Kazumasa Terada’s research while affiliated with Kyushu University and other places

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Publications (14)


A Novel Technique for Surgical Resection of Spinal Meningioma
  • Article

September 2001

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41 Reads

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69 Citations

Spine

Taichi Saito

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Takeshi Arizono

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[...]

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Yukihide Iwamoto

A technical note. To describe and discuss a novel technique for surgical resection of spinal meningioma. With conventional methods for surgical resection of isolated intradural spinal meningioma, there are two ways of dealing with the dural attachment of the tumor. One is complete resection of the involved dura together with the tumor, and the other is coagulation only of the tumor base of the dura. In the case of the novel technique herein described, the dura mater is preserved in a new manner. In the surgical procedure a small incision is made in the surface of the dura mater after the conventional laminectomy. The spinal dura can be easily divided into two layers, comprising inner and outer layers. The outer layer is stripped away from the inner layer surrounding the tumor base. The tumor is then resected together with the inner layer alone outside the arachnoid membrane, and finally the outer layer is simply closed. This method has been applied to three cases. The preserved outer layer of the dura mater did not demonstrate the existence of tumor cells histologically. Neither complications nor tumor recurrence have been experienced. The authors introduced a novel technique for surgical resection of isolated intradural spinal meningioma. Using this simple procedure the outer part of the dura mater, which is not involved by the tumor, can be preserved and complicated dural reconstruction is not necessary. Furthermore, there is less risk of postoperative cerebrospinal fluid fistulas than when the dura is completely resected together with the tumor. However, long-term observation as a result of the possibility of local recurrence is strongly recommended.



Assessment of subchondral blood flow in the rabbit femoral condyle using the laser speckle method

May 1999

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31 Reads

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5 Citations

Journal of Orthopaedic Research

The laser speckle method is a new form of flowmetry that can obtain a two-dimensional distribution of blood flow in tissue. This method is a noncontact, simple, and rapid technique that may aid in the diagnosis of osteonecrosis. We investigated whether the subchondral bone blood flow within the femoral condyles of rabbits could be measured by the laser speckle method. The hydrogen washout method was chosen as a comparison technique because of its ability to allow repetitive measurements of blood flow in various conditions in one rabbit and because of its reliability, which already has been established. We simultaneously measured the bone blood flow in 20 femoral condyles of 10 rabbits with the laser speckle and hydrogen washout methods and found a significant correlation between the blood flow levels with use of these two methods. For the clinical application of the laser speckle method, we also investigated the influence of cartilage thickness on the measurements and the depth in the bone to which blood flow could be measured with this method. A cartilage thickness of 0.2 mm did not influence the measurement of the bone blood flow, and the depth in the bone to which the laser speckle method could be used was approximately 2 mm.


Lymphangioma Presenting as a Dumbbell Tumor in the Epidural Space of the Lumbar Spine

February 1999

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18 Reads

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22 Citations

Spine

A case report. To report and discuss a case of lymphangioma presenting as a dumbbell-shaped tumor in the epidural space of the lumbar spine. Dumbbell tumor of the spine is not uncommon. Although the pathogenesis of such tumors varies widely, lymphangioma has not been reported previously, to these authors' knowledge. A 56-year-old woman with pain in the lower back and left leg was examined by plain radiographs and magnetic resonance imaging before surgery. Treatment consisted of the usual technique of surgical resection of the tumor. Histopathologic study of the resected material confirmed the diagnosis. Postoperative follow-up assessment was performed by magnetic resonance imaging. Magnetic resonance imaging demonstrated a dumbbell tumor in the epidural canal area of the lumbar spine. Histopathologic diagnosis of the resected tumor was cavernous lymphangioma. To the authors' knowledge, this is the first reported case of lymphangioma presenting as a spinal dumbbell tumor. Further observation is recommended because of the possibility of local recurrence.


Sternum Manubrium Splitting Approach for Upper Thoracic Myelopathy.

September 1998

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16 Reads

Orthopedics & Traumatology

In this report, we discuss two cases of upper thoracic myelopathy, treated successfully with anterior decompression and fusion utilizing sternum manubrium splitting approach. When considering surgical approach to lesions around the spinal canal, lesions existing in the anterior of spinal canal can basically be treated more effectively from the anterior approach. This is especially true at the thoracic level, because of physiological kyposis of the thoracic spine. Since the conventional anterior approach is difficult for the upper thoracic spine, this approach proves very useful for the treatment of intracanal lesions at the upper thoracic level localized at the anterior of the spinal canal.


Treatment of Dumb-bell Tumors of the Cervical Spine.

September 1997

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6 Reads

Orthopedics & Traumatology

We reviewed 7 cases who underwent surgical intervention for dumb-bell tumors of the cervical spine. According to Eden's classification was one case there of type 2, five type 3, and one type 4. The type 2 case was operated on by both the posterior and anterior approach. All of the type 3 cases were operated on by the posterior approach alone. The type 4 case was operated on by the anterior approach. Pathological diagnoseis were all neurinoma except one case of malignant Schwannoma. To make an appropriate decision for the best surgical approach, it is very important to elucidate the localization of the tumor preoperatively using MRI, myelography, CTM, and angiography, etc. In this study, clinical results were gererally good, with only one case having a kyphotic deformity in the cervical spine postoperatively. In order to avoid postoperative kyphotic deformity, some kind of fusion technique should be added to the posterior approach.


Studies of CDI for Treatment of Idiopathic Scoliosis.

January 1997

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7 Reads

Orthopedics & Traumatology

We reviewed roentgenograms of 17 patients who had been treated with CDI for idiopathic scoliosis, between 1988 and 1995. The correction of each type of scoliosis, using King's classification was good in about 50% of cases. Among the 17 patients, 4 were type II. and of these 4, 2 were unbalanced in the frontal plane after surgery. When we perform selective fusion of the thoracic curve for patients with type II scoliosis in whom the thoracic and lumbar curves are almost equal with a flexibility index less than 25, they tend to be unbalanced after surgery. We believe in these cases it is better to fix the scoliosis from the thoracic to the lumbar curve.


Tortuosity of the vertebral artery in patients with cervical spondylotic myelopathy. Risk factor for the vertebral artery injury during anterior cervical decompression

June 1996

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40 Reads

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59 Citations

Spine

The case report presented herein shows tortuosity of the vertebral artery in a patient with cervical myelopathy. This case led the authors to evaluate 22 other patients who also had undergone anterior cervical fusion. They were studied before operation by either magnetic resonance imaging angiography or selective vertebral angiography. To analyze the radiographs, computed tomography, magnetic resonance imaging, and angiography findings to detect any tortuosity of the vertebral artery in patients with cervical myelopathy to show the risk factors of vertebral artery injury during anterior decompression. Complications of vertebral artery laceration during cervical anterior decompression are rare, so this injury and abnormality in the course of vertebral artery in patients with cervical myelopathy receive little attention. The tortuosity of the vertebral artery was assessed by angiography, magnetic resonance imaging, and computed tomography. Mild vertebral artery tortuosity was observed in 10 patients and loop formation in three associated with cervical spondylotic changes. This study suggests that vertebral artery loop formation is developed associated with cervical spondylotic changes. During the anterior decompression of cervical spondylotic myelopathy or radiculopathy, the looped vertebral artery could be injured by an excessive wide rejection of the bone or disc material. In the case of vertebral artery migration, the looped vertebral artery can even be injured by routine procedures.


Tortuosity of the Vertebral Artery in Patients With Cervical Spondylotic Myelopathy

May 1996

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8 Reads

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77 Citations

Spine

Study Design: The case report presented herein shows tortuosity of the vertebral artery in a patient with cervical myelopathy. This case led the authors to evaluate 22 other patients who also had undergone anterior cervical fusion. They were studied before operation by either magnetic resonance imaging angiography or selective vertebral angiography. Objectives: To analyze the radiographs, computed tomography, magnetic resonance imaging, and angiography findings to detect any tortuosity of the vertebral artery in patients with cervical myelopathy to show the risk factors of vertebral artery injury during anterior decompression. Summary of Background Data: Complications of vertebral artery laceration during cervical anterior decompression are rare, so this injury and abnormality in the course of vertebral artery in patients with cervical myelopathy receive little attention. Methods: The tortuosity of the vertebral artery was assessed by angiography, magnetic resonance imaging, and computed tomography. Results: Mild vertebral artery tortuosity was observed in 10 patients and loop formation in three associated with cervical spondylotic changes. Conclusions: This study suggests that vertebral artery loop formation is developed associated with cervical spondylotic changes. During the anterior decompression of cervical spondylotic myelopathy or radiculopathy, the looped vertebral artery could be injured by an excessive wide rejection of the bone or disc material. In the case of vertebral artery migration, the looped vertebral artery can even be injured by routine procedures.


Complications of Cotrel-Dubousset Instrumentation in Lumbar Degenerative Disorders.

March 1996

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6 Reads

Orthopedics & Traumatology

We reviewed 27 cases who underwent Cotrel-Dubousset Instrumentation (CDI) for lumbar degenerative disorders and studied the major complications encountered. Intra-operative complications experienced were pedicular fractures in 2 cases, post-operative complications were local infection, non-union of the grafted bone, instrument failure, and decubitus at the screw head in 1, 4, 6, and 1 case, respectively. To avoid these complications, it is important to restrict the indication for using instrumentation in lumbar degenerative disorders and to develop good surgical techniques.


Citations (7)


... Tortuosity is also linked with vascular vertigo [129] but only if one segment of the VA is affected; if no vascular risk factors exist, symptoms may not appear [130]. A twisted vessel is at higher risk of iatrogenic injuries, as it does not pursue a common course [131]. Thus, a pre-surgical imagistic recognition of the anatomical peculiarities of the VA is fundamental. ...

Reference:

The Vertebral Artery: A Systematic Review and a Meta-Analysis of the Current Literature
Tortuosity of the Vertebral Artery in Patients With Cervical Spondylotic Myelopathy
  • Citing Article
  • May 1996

Spine

... В редки случаи е показана хирургична интервенция при пациенти с прогресиращ неврологичен дефицит или неповлияваща се от консервативното лечение болка [2,10,11,15]. Оперативното лечение включва цервикална дискектомия с или без вертебродеза, ламинектомия и ламинопластика [13]. ...

Herniation of Calcified Cervical Intervertebral Disc Causes Dissociated Motor Loss in a Child
  • Citing Article
  • December 1993

Spine

... On the basis of previous studies in small animal models (9,13,26), we expected that sensory dermatomes innervated by RTX-injected DRG would be less sensitive to nociceptive thermal stimuli when compared to the contralateral dermatomes injected with vehicle only. Our rationale for injecting four adjacent levels of the lumbar spine was to induce analgesia in a large enough area of the lateral hindlimb, which would allow for behavioral testing ( Fig. 2A) (27,28). We used an infrared diode laser, which does not contact the skin, to briefly and reproducibly activate the terminals of presumptive nociceptive afferents (6,26,29). ...

The Effect of Nerve Root Lesioning on Various Somatosensory Evoked Potenials in the Hog
  • Citing Article
  • July 1993

Spine

... Sakaida et al. [7] proposed that the elongation of the VA is secondary to disc space narrowing, leading to bone remodeling and erosion through arterial pulsation, resulting in an enlarged neural foramen and subsequent nerve root compression. Oga et al. [8] supported this theory, finding a direct correlation between the grade of cervical spondylosis and the degree of VA tortuosity. ...

Tortuosity of the vertebral artery in patients with cervical spondylotic myelopathy. Risk factor for the vertebral artery injury during anterior cervical decompression
  • Citing Article
  • June 1996

Spine

... In particular, in case of vertebral involvement, lymphangiomas cannot be distinguished from hemangiomas (showing the same T2 hyperintensity, T1 variable intensity, and CE); on CT images, they can even mimic the pathognomonic features of the "polka dot" and "jail bar" sign. [25] When they are confined to the spinal canal, lymphangiomas can mimic spinal schwannomas or neurofibromas, potentially recreating the typical dumbbell shape [18,26] (in our case, transforaminal extension with widening of the neural foramen was deemed particularly suggestive of schwannoma). Other important and common differential diagnoses are spinal meningiomas (especially in cases with homogeneous CE), cystic lesions, and metastases. ...

Lymphangioma Presenting as a Dumbbell Tumor in the Epidural Space of the Lumbar Spine
  • Citing Article
  • February 1999

Spine

... It was applied as a powerful and sensitive imaging technique for microstructure investigation of teeth enamel [43], characterization of atherosclerotic plaque [44,45], noncontact diagnosis of burn severity [46], and estimation of cartilage surface roughness [39,47,48]. Besides, studies of noninvasive investigation of blood flow in finger joints [49], critical limb ischemia [50], cerebral [51], retina [52], and femoral condyle [53] were performed through biospeckle imaging. ...

Assessment of subchondral blood flow in the rabbit femoral condyle using the laser speckle method
  • Citing Article
  • May 1999

Journal of Orthopaedic Research

... In addition, the risk of postoperative complications associated with Simpson grade I, including neurological complications, pseudomeningoceles, and CSF leak, should be considered. In this scenario, Saito et al. [44]. developed an alternative technique in which after tumor exeresis, only the inner dural layer is resected, preserving the outer dural layer, to avoid the technical difficulties in the dural reconstruction and the postoperative complications associated. ...

A Novel Technique for Surgical Resection of Spinal Meningioma
  • Citing Article
  • September 2001

Spine