Publications (17)20.8 Total impact
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Article: Insufficiency fractures of bilateral distal tibias associated with chronic liver disease.
Journal of Orthopaedic Science 09/2010; 15(5):678-81. · 0.84 Impact Factor -
Article: Enlargement of an osseous loose body in the cervical spine with cord compression.
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ABSTRACT: Loose bodies in the spinal canal are extremely rare, with only two cases reported previously in the literature. To report a rare case of an osseous loose body in the cervical spine with radiographic evidence of dramatic enlargement of the loose body in the spinal canal over the course of 9 years. Case report. A 50-year-old man presented with progressive numbness and weakness of the upper and lower extremities and swaying gait in 2007. He had a history of temporary incomplete tetraplegia after a fall in 1998. Magnetic resonance imaging revealed enlargement of the posterior mass-occupying lesion compressing the cord at C5-C6 over the course of 9 years. Neurological examination with motor and sensory status. Posterior decompressive laminectomy was performed. An isolated, smooth-surfaced, bony, hard mass was found between the ligamentum flavum and facet joint and removed. Histological examination demonstrated trabecular bone and peripheral cartilage mixed with fibrous and fibrocartilaginous tissue. Clinical evaluation of the patient 6 months postoperatively showed total resolution of neurological symptoms. We report herein an extremely rare case of an osseous loose body in the spinal canal with cord compression. This report represents the first documented case of growth of a loose body in the spinal canal.The spine journal: official journal of the North American Spine Society 09/2009; 9(11):e11-4. · 2.90 Impact Factor -
Article: Intraspinal canal migration of distal occipitocervical instrumentation rods causing incomplete tetraplegia.
Journal of Orthopaedic Science 06/2009; 14(3):344-7. · 0.84 Impact Factor -
Article: A study of athletic abilities in idiopathic scoliosis patients with brace therapy
Scoliosis. 01/2009; -
Article: Thoracic disk herniation with hematoma--case report.
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ABSTRACT: A 54-year-old man presented with an extremely rare case of intervertebral disk herniation with hematoma in the thoracic spine, manifesting as acute progressive numbness and muscle weakness in the bilateral lower extremities. He had been treated with anticoagulants. Magnetic resonance imaging of the thoracic spine showed intervertebral disk herniation and severe compression of the spinal cord at T9-10, appearing as hyperintense on T(1)- and hypointense on T(2)-weighted imaging suggestive of concomitant hematoma. His symptoms completely resolved after resection of the brownish herniated disk material. Old hemorrhage was also aspirated from the intervertebral disk space. Hemosiderin deposition was found in the cartilaginous tissue of the resected disk. Intervertebral disk herniation with hematoma is extremely rare, but may occur in patients with bleeding diathesis.Neurologia medico-chirurgica 10/2008; 48(9):414-7. · 0.61 Impact Factor -
Article: Two-level ligamentum flavum hematoma in the lumbar spine. Case report.
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ABSTRACT: Ligamentum flavum hematoma is a rare cause of spinal root or cord compression that usually occurs at a single level. No case of multiple-level ligamentum flavum hematoma has previously been reported. We report an extremely rare case of double, contiguous ligamentum flavum hematomas in the lumbar spine. A 71-year-old man with hypertension and degenerative lumbar scoliosis presented with pain and muscle weakness in the left lower extremity after physical exertion. Magnetic resonance imaging of the lumbar spine showed severe spinal stenosis caused by two-level ligamentum flavum hematoma (L3-L4 and L4-L5). Both hematomas were completely removed and the diagnosis was histologically confirmed. Symptoms completely resolved after surgery. Despite being extremely rare, ligamentum flavum hematoma with involvement of multiple levels may be observed.Neurologia medico-chirurgica 05/2008; 48(4):179-82. · 0.61 Impact Factor -
Article: Progressive myelopathy due to idiopathic intraspinal tumoral calcinosis of the cervical spine. Case report.
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ABSTRACT: Tumoral calcinosis is a rare disorder that most often occurs in periarticular regions of the extremities. Here, the authors report on an extremely rare case of idiopathic intraspinal tumoral calcinosis of the cervical spine. This 54-year-old man presented with a 2-week history of progressive cervical myelopathy. Results of magnetic resonance imaging and computed tomography myelography of the cervical spine revealed an intraspinal calcified mass lesion posterior to the spinal cord at the C3-4 level, resulting in marked spinal cord compression. Spinal cord decompression and en bloc resection of the mass lesion were performed via a C-2 laminoplasty and C3-4 laminectomy. The mass was localized in the dura mater. Histologically, the lesion consisted of numerous nodules with amorphous calcified materials and a florid proliferation of multinucleated giant cells; that is, its histological characteristics were identical to those of tumoral calcinosis. The symptoms disappeared completely after surgery. In all previously reported cases of cervical tumoral calcinosis, the lesion was located in the paraspinal soft tissue, with bone and facet joint involvement. The present case is the first reported instance of cervical tumoral calcinosis localized only in the spinal canal.Journal of Neurosurgery Spine 10/2007; 7(3):362-5. · 1.53 Impact Factor -
Article: Ligamentum flavum hematoma in the cervical spine - case report.
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ABSTRACT: A 67-year-old man presented with a rare case of ligamentum flavum hematoma manifesting as progressive tetraplegia following cervical traction therapy. Magnetic resonance imaging of the cervical spine showed a posterior mass that was continuous with the ligamentum flavum at the C3-4 levels. Complete resection of the mass that contained brownish hemorrhage was performed, resulting in excellent symptom relief. We speculate that repeated trivial trauma to the degenerative ligamentum flavum was the main predisposing factor in the present case. Ligamentum flavum hematoma is a rare cause of spinal root or cord compression which typically occurs in the lower thoracic or lumbar spine, but may also appear in the cervical spine.Neurologia medico-chirurgica 12/2006; 46(11):556-8. · 0.61 Impact Factor -
Article: Dural substitute with polyglycolic acid mesh and fibrin glue for dural repair: technical note and preliminary results.
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ABSTRACT: An ideal dural substitute that enables watertight closure, has sufficient strength, and can be absorbed without remnant materials that induce inflammation, adhesion, and infection is not available. The purpose of this study was to evaluate the efficacy of a bioabsorbable polyglycolic acid (PGA) mesh and fibrin glue as a substitute for dural repair. Altogether, 10 patients with noted dural tears during extradural spinal surgery and 20 patients who underwent durotomy for intradural spinal surgery were included in this study. In a series of 20 consecutive cases, dural closure was performed by suture and fibrin glue. In the subsequent 10 consecutive patients, dural closure was performed by suture and fibrin glue with the use of absorbable PGA mesh. The medical records and magnetic resonance imaging (MRI) of the surgical site were retrospectively reviewed to evaluate the presence of a cerebrospinal fluid (CSF) fistula or leakage after the surgery. A CSF fistula occurred in five patients who underwent dural repair with fibrin glue alone, and postoperative MRI showed CSF leakage in two patients with incidental dural tears after laminectomy for ossification of ligamentum flavum. No CSF fistula was present in patients who underwent dural repair using PGA mesh and fibrin glue, and no adverse effects or complications were encountered postoperatively. Follow-up MRI revealed no evidence of CSF leakage around the reconstructed dura mater. The use of PGA mesh and fibrin glue for the repair of dura mater is a useful method of preventing CSF leakage in spinal surgery.Journal of Orthopaedic Science 11/2006; 11(5):454-8. · 0.84 Impact Factor -
Article: Chronic subdural hematoma coexisting with ligamentum flavum hematoma in the lumbar spine: a case report.
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ABSTRACT: We present a case of a chronic spinal subdural hematoma combined with a ligamentum flavum hematoma in the lumbar spine treated surgically. An 83-year-old woman receiving antiplatelet medicine due to an angina suffered from pain in her lower extremity and gait disturbance after a backward fall. Radiological findings including magnetic resonance imaging (MRI) revealed hematoma in the ligamentum flavum at the level of L2 - L3 and a chronic subdural hematoma at the level from L3 to L5. Laminectomy through L2 to L5 was performed and a hematoma existing in the ligamentum flavum and cystic mass was removed. A chronic subdural hematoma was spontaneously evacuated after splitting of the dura mater and an intact arachnoid membrane was observed with no leakage of cerebrospinal fluid. Her clinical symptoms completely disappeared after surgery. To the best of our knowledge, this is the first case of combination of chronic subdural hematoma and ligamentum flavum hematoma in the lumbar spine treated by surgery. Chronic spinal subdural hematoma and hematoma in the ligamentum flavum should be considered as a cause of progressive nerve root compression in patients with anticoagulant therapy, and an appropriate pre-operative diagnosis would be needed to achieve complete decompression of subdural and epidural hematoma.The Tohoku Journal of Experimental Medicine 10/2006; 210(1):83-9. · 1.24 Impact Factor -
Article: Clinical application of peroneal nerve stimulator system using percutaneous intramuscular electrodes for correction of foot drop in hemiplegic patients.
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ABSTRACT: Objective. To assess the orthotic effect of a functional electrical stimulation device (Akita Heel Sensor System; AHSS) in the treatment of hemiplegic gait with foot drop. Materials and Methods. In the AHSS, a heel sensor is attached to a small plastic heel brace, and the peroneal nerve is stimulated via percutaneous intramuscular electrodes. During the swing phase of the hemiplegic gait, the common peroneal nerve is stimulated by the AHSS. Eight patients in chronic stages of hemiplegia participated in this study. Walking speeds and step cadences on a 10-m course were compared between walking with stimulation and walking without stimulation. Results. Mean walking speed (± SD) was 0.50 ± 0.26 m/sec without stimulation and 0.64 ± 0.31 m/sec with stimulation. The mean percentage increase in walking speed with stimulation was 30.1%. Mean step cadence was 31 ± 7 steps/10 m without stimulation and 27 ± 7 steps/10 m with stimulation. By correcting foot drop, the AHSS significantly increased walking speed and decreased cadence (p < 0.05). Conclusion. The AHSS can significantly improve walking in hemiplegic patients with foot drop.Neuromodulation 10/2006; 9(4):320-7. · 1.19 Impact Factor -
Article: Spondylolisthesis of the thoracic spine. Case report.
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ABSTRACT: The thoracic spine is stabilized in the anteroposterior direction by the rib cage and the facet joints. Spondylolisthesis of the thoracic spine is less common than that of the lumbar spine. The authors describe a rare case of thoracic spondylolisthesis in which the patient suffered back pain and myelopathy. The patient was a 44-year-old woman. Plain radiography revealed Grade I T11-12 spondylolisthesis. The pedicle-facet joint angle at T-11 was 118 degrees, greater than that of T-10 or T-12. Postmyelography computerized tomography scanning revealed posterior compression of the dural sac as well as enlargement of and degenerative changes in the facet joint at T-11. Magnetic resonance imaging showed anterior and posterior compression of the spinal cord at the level of the spondylolisthesis. To achieve posterior T10-12 decompression, the surgeons performed a laminectomy and posterolateral fusion in which a pedicle screw fixation system was placed. The patient's back pain disappeared immediately after the operation. The authors conclude that the enlargement of the pedicle-facet joint angle and the degenerative changes of the facet joint caused the thoracolumbar spondylolisthesis.Journal of Neurosurgery Spine 06/2006; 4(5):415-8. · 1.53 Impact Factor -
Article: Clinical features of cauda equina tumors requiring surgical treatment.
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ABSTRACT: In this study, we evaluated the clinical features of cauda equina tumors requiring surgical treatment. Medical records of 28 patients with cauda equina tumors (13 men and 15 women) undergoing surgical treatment were retrospectively reviewed. The majority of histological diagnoses indicated schwannoma (23 cases, 82%), and the remaining 5 indicated ependymoma, neurofibroma, meningioma, and ganglioneuroblastoma. In 86% of the cases, the initial symptom was pain in the lower back and/or lower extremities. Preoperatively, half of the patients had symmetrical pain in the lower back or lower extremities, severe pain in the supine position, or pain that was increased by coughing. One third of the patients needed morphine to control nocturnal pain. Tumor size, as determined by magnetic resonance imaging (MRI), correlated with preoperative symptom duration (r = 0.66, p < 0.001). These findings indicate that symmetrical lower back pain and/or pain that radiates to both lower extremities and increases in the supine position are characteristic of cauda equina tumors. The correlation between symptom duration and tumor size indicates that earlier diagnosis of this tumor is necessary. Earlier diagnosis based on these characteristic symptoms should make use of further examinations such as MRI.The Tohoku Journal of Experimental Medicine 05/2006; 209(1):1-6. · 1.24 Impact Factor -
Article: Effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in postmenopausal women with spondylosis.
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ABSTRACT: Osteoporosis and spondylosis often occur simultaneously. However, there are no previous reports about the effects of osteoporosis medication on incidence of vertebral fractures in people with spondylosis. In this study, we conducted a retrospective investigation of the effects of alfacalcidol alone or in combination with elcatonin on incidence of osteoporotic vertebral fractures in women with spondylosis. The present subjects were 101 postmenopausal women with osteoporosis aged >60 years, divided into three groups: D group (n = 45), treated for >5 years with alfacalcidol; D+ECT group (n = 26), treated for >5 years with alfacalcidol plus elcatonin; control group (n = 30), who received no medications for >5 years. Over the 5-year treatment period, bone mineral density (BMD) of the lumbar spine and proximal femur did not significantly change in the D and D+ECT groups, but they significantly decreased in the control group (P < 0.05). The number of incident vertebral fractures per patient was significantly higher in the control group (2.9) than in the D group (1.2) and D+ECT group (1.5) (P < 0.01). There was no significant difference in BMD or incident vertebral fractures between the D and D+ECT groups. In all three groups, the number of incident vertebral fractures positively correlated with the number of prevalent vertebral fractures (0.303 </= r </= 0.434), and negatively correlated with baseline BMD (-0.703 </= r </= -0.326) and the osteophyte score representing the degree of spondylosis (-0.769 </= r </= -0.365). Further multiple regression analysis revealed that the medication (D or D+ECT, P < 0.001) and the osteophyte score (P < 0.001) were the most significant contributors for the number of incident vertebral fractures. In conclusion, elcatonin had no additive effects on BMD or prevention of vertebral fractures in postmenopausal women receiving alfacalcidol. Presence of spondylosis (indicated by a high osteophyte score) appears to have an effect on prevention of vertebral fractures.Journal of Bone and Mineral Metabolism 01/2006; 24(6):491-7. · 2.27 Impact Factor -
Article: Clinical application of acceleration sensor to detect the swing phase of stroke gait in functional electrical stimulation.
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ABSTRACT: Functional electrical stimulation (FES) can improve the gait of stroke patients by stimulating the peroneal nerve in the swing phase of the affected leg, causing dorsiflexion of the foot that allows the toes to clear the ground. A sensor can trigger the electrical stimulation automatically during the stroke gait. We previously used a heel sensor system, which detects the contact pressure of the heel, in FES to correct foot drop gait. However, the heel sensor has disadvantages in cosmetics and durability. Therefore, we have replaced the heel sensor with an acceleration sensor that can detect the swing phase based on the acceleration speed of the affected leg, using a machine learning technique (Neural Network). We have used a signal for heel contact in a gait using the heel sensor before training with the Neural Network. The accuracy of the Neural Network detector was compared with a swing phase detector based on the heel sensor. The Neural Network detector was able to detect similarly the swing phase in the heel sensor. The largest difference in timing of the swing phase was less than 60 milliseconds in normal subjects and 80 milliseconds in stroke patients. We were able to correct foot drop gait using FES with an acceleration sensor and Neural Network detector. The present results indicate that an acceleration sensor positioned on the thigh, which is cosmetically preferable to systems in which the sensor is farther from the entry point of the electrodes, is useful for correction of stroke gait using FES.The Tohoku Journal of Experimental Medicine 12/2005; 207(3):197-202. · 1.24 Impact Factor -
Article: Functional electrical stimulation
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ABSTRACT: Percutaneous intramuscular electrodes and a portable multichannel system were used to restore the function of paralyzed upper and lower extremities in spinal cord injuries and hemiplegic patients. The hybrid functional electrical stimulation (FEC) using percutaneous intramuscular electrodes provides practical ambulation for paraplegics. FES was more effective than the flexor hinge splint in increasing the grasping power (GP) of tetraplegic patients, and a stronger and stable GP which was not affected by wrist position make FES practical for improving the activities of daily living. A tilt sensor, which was put on the thigh, could be used to measure a gait cycle. This study suggests that putting a tilt sensor on a hemiplegic patient's thigh improves the FES procedure and may help to restore gait in these patients. We conclude that percutaneous intramuscular FES is useful for spinal cord injuries and hemiplegic patients.Artificial Life and Robotics 01/2000; 4(4):212-219. -
Article: Giant cell tumor of fifth lumbar vertebrae: two case reports and review of the literature.
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ABSTRACT: complete or total en bloc spondylectomy has been recommended for giant cell tumors of the spine. Wide local resection of the fifth lumbar vertebra carries potential risks of major complications because of its anatomical features. Only nine cases of the giant cell tumors involving the fifth lumbar vertebra have been reported in the literature. to present two cases of giant cell tumor of the fifth lumbar vertebra treated by single-stage combined anterior and posterior tumor resection over 7 years of follow-up. Case report and a review of literature. A 33-year-old female and a 20-year-old female, each diagnosed with giant cell tumor of fifth lumbar vertebra, underwent single-stage tumor resection through a combined posterior and retroperitoneal anterior approach. The resection of the fifth lumbar vertebra was completed in the first case without major perioperative complications. In the second case, massive bleeding during the anterior procedure for resection of the vertebral body interrupted the total resection of the tumor, resulting in possible residual tumor which required adjuvant radiotherapy. The patients recovered both clinically and neurologically after the operation. Spinal reconstruction was maintained, and no recurrence of the tumor was evident at the 7-year and 8-year follow-up, respectively. There was no recurrence of the tumor after the combined single-stage anterior and posterior tumor resection and adjuvant radiotherapy for the second case for over 7 years follow-up. However, complete resection of the vertebra and tumor at the fifth lumbar vertebra is still challenging to accomplish.The Spine Journal 7(4):499-505. · 3.29 Impact Factor
Top co-authors
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Institutions
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2008–2009
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Akita University
- Department of Orthopaedic Surgery
Akita, Akita-ken, Japan
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2000–2009
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Akita University Hospital
Akita, Akita-ken, Japan
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