. Paraplegia was due to abscess in six cases, metastatic tumor is two and intradural tuberculoma in one. In the remaining case, vertebral instability just below the kyphotic spine caused paraplegia. The present study indicated that kyphotic deformity might rarely cause paraplegia solely, although such deformity over long periods tends to make spinal cords susceptible to compression.
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高下 光弘, 大賀 正義, 野口 康男, 真島 龍興, 田縁 竜一, 杉岡 洋一
1993 年 42 巻 1 号 p.
146-148
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
One hundred twenty seven cases of idiopathic scoliosis were evaluated by measuring. Cobb's angle, vertebral rotation. Vertebral wedging. Risser's sign and classification of the cu ve pattern using King's method.
Although factors concerned with the progression of idiopathic scoliosis were not completely revealed, it was shown that at the first visit the scoliotic patients age. Risser's sign, vertebral wedging and some type of curve pattern were related to curve progression.
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沖本 信和, 安田 金蔵, 秋山 明三, 西田 智, 山名 圭哉, 高橋 雅也, 加原 尚明
1993 年 42 巻 1 号 p.
149-152
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
This study reports on five cases of fracture of the hamate hook. The cases were classified by cause into three sport injuries (baseball, golf and tennis) and two accidents (fall and compression by rolling press).
Four cases were treated by excision of the hamate hook. Osteosynthesis with three threaded Kirschner wires and chip bone graft into the fractured site was performed on one case. Union was obtained with in four months after osteosynthesis. The clinical result was rated as good in all cases.
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吉田 豪, 後藤 琢也, 賀茂 和典, 緒方 達也, 広松 聖生
1993 年 42 巻 1 号 p.
153-156
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
From 1982 to 1991, 30 cases of fracture and dislocation of the first carpometacarpal (CM) joint were experienced, in cluding 11 cases of Bennett's fracture, 3 cases of Rolando fracture, and 5 cases of dislocation. 24 cases were treated by percutaneous pinning, and the remaining 6 cases by conservative measures.
In a series of 30 cases, 14 were followed up at 6 months or later. Of these 8 had an excellent outcome 5 were judged as good, and the outcome in one case was poor. The majority of cases with radiographic findings of osteoarthritis in the first carpometacarpal joint complained of no trouble at all.
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中島 英親, 平野 哲也, 宮田 剛治, 飯田 直成, 米満 弘之
1993 年 42 巻 1 号 p.
157-161
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
This apparatus is useful in accurately adjusting the articular surface in an intra-articular finger, fracture and provides moveability of about 40° in the joint.
This apparatus was used in 4 cases of intra-articular PIP joint fractures and 1 case of intra-articular MP joint fracture. The 5 cases in which this apparatus was used yielded better results in spite of intraarticucar fractures.
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山村 正統, 野村 一俊, 平野 真子, 緒方 宏臣, 清水 泰宏
1993 年 42 巻 1 号 p.
162-164
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We treated three cases of dorsal dislocation of the DIP joint with fracture of the volar base of the distal phalanx. It is rare to find a dorsal dislocation of the distal phalanx with a volar bony fragment. Causes of injury were ball games in two cases and a violent fall in one case with an external force acting in the axial direction of the distal phalanx.
In two fresh cases in which reduction was easily obtained by keeping the joint in the flexed position, good results were achieved by inserting a Kirschner wire to provide temporary fixation of the joint in the reduced position. In one case where the injury had occurred more than five weeks earlier, open reduction was adopted through a mid-lateral incision. The scar tissue around the joint was resected and a Kirschner wire was inserted to maintain reduction of the joint.
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富田 雅人, 今村 宏太郎, 長谷 芳文, 平野 英二, 古川 泰之
1993 年 42 巻 1 号 p.
165-169
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Nine wrists of nine patients treated with Bowers procedure for distal radioulnar joint disorders were reviewed and evaluated using Coony's criteria.
The results were assessed as excellent in two, good in three, fair in one, and poor in three.
If we select patients without osteoarthritis of the radiolunate joint, satisfactory results can be achieved using this procedure.
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猪原 史敏, 野村 茂治, 小山 耕一, 津村 弘
1993 年 42 巻 1 号 p.
170-172
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
We experienced a very rare case of aseptic necrosis of the trapezoidal bone. A 25 year-old man, a mechanic, was referred to our clinic in June 1990 with a 6-month history of pain in the dorsal wrist. He was diagnosed as having aseptic necrosis of the trapezoidal bone by plain X-ray, tomography,
99mTc bone scintigraphy and MRI. He was treated by 2nd CMj arthrodesis with bone graft leading to relief of his pain and recovery of grip power from 50% to 80% against the uninvolved wrist. One possible cause of his osteonecrosis was change of force caused by repetitive radial and ulnar wrist flexion and subsequently added obstruction of the dorsal nutrient vessel of the trapezoidal bone.
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普天間 朝上, 金谷 文則, 新垣 晃, 田崎 法昭, 森山 朝裕, 佐藤 栄, 茨木 邦夫
1993 年 42 巻 1 号 p.
173-176
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Four cases treated with tendon transfer for pinch reconstruct were studied. Three patients with loss of both thumb adduction and index abduction by either ulnar nerve injury (2 cases) or brachial plexus injury (1 case) received simultaneous reconstruction of index abduction by transfer of abductor pollicis longus (APL) after Neviaser's method and thumb adduction by extensor indicis proprius transfer (EIP transfer). Average side pinch strength improved from 1.9kg to 3.1kg after surgery. One patient who could not pinch at all after adductor release for burn contractures only received EIP transfer. However, he became able to pinch small objects, even though his pinch strength was 0kg. EMG recordings from APL of healthy volunteers demonstrated little APL activity during side pinch movement. However, high APL activity was seen during side pinch in cases who had received a Neviaser transfer. Functional side pinch was regained in cases who received simultaneous tendon transfer to reconstruct both index abduction and thumb adduction. Transferred APL started to abduct the thumb independently.
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小宮 節郎, 都築 克幸, 平岡 弘二, 橋本 三四郎, 成田 修吾, 井上 明生
1993 年 42 巻 1 号 p.
177-181
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
This study was designed to examine the effect of M-CSF on OS cells. Tissue culture techniques were used in the study. Cultured osteosarcoma cells were treated with various M-CSF contents and the effect evaluated using both proliferation and phenotypic activity of the cells. M-CSF showed no stimulating effects on the osteosarcoma cells. M-CSF was considered safe in the treatment of bone marrow suppression during the course of chemotherapy for osteosarcoma. M-CSF mediated the generation of hydroxyl radicals from H
2O
2. M-CSF may have a supplemental tumoricidal effect by generating hydroxyl radicals.
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園田 昭彦, 内野 潔, 有馬 博隆, 折口 信夫, 谷口 良康, 吉野 伸司, 牧 信哉, 酒匂 崇
1993 年 42 巻 1 号 p.
182-185
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Two patients with a transhumeral limb amputation had their limb replanted. In both patients latissimus dorsi myocutaneous flap transfer was performed for reconstruction of unrecovered limb function.
Case 1: A 11-year-old boy suffered an avulsion-type amputation of his left upper arm in a traffic accident. One and half years after replantation he achieved useful elbow function and active extension of his wrist and digits but did not recover the function of extrinsic finger flexors. Latissimus dorsi transfer was performed for reconstruction of flexion of digits. Postoperatively he regained powerful hook grip and key pinch.
Case 2: A 59-year-old workwoman suffered incomplete amputation of her left upper arm. She lost the elbow flexors and extensors. Latissimus dorsi transfer was performed for elbow flexion. Postoperatively she had 130° of active elbow flexion and lacked 35° of extension.
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瀧下 純夫, 谷口 良康, 牧 信哉, 吉野 伸司, 岡野 智裕, 園田 昭彦
1993 年 42 巻 1 号 p.
186-189
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Nine cases of free scapular flap to extremities were investigated postoperatively for an average of three years.
Patients comprised seven male and two female with an average age of 28 years range: four to 63 years.
The flap size ranged from 5×8cm to 7×20cm and all donor defects were able to be closed primarily.
All the flaps survived postoperatively. The merits of this flap are as follows:
(1) Relatively bigger flap can be obtained.
(2) Its vascular bundle is suitable for anastomosis. (diameter and length)
(3) There is no functional defect postoperatively.
In contrast, their disadrantages are as follows:
(1) It requires defatting after transfer to the hand.
(2) Cosmetic problem at the donor site.
(3) There is no sensory gain.
This flap is not as popular in orthopaedic surgery, but appears to be versatile.
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大宮 克弘, 岩本 幸英, 中馬 広一, 田仲 和宏, 岩熊 智雄, 杉岡 洋一
1993 年 42 巻 1 号 p.
190-193
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Since 1969, twenty-nine cases of unicameral bone cyst were treated in our institute. Curettage with bone graft and single injection of steroid were performed in 23 and 6 cases, respectively. Follow-up ranged from 6 months to 12 years (average 2 years and 3 months). The results of each treatment were evaluated by Campanacci's criteria. The percentage of healed cases (complete healing plus incomplete healing) following curettage with bone graft was 82%. However the result after steroid injection was much worse with only 33% evaluated as healed.
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寺本 司, 岩崎 勝郎, 乗松 敏晴, 藤田 雅章, 松坂 誠廳
1993 年 42 巻 1 号 p.
194-197
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
The purpose of this study is to analyse the residual deformity of congenital club foot treated by posteromedial release. In our hospital we have treated 47 cases of congenital club foot by posteromedial release.
Lateral talocalcaneal angle (LTC) was measured preoperatively. Postoperatively MTR angle and ratio using Meary's method (α) were measured.
LTC was significantly related to MTR (r=0.5, p<0.001) and (r=0.53, p<0.001) and also MTR was significantly related to α (r=-0.51, p<0.001).
In conclusion, we can say that the residual deformity of congenital club foot treated by posteromedial release, was related to the preoperative severity of the foot deformity.
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北原 博之, 川口 幸義, 山口 和正, 中村 隆幸, 穐山 富太郎
1993 年 42 巻 1 号 p.
198-201
発行日: 1993/03/25
公開日: 2010/02/25
ジャーナル
フリー
Pes planovalgus is commonly seen as an ankle deformity regarded as a secondary deformity associated with Cerebral Palsy. X-ray films often reveal vertical talus. We attempted to conservatively treat 18 cases using an original orthosis. Subjects ranged in age from 3 to 9 years. To assess the deformities radiographically, we measured the tala axis-first meta-tarsal base angle (TAMBA) and calcaneal axis-first metatarsal base angle (CAMBA). Nine patients had the orthsis applied for 3 months or more, and in most of these oatients vertical talus was obviously improved. However severe spastic deformities were not improved.
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