The Journal of Japanese Society of Lumbar Spine Disorders
Online ISSN : 1882-1863
Print ISSN : 1345-9074
ISSN-L : 1345-9074
Volume 13 , Issue 1
Showing 1-36 articles out of 36 articles from the selected issue
  • Yuzuru TAKAHASHI, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 10-16
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Recent advances in the basic study on the nerve tissues innervating the lumbar intervertebral disc were digested. Nociceptive fibers and receptors are found in the outer layer of the annulus fibrosus with histological, immunohistochemical, and electrophysiological methods, demonstrating that disc disorders cause acute pain. Sensory fibers projecting to the rat L5-L6 disc are mainly derived from the L2 dorsal root ganglion (DRG) for the ventral and lateral portions, whereas they are from L5 in the dorsal portion. The segmental levels of the innervating DRGs are 7 and 9 for the ventral and dorsal portions, respectively. This structure of innervation should be considered in planning of nerve block and surgery. Sympathetic sensory fibers are abundant in the dorsal portion of the disc, and they play a role as nociceptors in inflammatory conditions. Nerve growth factor (NGF) sensitive neurons are predominant in small-sized nociceptive DRG neurons. NGF sensitive fibers and neurons increase in experimental disc inflammation models.
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  • Seiji OHTORI, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2007 Volume 13 Issue 1 Pages 17-23
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Low back pain is common disease, and is one of the most crucial problems in Japan and the United States. Fifty thousands million dollars per year were paid for the low back problem. Many authors have reported etiology, pathology, diagnosis, and treatment of pain originated from lumbar intervertebral discs, however the mechanism and treatment for discogenic pain remains to be unclear. In the United States, artificial disc has became to be used for treatment of discogenic low back pain, however, some authorities gave problems for the use of artificial disc. In this paper, we stated mechanism, estimation, treatment, and surgical results of the discgenic low back pain.
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  • Toshihiko YAMASHITA
    2007 Volume 13 Issue 1 Pages 24-30
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Many small nerve fibers and nociceptors that contribute to pain transmission were found in the lumbar facet joint and adjacent tissues. Acute inflammation of the facet joint induced prolonged excitation of the mechanoreceptors and a decrease in the mechanical thresholds of receptors. A recent report revealed that inflammatory reactions spread to nerve roots and increased the expression of TNF-α in the DRG.Mechanical noxious stimulation and chemical factors produced by inflammation of the facet joint and/or degeneration of the intervertebral disc may excite nociceptors in the facet joint and adjacent tissues and generate acute or chronic low back pain. Inflammation and degeneration of the facet joint may also induce radiculopathy.
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  • Toshihiko TAGUCHI
    2007 Volume 13 Issue 1 Pages 31-39
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Lumbar zygapophyseal joints are important causes of low back pain without neurological deficits. Pathogenesis of lumbar zygapophyseal joints pain are various due to the anatomical and biological characteristics. Their clinical features have many common symptoms but not definitive symptoms. Facet block or medial branch block of dorsal ramus are useful in the diagnosis. Treatment is mainly conservative care including medication and facet block. In some cases, percutaneous electrocauterization of lumbar medial branch is an effective means of long-term treatment.
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  • Eiichi MURAKAMI
    2007 Volume 13 Issue 1 Pages 40-47
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    The prevalence of sacroiliac joint (SIJ) pain would appear to be about 10% of low back pain and the pain may develop in men and women of all ages. SIJ pain has not specific findings on CT and MR imaging. Pain area peculiar to SIJ pain is located laterally over the SIJ line, groin area (some cases). Most cases have numbness, pain not to correspond to sensory dermatome in leg, and tenderness on posterior superior iliac spine (PSIS) and around it, sacrotuberal ligament, iliac muscle. By one finger test, patients with SIJ pain may especially indicate PSIS and around it on iliac side. Diagnosis of SIJ pain is determined by diagnostic block. Most patients are adequately responsive to conservative treatments including SIJ block and stabilization by pelvic belts. SIJ arthrodesis is effective for patients with severe SIJ pain being markedly restricted their activities of daily living and working.
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  • Shinichi KONNO
    2007 Volume 13 Issue 1 Pages 48-51
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    The clinical feature of radicular low back pain is unilateral low back pain restricted in the area cranial to the medial iliac crest and frequently accompanied with leg pain due to nerve root impairment. Since radicular low back pain is relieved by single nerve root block, the development and pathway of radicular low back pain might be focused to the blocked nerve root. Nerve root block can be expected not only analysis of low back pain but also therapeutic effect.
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  • Chiaki HAMANISHI
    2007 Volume 13 Issue 1 Pages 52-57
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    A handy dinamometer (Microfet®) has been introduced to measure the muscle strength in 49 patients with low back pain, cauda equina symptom or radicular pain, and in 35 asymptomatic controls. In sitting position , the “corset muscle” strength to raise up the trunk from 15 degrees posteriorly inclined position was measured. The mean strength of the controls were 116 Newton in males and 78N in females. The initial mean strength of the patients were 86N in 17 males and 64N in 32 females. In followed up patients, after introducing the simple muscle exercises in sitting position, these “corset muscle” strength has increased from 69N to 95N in 9 males and 51N to 78N in 15 females, and not only low back pain but also neurological symptoms due to several lumbar diseases and psychological factors has improved in 17 out of these 24 patients. The instant handy measurement of the muscle strength and simple muscle training were very useful in encouraging the patients to fight upon their pain.
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  • Keiji FUJINO
    2007 Volume 13 Issue 1 Pages 58-62
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We changed to the classification that a frame of the rehabilitation depended according to a disorder / disease from a conventional institution standard, a classification by the staff placement by a fee-for-service revision of April, 2006. It is easy to have come to start an evaluation of the effect of treatment in what we took responsibility with the specialist of each field and performed from a diagnosis to treatment for one patient, but the responsibility depended and became serious. Lumbago is the disorder that man and woman is very frequent together in our country, and the cause is organic and, from the clear thing of pathologic findings, is social and varies to the strong thing of the factor of the mind. Also, the treatment preferences that a doctor thinks about do not necessarily agree with a patient expecting it for treatment. It is necessary for the choice of the rehabilitation to consider each cause, symptom, individual trait, besides, local characteristics, family constitution.
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  • Toshihiko WATANABE
    2007 Volume 13 Issue 1 Pages 63-70
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    The transverse abdominis, a deep muscle forms a containing hoop structure around the entire abdomen with the anterior of the hoop composed of the abdominal fascia and the posterior composed of the lumbodorsal fascia. This hoop structure, together with the multifidus, deep muscle packed against the spine and consisting of a characteristic laminar arraingement, provides the stability of the spine. Deepmuscle exercise attempts a synchronous contraction of both multifidus and transverse abdominis to increase spine's stability. It can thus be concluded that deep muscle exercise is almost a radical therapy for unstable lumbar disorders. In addition, our study of the deep muscle exercise for unstable lumbar disorders showed a good clinical efficacy. Conseqently we may cocider that therapeutic exercise for lower back pain acts directly on the cause of the pain and is almost a radical therapy. Therefore a suitable exercise can be applied for each cause of lower back pain. A doctor shoud try to ascertain the feasibility and limits of efficacy for each cause of pain, and make them clear to the patient before prescribing exercise.
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  • Yoichi AOTA, Haruhiko IDUKA, Masaaki UESUGI, Nobutake OZEKI, Kanichiro ...
    2007 Volume 13 Issue 1 Pages 71-77
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    To prevent low back pain during prolonged sitting, an inflatable lumbar support cushion has been developed that provides lumbar continuous passive motion (CPM). We have developed a dual CPM device, in which an additional CPM cushion is located in the front portion of the seat. The dual CPM device has two synchronized bladders with reciprocal motion in the opposite phase: When one bladder inflates the other deflates. A total of 23 male volunteers without low back pain sat in a chair for a two-hour period under several test modalities and indicated lumbar discomfort on a 10-cm visual analog scale (VAS). The VAS scores were 8.2±1.6 without lumbar support, 5.9±1.9 with the static support, 5.7±2.3 with lumbar support CPM, and 4.3 ±2.4 with dual CPM. Compared to the lumbar support CPM, significant (p<0.05) improvement in VAS scores was obtained with the dual CPM device.
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  • Shoko IKEDA, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 78-83
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    This study was designed to evaluate the efficacy of physical therapy for patients with low back pain (LBP). 90 cases were classified into 4 groups, for low back pain appeared on flexion in standing and extension in standing. A clinical evaluation was carried out using the Visual Analogue scale (VAS) for LBP; Japanese Orthopedic Association Score (JOA score) .The data was collected at the initial consultation and after 1 month and after 2 month. As a result, The mean scores of VAS improved at the 1 month's , but the mean scores of JOA score unchanged at the 2 month's evaluation. McKenzie's extension exercise was effective on the improvement of VAS and ADL score. It is suggested that there is need for over 2 month's follow up. It is important for efficient therapeutic exercise of the LBP patients to evaluation of symptoms.
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  • Takafumi AOKI, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 84-87
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    A trunk rotating exercise was developed for chronic low back pain patients. Total 13 (5 male and 8 female) patients were involved in this study, clinical outcomes were investigated at 1 month after starting the therapeutic exercise. The exercise is very simple and easy to perform. While sitting on a chair, a patient was asked to rotate his or her body trunk as much as possible and stay at the rotated position for 3 seconds. Then let the patient turn to another direction and do the same way. Five to ten times right and left rotations were required in one set. Patients were asked to do it for three sets a day (one set for each morning, afternoon and evening). Nine patients (70%) had a good result at one month after doing the exercise. This exercise was supposed to have a stretching effect for back muscles surrounding lumber spine.
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  • Seiichiro SHIMADA, [in Japanese], [in Japanese], [in Japanese], [in Ja ...
    2007 Volume 13 Issue 1 Pages 88-95
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Objectives: We developed new medical support system for musculo-skeletal rehabilitation using personal computer and Internet system to provide effective information to the customers widely. Needs of our system: To prevent increase of lifestyle-related and degenerative musculo-skeletal diseases, and to reduce interregional health disparity, our system would be effective. Delineation of our system: The customers can use our system easily using personal computer thru Internet system and can obtain beneficial medical information corresponding individual physical condition. In addition, bidirectional communication between the customers and medical stuffs is available using Internet system. Conclusion: Our system is in the process of production. Despite we could not show effectiveness of our system, we believe effectiveness of our system for the customers and expect it becomes one of strategy contributing for modern medicine.
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  • Yoshihito SAKAI, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 96-103
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Effects of eperisone hydrochloride (EMPP) were investigated in view of the muscle hemodynamics for patients with chronic low back pain (LBP). Males with chronic LBP (>6 months) were randomized to 3 treatment groups; Group A: physical therapy only (n=25), Group B: administration of EMPP for 4 weeks (n=23), Group C: McKenzie therapy (n=25). JOA-score, VAS, Faces Pain Scale-Revised, and SF-36 were recorded at 2 and 4 weeks. Intramuscular oxygenation was evaluated using near-infrared spectroscopy (NIRS) attached to the paraspinal muscle during lumbar extension and flexion, and oxygenated hemoglobin (Oxy-Hb) and deoxygenated hemoglobin (Deoxy-Hb) were compared. VAS was significantly lower at 4 weeks in group C than in group A. Oxy-Hb in lumbar extension at 4 weeks was significantly higher in group B than in the other 2 groups. NIRS measurements demonstrated significant increases in Oxy-Hb during lumbar extension, which we proposed to be one of the important factors in muscular LBP. The results suggest a combination of EMPP and back exercises may be a desirable approach to conservative treatment for chronic LBP.
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  • Takahiro Segawa, Masahiko Kanamori, Taketoshi Yasuda, Shigeharu Nogami ...
    2007 Volume 13 Issue 1 Pages 104-107
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Many small nerve fibers and nociceptors that contribute to pain transmission were found in the lumbar facet joint and adjacent tissues. Acute inflammation of the facet joint induced prolonged excitation of the mechanoreceptors and a decrease in the mechanical thresholds of receptors. A recent report revealed that inflammatory reactions spread to nerve roots and increased the expression of TNF-α in the DRG.Mechanical noxious stimulation and chemical factors produced by inflammation of the facet joint and/or degeneration of the intervertebral disc may excite nociceptors in the facet joint and adjacent tissues and generate acute or chronic low back pain. Inflammation and degeneration of the facet joint may also induce radiculopathy.
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  • Kouichiro TOYODA
    2007 Volume 13 Issue 1 Pages 108-112
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We evaluated efffectiveness of epidural bolck (EDB) for lumbar disc heruniation. EDB was effective in 70% of cases, while a combination of EDB and nerve root block (RB) was effective in 10%. However, the remaining 20% was needed surgery after EDB and RB. There was significant difference was found in JOA, RDQ, and SF36 scores obtained prior to EDB treatment, and in VAS and SLR obtained after-EDB treatment between the group in which EDB was effective and the group in which it was not.VAS, JOA, and RDQ scores gradually improved after EDB traetment. Not only pysical but also emotional QOL was improved by EDB in our series. EDB was useful for conservetiv etreatment for lumbar disc herniation.
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  • Kinuka BONO, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...
    2007 Volume 13 Issue 1 Pages 113-120
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    The purposes of this study was to assess the association between prevalence of low back pain and working status in Nozaki Higashi Hospital and Health Services Facilities for making a plan to prevent LBP and improve the status. The survey was carried out using a questionnaire. The subjects of the first research consisted of nurses, care workers and assistant nurses (total 118 workers). The results inclicated that 75% of them suffered from low back pain. And more, the result by using a statistics technique, the second research, which of addressing object is the nurses, (72 people), was that the sleeping time of the group of suffered from the back pain (group P) was intentionally short compared with the group of not suffered. This study indicated that the review on the environment and the system of the work is necessary for nursing or nursing engaging persons.
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  • Seiji OHTORI, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2007 Volume 13 Issue 1 Pages 121-126
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We evaluated surgical result for lumbar spinal canal stenosis involved with wedging intervertebral disc at one level. These patients did not show lateral slipping or severe scoliosis. We used laminectomy or posterior lateral fusion (PLF) with pedicle screw fixation (PS) for the patients. We followed up 25 patients after surgery, and average follow up period was 2.3 years. JOA score improved from 11.0 to 21.2 in laminectomy group, and 12.1 to 25.2 in PLF group. The score in PLF group was significantly higher than that in laminectomy group. Three cases in laminectomy group show unsatisfactory results. X ray findings in 3 cases showed lateral instability of the intervertebal disc over 10 degree before surgery, and became worse to 14.6 degree after surgery. We concluded that in case of lumbar spinal canal stenosis involved with lateral instability of the wedging intervertebral disc with 10 degree and over, surgery with fusion is favorable to good results.
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  • Jun-ichiro NAKAMURA, [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 127-129
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Tissue distribution of NSAIDs at lumbar region using tapes was never examined. Ten lumbar spinal canal stenosis patients were percutaneously applied GF-Na at 30 mg before surgery. Sample of blood, subcutaneous fat tissue and paraspinal muscle were taken at surgery and examined GF-Na concentration of each sample by liquid chromatography (LC/MS/MS). The concentration of GF-Na of fat and muscle were higher than that of blood.
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  • Nobutake OZEKI, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    2007 Volume 13 Issue 1 Pages 130-135
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    The clinical results of intrapedicular partial pediculectomy (IPPP), first described by Kunogi, for lumbar spinal foraminal stenosis were studied. A total of 27 patients with more than 1 year follow-up were included in this study. An average age at surgery was 63.5 (42-83) years, and the mean follow-up was 4.2 (1-11) years. Foraminal narrowing was classified into three types on parasagittal MR images: antero-posterior (n=2); cephalo-caudal (n=5); and circumferential (n=22). The affected levels were L3/4 in 1 case, L4/5 in 7, L5/S1 in 19. Among them, two had bilateral stenosis at L5/S1. Two patients required revision surgery because of incomplete decompression. The average JOA score in the remianing 25 patients were 6.8 (-1~10) before surgery, 12.6 (9~15) three months after surgery, 12.2 (9~15) one year after surgery, and 11.8 (5~15) at the final follow-up. IPPP affords long lasting pain relief.
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  • Hideki MITAKI, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 136-143
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    This study investigated whether flexion relaxation phenomenon (FRP) can be used as an evaluation technique for low back pain (LBP) independent of age and measurement site. Subjects were comprised of normal young individuals (n=12), young individuals with chronic lower back pain (CLBP) (n=6), normal elderly individuals (n=7), and elderly individuals with CLBP (n=7). Measurements using surface electromyography were conducted at the L2 and L5 levels. Regarding age, FRP occurrence was significantly higher in normal young individuals than the young individuals with CLBP; however, there were no differences observed between normal elderly individuals and elderly individuals with CLBP. In addition, regarding measurement site, FRP occurrence tended to be greater at L2 than L5. Therefore, FRP occurrence can be used for objective evaluation of LBP in young individuals, and the upper lumbar area is favorable for measurement. In elderly individuals, FRP alone is insufficient for accurate evaluation.
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  • Kimiaki SATO, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2007 Volume 13 Issue 1 Pages 144-149
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We analyzed subjective symptoms in patients with lumbar canal stenosis (LCS) compared to those in patients with peripheral arterial disease (PAD) reported in a large-scale survey of 4,750 patients treated at 218 hospitals between July 2004 and August 2005. Symptoms included pain or numbness in the lower-back and legs. Among patients aged between 50 and 79 years, 329 patients were diagnosed as having LCS based on lumbar MRI (LCS Group), and 64 were diagnosed as having PAD based on ABI (ankle-brachial pressure index) testing and/or foot pulses (PAD Group). Subjective symptoms were more severe in the LCS Group than in the PAD Group. Postural factors, in which the symptoms increased with flexion and/or decreased with extension, were reported in 50.9% of the LCS Group, in 18.2% of the PAD Group.
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  • Tsuyoshi ARA, [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 150-154
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Postoperative donor-site pain was evaluated in 77 consecutive patients who underwent autogenous iliac crest bone graft (ICBG) harvest for reconstructive spine surgery and had a minimum follow-up of 6-months. The patients were classified to 3 groups according to the location and the technique of harvesting: Posterior ICBG group, Anterior full-thickness ICBG group, Anterior inner-table ICBG group. The significance of differences between the two anterior ICBG groups was analyzed. Overall, sixteen patients (20.8%) reported the presence of postoperative pain at the donor site. Five patients (25%) from the posterior ICBG group, nine patients (27%) from the anterior full-thickness ICBG group and two patients (8%) from the anterior inner-table ICBG group reported postoperative pain at the donor site. Althought there were no significant differences between the two anterior ICBG groups, there were fewer patients complaining of pain in the inner-table group than in the full-thickness group.
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  • Yoshinobu HAGIHARA
    2007 Volume 13 Issue 1 Pages 155-160
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We investigated a test method that could be useful for differentiating peripheral arterial occlusive disease (P) from lumbar spinal canal stenosis (S) in the patients whose major complaint is intermittent claudication. The results are reported in the following. The subjects of study were 136 patients who visited Jyoto Insurance Hospital with a major complaint of intermittent claudication. As the first step, the ankle brachial pressure index (ABPI) was determined and the subjects were classified into groups depending on the result. Subsequently, the palpation of dorsal artery of foot, loading test in standing position and the postural factor were investigated. According to the results, dorsal artery of foot was not tactile in 11 patients in P group and 23 patients in S group at the sensitivity of 61.1% and specificity of 80.5%; loading test in standing position was negative in 7 and 25 respectively at the sensitivity of 38.9% and specificity of 78.8%; postural factor was negative in 16 and 49 respectively at the sensitivity of 88.9% and specificity of 58.5%. The sensitivity and specificity of method investigated this time to differentiate P from S were not sufficiently high. Accordingly, we reached the conclusion that there is no method to replace the ABPI determination method.
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  • Toshiya Tachibana, [in Japanese], [in Japanese], [in Japanese], [in Ja ...
    2007 Volume 13 Issue 1 Pages 161-164
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    This study examined the relationship among the duration of sciatica, morphological differences in disc, and surgical outcomes in patients with lumbar disc herniation. Thirty-two patients were followed for more than 1 year after surgery. One-year postoperatively, JOA scores did not correlate with duration of sciatica in these patients. However, although preoperative the proportion of patients with contained disc was higher among these with longer preoperative duration. JOA scores were more severe in patients with noncontained disc than in those with contained disc. JOA scores were not different between the groups one-year postoperatively. It seems that the duration of symptoms is unlikely to influence surgical outcomes. Patients with noncontained disc generally had more severe symptoms and thus underwent surgery earlier than patients with contained disc. However, there was no significant difference in surgical outcomes between patients with contained disc and those with noncontained disc.
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  • Norio HAYASHI, [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 165-170
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    In 23 patients with intermittent claudication due to cauda equina compression who underwent therapeutic exercises, we examined the effects of these exercises. Therapeutic exercises to improve the hip joint as well as lumbar contraction were effective for 21 patients (91.3%) in their recovery of the walking distance. In the first examination, an average walking distance was 102.1m, however 8 patients (38.0%) were able to walk more than 1km after 1 month. After 2 months, 15 patients (71.4%) were able to walk for more than 1 km. The remaining 6 patients were able to walk an average of 640m with a high degree of satisfaction. In the patient who had intermittent claudication with contracture of the hip joint and the lumbar region, it is considered worthwhile to attempt therapeutic exercise for approximately 2 months.
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  • Koki ANABUKI
    2007 Volume 13 Issue 1 Pages 171-174
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    This study was to assessed the effect of vertebroplasty for osteoporotic compression fracture. Fifteen patients with seventeen vertebral fractures underwent vertebroplasty. Fracture levels were one Th11, five Th12, six L1, three L2, one L3, one L4. Average age was 70 years old. Cases showing an interval of more than 1 month after onset of low back pain were indicated. The average interval between the onset of low back pain and surgery was 3.5 months. Average surgical duration was 35 minutes. Blood loss was limited. The average injected cement volume was 4.2cc. The procedure resulted in good pain relief and without any complications in this series.
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  • Takatoshi SHIMOMURA, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 175-179
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Microendoscopic discectomy is widely performed as a minimally invasive surgery for patients with lumbar disc herniation in Japan. However, the reduced invasiveness in microendoscopic discectomy has not yet been fully evaluated. This is partly because effective scale has not been used to evaluate invasiveness. In this study, visual analogue scale was used prospectively to assess low back pain, leg pain and numbness. Microendoscopic discectomy was performed in 20 patients (10 men and 10 women). The average age was 34.1 years. Low back pain, leg pain and numbness were individually assessed in each patient for one week. After surgery scores for low back pain and leg pain were significantly reduced from 5.8±1.2 to 2.1±2.0 in 3 days and 7.0±1.5 to 0.2±0.3 in 1 day, respectively, whereas score for numbness of the legs was not reduced. Using the visual analogue scale to assess low back pain and leg pain could effectively evaluate the reduced invasiveness after microendoscopic discectomy within one week.
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  • Sunao TANAKA, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    2007 Volume 13 Issue 1 Pages 180-185
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We retrospectively examined symptoms and findings characteristic of cauda equina tumors, and reviewed our surgical procedures used to treat them in 18 patients (9 males and 9 females). Neurinoma was the most common type of cauda equina tumor and most tumors involved the fourth to fifth lumbar spine levels. There was an average interval of 25.2 months between onset of primary symptoms and diagnosis of the cauda equine tumor. The initial symptoms were radicular ache in 3 patients (16.7%), and backache, buttock pain, or a feeling of lower extremity weakness in 5 patients each (28%). 12 of 18 experienced variation in the pain. Transient pain, sensory loss, and urination disorder were reported by many patients. There were 11 patients who complained of numbness after surgery. There were 14 patients who reported pain in the lumbar region or lower extremities before surgery. 11 of the 14 reported no pain after surgery, 1 reported improvement, and 2 patients reported persistent pain. However, not all of these patients needed medication for pain. Persistent numbness is a problem after treatment of cauda equina tumor. Early diagnosis before irreversible neurological damage occurs is important.
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  • Haruo KANNO, [in Japanese], [in Japanese], [in Japanese]
    2007 Volume 13 Issue 1 Pages 186-191
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We compared sites of low back pain indicated by patient between with and without pain provocation. The subjects were asked to indicate the site of their pain with the index finger in standing up straight without pain provocation and in a position provoking the pain, respectively. The site was outlined on the subject's skin after the indication. The sites identified with and without the provocation were compared in terms of surface area, accuracy, distribution and extent of the site. The surface area of the sites identified with the provocation was significantly smaller than that identified without the provocation. The identification with the provocation indicated more accurate site of the pain. The distributions of sites identified with the provocation were mostly different from the sites identified without the provocation. The extent of the sites identified with the provocation was significantly smaller. We conclude that indication of the pain site by patient with pain provocation result in more accurate identification of the site of low back pain.
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  • Ko MATSUDAIRA, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2007 Volume 13 Issue 1 Pages 192-196
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    We investigated the relationship among symptoms, depression and health-related quality of life (QOL) in the patients with lumbar canal stenosis by using pass analysis in an exploratory manner (n=253, mean age 71). The proposed model, where the severity of leg pain and/or numbness increases with the deterioration of walking ability, resulting in decreasing physical QOL and worsening depressive tendency worse, leading to decreasing mental QOL, showed a good fit (good fitness index=0.945). As a result, it has been suggested that the physical symptoms of lumbar canal stenosis may promotion of an impacts on not only physical QOL but also mental QOL through depressive tendency. Our finding recommends that screening for depression and providing mental care and support, as well as treatment for the symptoms of lumbar canal stenosis are necessary.
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  • Eiichi MURAKAMI, [in Japanese], [in Japanese], [in Japanese], [in Japa ...
    2007 Volume 13 Issue 1 Pages 197-203
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Sacroiliac joint (SIJ) arthrodesis through anterior approach was performed for 15 patients with severe SIJ pain. All patients were not adequately responsive to the conservative treatments including sacroiliac joint injection and stabilization by pelvic belts, and were markedly restricted their activity of daily living and working. They were 6 males and 9 females and the averaged age at surgery was 49 years old (range; 30-86). The mean duration of preoperative symptoms was 3.9 years (range; 1-7) and the postoperative follow-up period was averaged 2.3 years (6 months-5 years). Unilateral SIJ arthrodesis was performed for 14 patients and bilateral for 1 patient. CT scan confirmed that the SIJ were completely fused in all cases. The preoperative JOA score was 5.6 (4-9, full mark is 29 points) and improved to 18 (7-24). Visual analogue scale of pain (VAS) was 84 (70-93) preoperatively and decreased to 40 (10-75) after surgery. Roland-Morris disability questionnaire (RDQ) score was also improved from 21.1 (17-23, worst is 24 ) to 6.9 (1-14). The surgical outcome of SIJ arthrodesis through anterior approach was relatively good but the indication and timing of surgery still need some discussions.
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  • Masabumi Miyamoto, Ryu Tsunoda, Yoshikazu Gembun, Shunsuke Konno, Akir ...
    2007 Volume 13 Issue 1 Pages 204-207
    Published: 2007
    Released: January 22, 2008
    JOURNALS FREE ACCESS
    Download PDF (225K)
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