Kazuta Yamashita and Koichi Sairyo : PPS:腰椎分離症修復術 Smiley face Rod Method, MEDICAL VIEW CO., LTD., May 2017.
Academic Paper (Judged Full Paper):
1.
Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Kosuke Sugiura, Yoshihiro Ishihama, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan., Neurologia Medico-Chirurgica, Vol.60, No.1, 26-29, 2020.
(Summary)
For full-endoscopic lumbar discectomy, operating costs are also important because expensive equipment are necessary. We surveyed the operating costs of surgical equipment necessary for full-endoscopic surgery together with surgical procedure reimbursement fees. A total of 295 cases of full-endoscopic surgery via a transforaminal approach were retrospectively analyzed. We calculated the frequency of damage and the unit purchase price of devices such as endoscopes, and surgical instruments such as grasping forceps for nucleotomy, high-speed drill bar, and bipolar forceps, and examined the operating costs in Japanese yen against the procedure fee per case. Endoscope breakage occurred seven times, and a payment of ¥760,000 was necessary for trade-in and purchase of a new endoscope. The total breakage number of grasping forceps was 58, and the purchase price per unit was ¥116,000. Therefore, a total of ¥12,020,000 was required for the 295 cases, and the calculated operating cost that accompanies equipment breakage was ¥40,000 per case. In addition, about ¥118,000 was required for disposable bipolar forceps and high-speed drill bar to be used intraoperatively for each case. Thus, for one case it is calculated that total ¥158,000 is utilized for equipment from the surgical reimbursement fee per case specified by the Japanese Ministry of Health being ¥303,900. Minimally invasive procedures provide great benefit to patients; however, the eventual contribution to hospital profits is small and may not be sufficient. To resolve this issue, the cost of surgical equipment should be lowered and/or the surgical reimbursement fee of the full-endoscopic surgery should be raised.
Shota Shigekiyo, Toshihiko Nishisho, Yoichiro Takata, Shun-ichi Toki, Kosuke Sugiura, Yoshihiro Ishihama, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Intracanalicular Osteochondroma in the Lumbar Spine., NMC Case Report Journal, Vol.7, No.1, 11-15, 2019.
(Summary)
resection of the osteochondroma with the ligamentum flavum relieved the symptoms. Spinal osteochondroma occurs relatively frequently in elderly individuals compared with peripheral lesions and mimics a degenerative spinal disorder. Careful physical examination and imaging evaluation can reveal this tumor and surgery is effective for relieving the symptoms.
Hiroaki Manabe, Kosuke Sugiura, Yoshihiro Ishihama, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Imaging Features of Non-Isthmic Spondylolysis: A Case Report., Spine Surgery and Related Research, Vol.4, No.2, 187-189, 2019.
Haruhiko Yoshinari, Fumitake Tezuka, Kazuta Yamashita, Hiroaki Manabe, Fumio Hayashi, Yoshihiro Ishihama, Kosuke Sugiura, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Transforaminal full-endoscopic lumbar discectomy under local anesthesia in awake and aware conditions: the inside-out and outside-in techniques., Current Reviews in Musculoskeletal Medicine, 311-317, 2019.
(Summary)
Initially, TELD was performed as the "inside-out" technique but was associated with reports of postoperative dysesthesia due to exiting nerve injury. Recently, the "outside-in" technique after foraminoplasty was proposed for safer insertion of the cannula into the disc. Foraminoplasty can widen the narrow foramen, thereby allowing the 8-mm cannula to pass through easily and safely, and thus injury to the exiting nerve root can be theoretically avoided. We described two types of the TELD in this review. Surgeons should be familiar with the inside-out and outside-in techniques for TELD; therefore, we can select appropriate technique for each case.
Yuhei Yamasaki, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Multiple Loose Bodies in the Lumbar Facet Joint: Case Report., NMC Case Report Journal, Vol.6, No.3, 79-81, 2019.
(Summary)
We describe here a patient diagnosed with multiple loose bodies in the lumbar facet joint. The patient was a 52-year-old woman who presented with left sciatic pain. Neurological findings indicated L5 radiculopathy. Radiological findings revealed lateral recess stenosis at the L4-L5 level, and loose bodies in the left L4-L5 facet joint were noted that compressed the left L5 nerve root. We performed laminotomy at the left L4-L5 level, and removed five loose bodies located on the dorsal side of the ligamentum flavum. Following removal of the loose bodies and flavectomy, the L5 nerve root was decompressed. Postoperatively, the patient's symptoms improved markedly. Symptomatic multiple loose bodies in the lumbar facet joint are very rare, and can cause lumbar radiculopathy. It is important for spine surgeons to recognize this pathology.
Kaori Momota, Toshihiko Nishisho, Ryo Miyagi, Shun-ichi Toki, Kazuta Yamashita, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Akihiro Nagamachi, Toru Maeda and Koichi Sairyo : A Rare Case of Acute-Onset Spastic Quadriparesis Caused by a Chondroma of the Cervical Spine., Case Reports in Orthopedics, Vol.2019, 2019.
(Summary)
Chondromas are benign cartilaginous tumors that occur very rarely in the spine. Moreover, chondromas of the extraskeletal origin are also very rare. In this case report, we describe an extremely rare case of chondroma arising from the ligamentum flavum in the cervical spine. A 67-year-old man presented to our clinic with acute-onset spastic quadriparesis. We performed emergent magnetic resonance imaging and found an epidural mass in the right ligamentum flavum at C4-C5. The acute-onset presentation was suspicious for intraligamentous hematoma in the ligamentum flavum at this level. We performed emergency decompression surgery and en bloc removal of the epidural mass with the right C4 and C5 lamina. The lesion had the appearance of cartilaginous tissue rather than hematoma. Based on the histological investigation, the final diagnosis was intraligamentous chondroma of the cervical spine. The quadriparesis improved postoperatively, as did the results of manual muscle testing in the affected area, and he was able to resume walking independently with a cane. At the one-year follow-up, the manual muscle testing results were almost normal. Surgeons should keep in mind the possibility of benign tumors including chondroma of the cervical spine when a patient presents with acute-onset quadriparesis.
Kazuta Yamashita, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Hiroaki Manabe, Masatoshi Morimoto, Yutaka Kinoshita, Hiroshi Yonezu, Takashi Chikawa, Yasuyoshi Mase and Koichi Sairyo : Low Back Pain in Adolescent Athletes: Comparison of Diagnoses Made by General Orthopedic Surgeons and Spine Surgeons., International Journal of Spine Surgery, Vol.13, No.2, 178-185, 2019.
(Summary)
In adolescent athletes, the rate of NSLBP diagnosed by general orthopedic surgeons decreased markedly when the diagnosis was made by spine surgeons. A thorough medical interview, careful physical examination, appropriate diagnostic imaging, and selective nerve block examination can effectively identify the cause of low back pain.
Hiroaki Manabe, Toshinori Sakai, Ryo Miyagi, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata and Koichi Sairyo : Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography., European Spine Journal, Vol.28, No.4, 849-854, 2019.
(Summary)
Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study were to identify lumbar nerve tract abnormalities caused by congenital variation or a high nerve root take-off angle using DW-MRN and to assess the diagnostic value of this imaging modality.
Hiroaki Manabe, Kazuta Yamashita, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Thermal Annuloplasty Using Percutaneous Endoscopic Discectomy for Elite Athletes with Discogenic Low Back Pain., Neurologia Medico-Chirurgica, Vol.59, No.2, 48-53, 2019.
(Summary)
The purpose of this study was to assess the usefulness of radiofrequency thermal annuloplasty (TA) using percutaneous endoscopic discectomy/TA (PED/TA) in elite athletes with discogenic low back pain. Twelve patients (11 men, 1 woman; mean age 27.9 years) underwent PED/TA under local anesthesia. Clinical data for these patients (17 affected intervertebral discs), including type of sport played, average duration of low back pain, disc level affected, presence or absence of a high signal intensity zone on magnetic resonance imaging, and whether the patient returned to playing competitive sport, were retrospectively reviewed. The most common sport played by the patient was baseball (n = 8), followed by cycling (n = 2), tennis (n = 1), and hammer throw (n = 1). The average duration of low back pain was 24.3 months. The intervertebral disc levels affected were L4/5 (n = 11) and L5/S1 (n = 6). A high signal intensity zone was detected in nine discs. Although two patients required additional surgery, all patients were able to return to their original competitive level of play. Duration for the return to play was 2.8 months after surgery except the two revision cases. PED/TA for discogenic pain enables an early return to competitive sports, and so is particularly useful for elite athletes.
Masatoshi Morimoto, Kousaku Higashino, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Shoichiro Takao, Toshinori Sakai, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Age-related changes in axial and sagittal orientation of the facet joints: Comparison with changes in degenerative spondylolisthesis., Journal of Orthopaedic Science, Vol.24, No.1, 50-56, 2019.
(Summary)
Despite facet joints being three-dimensional structures, previous computed tomography and magnetic resonance imaging studies have evaluated facet joint orientation in only the axial plane. Facet joint orientation in the sagittal plane has rarely been studied using these imaging techniques. The aim of this study was to elucidate facet joint orientation in both the axial and sagittal planes on computed tomography. A total of 568 patients (343 men, 225 women) (excluding orthopedic outpatients) for whom abdominal and pelvic computed tomography scans were obtained at our hospital between September 2010 and October 2012 were included. Mean age was 63 (range 21-90) years. Patients were divided into a degenerative spondylolisthesis group (67 patients; 30 men, 37 women) and a control group (313 patients; 313 men, 188 women). Facet joint orientation was evaluated in the control group according to patient age (≤50, 51-60, 61-70, or ≥71 years). The findings in the control group were then compared with those in the degenerative spondylolisthesis group. The orientation of the lumbar facet joints at each level was measured in the axial and sagittal planes on computed tomography images. Facet joint angles decreased with age at L4/5 and L5/S1 in women in the axial plane and at L4/5 in men and L3/4 and L4/5 in women in the sagittal plane. The variation in facet joint angle was greatest at L4/5 in women. Patients with degenerative spondylolisthesis showed more sagittally and horizontally oriented facet joints in the axial and sagittal planes; facet tropism showed an association with degenerative spondylolisthesis in the axial plane. The axial and sagittal orientation of facet joints in the lower lumbar vertebra, especially L4/5, was negatively correlated with age. This finding could help to explain why older people are more prone to degenerative spondylolisthesis.
(Keyword)
Adult / Age Factors / Aged / Aged, 80 and over / aging / female / Humans / Lumbar Vertebrae / magnetic resonance imaging / male / Middle Aged / ROC Curve / Spondylolisthesis / Tomography, X-Ray Computed / Young Adult / Zygapophyseal Joint
Kenichiro Kita, Toshinori Sakai, Kazuta Yamashita, Akihiro Nagamachi and Koichi Sairyo : Spontaneous lumbar spinal subdural hematoma: a case report., British Journal of Neurosurgery, Vol.33, No.3, 264-268, 2019.
(Summary)
Spinal subdural hematoma (SSDH) is an uncommon disease causing acute onset of spinal disorder. Several causes of SSDH have been reported, but reports of spontaneous occurrence of SSDH are limited.
Yuto Sugimine, Kentaro Sakaeda, Kazuta Yamashita, Hiroaki Manabe, Kosuke Sugiura, Fumio Hayashi, Yoshihiro Ishihama, Yoichiro Takata, Toshinori Sakai, Toru Maeda, Tomohiko Tateishi and Koichi Sairyo : Surgical Treatment of Lumbar Herniated Nucleus Pulposus Combined with Residual Bony Fragment of Apophyseal Ring Fracture in High-Level Athletes : A Report of Two Cases., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 358-361, 2019.
(Summary)
In this paper, we present 2 cases of herniated nucleus pulposus (HNP) combined with the residual bony fragment of apophyseal ring fracture. HNP typically exists at the narrow lateral recess formed by the bony fragment, and so it has been reported that symptoms may persist. Case 1 was a 22-year-old man, a high-level javelin thrower and Paralympic athlete. He had a history of persistent pain for 4 years due to HNP, and so we performed surgical removal. Case 2 was a 23-year-old male professional baseball player. He was referred to us only 17 days after the onset of pain and presented with muscle weakness, a feature which may prolong the clinical course in addition other features such as pain. Thus, we performed a comparatively quick intervention of surgical removal. In both cases, we had excellent clinical outcomes and better function and performance. In conclusion, in cases with HNP and apophyseal ring separation, surgical intervention in the comparatively early phase can be recommended, particularly if the patients desire quick return to their original level of activity. J. Med. Invest. 66 : 358-361, August, 2019.
Yoshihiro Ishihama, Fumitake Tezuka, Hiroaki Manabe, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Koichi Sairyo : Minimally invasive cervical micro-endoscopic foraminotomy for C6 radiculopathy with overlooked scapular winging - A case report., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 340-343, 2019.
(Summary)
A 73-year-old woman complained of right medial side of scapular pain associated with winged scapula to miss without observing the back in minute detail. Additional treatment was required due to overlooking caused by insufficient examination. We performed micro-endoscopic foraminotomy that provided the disappearance of scapular pain and improvement of winged scapula in relatively early. It was commonly said that winged scapula is an extremely rare condition that causes dysfunction of the upper extremities. We suggest that there are the meaning of winged scapula in diagnosis and the importance of physical examination. Further studies should be required to research the morbidity of winged scapula associated with cervical disease. By sharing our experience of this attention arousing case, we provide information not to repeat the same mistakes. J. Med. Invest. 66 : 340-343, August, 2019.
Tsuyoshi Goto, Toshinori Sakai, Kosuke Sugiura, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Shinsuke Katoh and Koichi Sairyo : A semi-rigid thoracolumbar orthosis fitted immediately after spinal surgery : stabilizing effects and patient satisfaction., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 275-279, 2019.
(Summary)
Purpose : To evaluate the stabilizing effects of a Fit Cure-Spine® semi-rigid thoracolumbar orthosis and wearer satisfaction after lumbar surgery. Methods : In study 1, the spinal angle, spinal motion angle, and distribution of load were measured in 8 adult male volunteers when the orthosis was worn (1) with no custom-made stay (CMS), (2) with a CMS in the prone position (P-CMS), and (3) with a CMS in the prone position and decreased lordosis (DP-CMS). In study 2, pain scale scores and responses to a questionnaire were recorded in 40 consecutive patients who underwent lumbar spinal surgery in our hospital. Results : In study 1, the mean lumbar lordosis when standing was similar to that in the prone position. When the trunk was bent forward, loads on the back support in P-CMS and DP-CMS were concentrated at the center of the CMS, unlike those for No-CMS. In study 2, there was a significant decrease in postoperative wound pain after wearing the Fit Cure-Spine orthosis for 2 weeks. Most patients who wore the orthosis were satisfied with their pain outcome. Conclusion : Adjustment to lumbar lordosis and the prone position was restricted in volunteers wearing the Fit Cure-Spine with a CMS. J. Med. Invest. 66 : 275-279, August, 2019.
Kazuta Yamashita, Kosuke Sugiura, Hiroaki Manabe, Yoshihiro Ishihama, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Toru Maeda and Koichi Sairyo : Accurate diagnosis of low back pain in adult elite athletes., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 252-257, 2019.
(Summary)
Background : There is few reports evaluated accurately the pain generator of low back pain in elite athletes. The purpose of this report was to show case series and to investigate the cause of unidentified low back pain of elite athletes. Methods : Twenty-three adult elite athletes consulted our sports spine clinic to seek a second opinion for low back pain between April 2013 and March 2016. Their cause of low back pain had not been identified by nearby doctor. Spine surgeons had diagnosed using diagnostic injection and STIR-MRI and the final diagnosis made by the spine surgeon were collected. Results : The mean age of 23 patients (16 male, 7 female) was 30.4 years. The most common sport played was baseball. The final diagnosis made by a spine surgeon was as follows : disc related low back pain (n = 12), facet joint arthritis (n = 5), vertebral endplate injury (n = 4), early-stage lumbar spondylolysis (n = 1), supraspinous ligament injury (n = 1). Conclusions : A thorough medical interview, careful physical examination, appropriate diagnostic imaging, and injection block examination can effectively identify the cause of low back pain. J. Med. Invest. 66 : 252-257, August, 2019.
Koichi Sairyo, Kazuta Yamashita, Hiroaki Manabe, Yoshihiro Ishihama, Kosuke Sugiura, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Yasuyuki Omichi, Nobutoshi Takamatsu, Ayaka Hashimoto and Toru Maeda : A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review., The Journal of Medical Investigation : JMI, Vol.66, No.3.4, 224-229, 2019.
(Summary)
Full-endoscopic spinal surgery was first developed for the lumbar herniated nucleus pulposus. Mainly, there are two types in the full-endoscopic lumbar surgery : i.e., transforaminal (TF) and interlaminar approach. The surgery can be done under the local anesthesia for the TF approach ; therefore, we need to further develop the TF approach to variety of the spinal disorders. Recently, the TF full-endoscopic surgery has been applied for the spinal canal stenosis. First, transforaminal full-endoscopic lumbar foraminoplasty for the foraminal stenosis ; then, transforaminal lumbar lateral recess decompression for the lateral recess stenosis has been developed. Finally, we have developed the surgical technique to decompress the central stenosis via TF approach under the local anesthesia. Prior to initiate the clinical case, we have attempted the lumbar undercutting laminectomy using a fresh cadaveric spine. After we technically confirmed that the transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) is possible, we applied the technique to the patient whose lung capacity did not allow general anesthesia. The 72 years old female patient with central canal stenosis could be improved her left leg pain and muscle weakness after TE-LUL under the local anesthesia. In this paper, we introduce the surgical technique of the TE-LUL and discuss of the efficacy of the TE-LUL. J. Med. Invest. 66 : 224-229, August, 2019.
Hiroaki Manabe, Toshinori Sakai, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata and Koichi Sairyo : Radiological Outcomes of Posterior Lumbar Interbody Fusion Using a Titanium-coated PEEK Cage., The Journal of Medical Investigation : JMI, Vol.66, No.1.2, 119-122, 2019.
(Summary)
INTRODUCTION Titanium (Ti) coated polyether ether ketone (PEEK) interbody cages (IBCs) have been introduced to overcome any disadvantages. The purpose of this study was to investigate the radiological outcomes of lumbar interbody fusion (LIF) surgery using the Ti-coated PEEK IBC with a minimum of 1-year of follow-up. METHODS A total of 26 intervertebral spaces in consecutive 21 patients who underwent posterior/transforaminal LIF using the Ti-coated PEEK IBC were evaluated. Rates of bone union, screw loosening, cage subsidence and bone cyst formation around the endplate were evaluated on computed tomography scans acquired at least 1 year postoperatively. RESULTS AND DISCUSSION At the 1-year follow-up, bone fusion was achieved in 23 (88.4%) of 26 intervertebral spaces. Cagesubsidence was found in 5 intervertebral spaces ; however,bone fusion was achieved in all these spaces. Bone cysts formed in 4 intervertebral spaces and 4 of 94 screws were found to be loosened. Three of the loosened screws were found in vertebral bodies adjacent to intervertebral spaces with nonunion. However, there was no association between these events. Although more scientific evidence is required to determine the advantages of Ti-coated PEEK IBCs, we believe the clinical outcomes achieved were favorable at the 1 year minimum follow-up. J. Med. Invest. 66 : 119-122, February, 2019.
Kazuta Yamashita and Koichi Sairyo : Ⅱ．成長期スポーツ外傷・障害について -部位別の特徴と種目- 腰椎外傷の特徴と種目関連性, Monthly Book MEDICAL REHABILITATION, No.228, 48-55, 2018.
20.
Kazuta Yamashita, Fumitake Tezuka, Hiroaki Manabe, Masatoshi Morimoto, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Hiroshi Yonezu, Kousaku Higashino, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Successful Endoscopic Surgery for L5 Radiculopathy Caused by Far-Lateral Disc Herniation at L5-S1 and L5 Isthmic Grade 2 Spondylolisthesis in a Professional Baseball Player., International Journal of Spine Surgery, Vol.12, No.5, 624-628, 2018.
(Summary)
Minimally invasive endoscopic surgery is an option for radiculopathy in very active patients who need an early return to their previous level of physical activity.
Tsuyoshi Goto, Toshinori Sakai, Kosuke Sugiura, Hiroaki Manabe, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa, Shinsuke Katoh and Koichi Sairyo : Dash-Associated Spondylolysis Hypothesis., Spine Surgery and Related Research, Vol.3, No.2, 146-150, 2018.
(Summary)
Kinematically and kinetically, the spinopelvic angles in Dash were considered similar to those in Shoot. Dash could cause mechanical stress at the pars interarticularis of the lumbar spine, similar to that caused by Shoot, thus leading to spondylolysis.
Toshinori Sakai, Tsuyoshi Goto, Kosuke Sugiura, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : Bony Healing of Discontinuous Laminar Stress Fractures Due to Contralateral Pars Defect or Spina Bifida Occulta., Spine Surgery and Related Research, Vol.3, No.1, 67-70, 2018.
(Summary)
Contralateral pars defect remains an unfavorable factor for bony healing discontinuous laminar stress fractures.
Norio Yamamoto, Hirofumi Kosaka, Kousaku Higashino, Masatoshi Morimoto, Kazuta Yamashita, Fumitake Tezuka, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Akihiro Nagamachi and Koichi Sairyo : Vertebral Lateral Notch as Optimal Entry Point for Lateral Mass Screwing Using Modified Roy-Camille Technique., Asian Spine Journal, Vol.12, No.2, 272-276, 2018.
(Summary)
The vertebral lateral notch of the cervical spine was an effective landmark to determine the entry point for lateral mass screwing. The modified Roy-Camille technique proposed here may prevent surgical complications and poor outcomes.
Nori Sato, Kousaku Higashino, Toshinori Sakai, Tomoya Terai, K Vijay Goel, Ashok Biyani, Nabil Ebraheim, Yoichiro Takata, Fumio Hayashi, Kazuta Yamashita, Masatoshi Morimoto, Hiroaki Manabe and Koichi Sairyo : Role of Epiligament in Ligamentum Flavum Hypertrophy in Patients with Lumbar Spinal Canal Stenosis:a Pilot Study., The Journal of Medical Investigation : JMI, Vol.65, No.1.2, 85-89, 2018.
(Summary)
Ligamentum flavum (LF) hypertrophy is one of the main factors of lumbar spinal canal stenosis (LSCS). The primary object of this study is to clarify the existence of epiligament in the LF and its role in hypertrophy, and to develop an LF hypertrophy animal model. A cadaveric spine from a 30-year-old man was used to investigate the existence of epiligament in LF. Five LF samples from LSCS patients were obtained to evaluate hypertrophied LF. To create a rat model, we destabilized the lumbar spine. Each LF was sagittally cut for histological evaluation. The epiligament was clearly evident in normal LF specimens, which stained pink on Elastica van Gieson and green on Masson Trichrome. One layer was observed on the dural side and another on the dorsal side of the LF. LSCS patients had an enlarged dorsal epiligament, at around 30 times that of the regular thin epiligament on the dural side. The destabilized rat model showed an enlarged dorsal epiligament, with a mean thickness 8-fold that of the control. LF hypertrophy may be due to enlargement of the dorsal epiligament. Mechanical loading of the LF is an important factor for inducing hypertrophy in the rat model. J. Med. Invest. 65:85-89, February, 2018.
Kazuta Yamashita, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Yutaka Kinoshita, Akihiro Nagamachi, Takashi Chikawa, Hiroshi Yonezu, Kousaku Higashino, Tadanori Sakamaki and Koichi Sairyo : Utility of STIR-MRI in Detecting the Pain Generator in Asymmetric Bilateral Pars Fracture: A Report of 5 Cases., Neurologia Medico-Chirurgica, Vol.58, No.2, 91-95, 2017.
(Summary)
Lumbar spondylolysis usually occurs as a stress fracture in the pars interarticularis of the vertebra. It is a prevalent sports-related disorder and a common cause of low back pain. We encountered five athletes (4 males, 1 female) with severe low back pain. Mean age was 14.5 years. All five patients were found to have bilateral pars fracture. In all cases, staging based on the findings from computed tomography scan of the right and left pars fracture was different. On short tau inversion recovery magnetic resonance imaging (STIR-MRI) of the comparatively newer more recently injured side, high signal intensity changes were obvious and dominant at the intra- and extraosseous area, which would indicate tissue edema and/or bleeding. Furthermore, the imaging findings corresponded to the side of the low back pain. In conclusion, STIR-MRI can effectively distinguish between painful pars fracture and painless pars fracture.
Kenji Yokoyama, Kenji Endo, Yoichiro Takata, Fumitake Tezuka, Hiroaki Manabe, Kazuta Yamashita, Toshinori Sakai, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Bone Bruise of the Thoracic Spine Caused by Mild Physical Activity in Children., Case Reports in Orthopedics, 2017.
(Summary)
Vertebral bone bruise (VBB) in children commonly occurs following a fall from a height, and more than one vertebral body may be affected. We encountered 6 children each with a single VBB caused by mild physical activity. All the children had tenderness on the corresponding spinous process with no neurologic findings. Magnetic resonance imaging (MRI) showed typical findings of VBB in all cases. The children were treated conservatively with a soft thoracolumbar brace and instructed to rest with no physical activity for a month. At follow-up 1 month later, the back pain had diminished, and the signal changes seen on MRI had disappeared in all cases. We conclude that mild physical activity may be a cause of VBB in children and good clinical results can be achieved by using a soft thoracolumbar brace and rest.
Hideyuki Uraoka, Kousaku Higashino, Masatoshi Morimoto, Kazuta Yamashita, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Akihiro Nagamachi, Masaaki Murase and Koichi Sairyo : Study of lesions of the lumbar endplate based on the stage of maturation of the lumbar vertebral body: the relationship between skeletal maturity and chronological age., European Journal of Orthopaedic Surgery & Traumatology, Vol.28, No.2, 183-187, 2017.
(Summary)
The lesion of the lumbar endplate is sometimes identified in the vertebrae of children and adolescents. The purpose of this study is to compare between skeletal maturity and chronological age. The second purpose of this study is to clarify the lesions of the lumbar endplate based on the maturation of the lumbar vertebral body. Six hundred and thirty-two (485 men and 147 women) consecutive patients were included. The mean age at the first medical examination was 13.8 years. Their skeletal maturity was evaluated based on the appearances of the secondary ossification center of L3. The area of the endplate lesions was classified into five types. The apophyseal stage was observed from 10 years old to 18 years old, and the apophyseal stage was shown the peak at 14 years old. The appearance of the apophyseal ring was observed earlier in female patients than in male patients. For the concave type, the lesion at upper level vertebra was more prevalent. The anterior and middle type of the lesion at upper level vertebra was more prevalent. For the posterior type, the lesion of the inferior rim of L4 and the lesion of the rim of L5 were more prevalent. This study emerged after comparing skeletal maturity based on the maturation of the lumbar vertebral body with the chronological age of a large number of patients and examining the lesions of the lumbar endplate based on the stage of maturation of the lumbar vertebral body.
Fumitake Tezuka, Toshinori Sakai, Mitsunobu Abe, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Anatomical considerations of the iliac crest on percutaneous endoscopic discectomy using a transforaminal approach., The Spine Journal, Vol.17, No.12, 1875-1880, 2017.
(Summary)
From the results of this study, the trajectory of TF-PED can be limited by the surrounding anatomical structures. The maximum inclination angle indicated that treatment for the central type of LDH at the L5-S1 disc level was considered more difficult than that at the L4-L5 disc level because of the iliac crest. In the clinical setting, such anatomical particularities can be overcome by using a more perpendicular approach (hand-down technique) with the possible addition of a foraminoplasty. Moreover, we found that we must consider the laterality of the trajectory of TF-PED in terms of the patients' age or sex.
Toshinori Sakai, Fumitake Tezuka, Mitsunobu Abe, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : Pediatric Patient with Incidental Os Odontoideum Safely Treated with Posterior Fixation Using Rod-Hook System and Preoperative Planning Using 3D Printer: A Case Report., Journal of Neurological Surgery. Part A, Central European Neurosurgery, Vol.78, No.3, 306-309, 2017.
(Summary)
Os odontoideum is often found incidentally. Surgical treatment is recommended for patients with atlantoaxial instability or neurologic deficits. Although various techniques have been used for C1-C2 fusion in adults, the use of these procedures in children is not widely accepted. We present a 12-year-old boy with incidental os odontoideum and obvious C1-C2 instability, in which bony union was achieved safely and successfully by posterior fixation using a rod-hook system and perioperative planning using a three-dimensional printer. At the 2-year follow-up, bone formation around the gap of the dens, which has been generally considered as pseudoarthrosis, was obtained after union of the posterior element of C1-C2.
Kazuta Yamashita, Hisanori Ikuma, Takuya Tokashiki, Takashi Maehara, Akihiro Nagamachi, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino and Koichi Sairyo : Radiation Exposure to the Hand of a Spinal Interventionalist during Fluoroscopically Guided Procedures., Asian Spine Journal, Vol.11, No.1, 75-81, 2017.
(Summary)
Our findings indicated that the cumulative radiation dose measured at the dominant hand may exceed the annual dose limit specified by the International Commission on Radiological Protection. Spinal interventionalists should take special care to limit the duration of fluoroscopy and radiation exposure.
Kenichiro Kita, Yoichiro Takata, Kousaku Higashino, Kazuta Yamashita, Fumitake Tezuka, Toshinori Sakai, Akihiro Nagamachi and Koichi Sairyo : Surgical Removal of Circumferentially Leaked Polymethyl Methacrylate in the Epidural Space of the Thoracic Spine after Percutaneous Vertebroplasty., The Surgery Journal, Vol.3, No.1, e1-e5, 2017.
(Summary)
Background The major complication of percutaneous vertebroplasty (PVP) using polymethyl methacrylate (PMMA) is epidural leakage of PMMA that damages the spinal cord. Methods This is a case report. Result A 77-year-old man presented to our institution with a 6-month history of muscle weakness and an intolerable burning sensation of both lower limbs after PVP with PMMA for thoracic compression fracture at T7 at another hospital. His past medical history was significant for hypertension. He had no history of smoking and alcohol. Computed tomography revealed massive leakage of PMMA into the T6 and T7 spinal canal circumferentially surrounding the spinal cord that caused marked encroachment of the thecal sac. Magnetic resonance images revealed cord compression and intramedullary signal change from T6 to T7 level. After we verified that the leaked PMMA could be easily detached from the dura mater in the cadaveric lumbar spine, surgical decompression and removal of epidural PMMA was performed. The leaked PMMA was carefully thinned down with a high-speed diamond burr. Eight pieces of PMMA were detached from the dura mater easily without causing a dural tear. No neurologic deterioration was observed in the postoperative period. The burning sensation resolved, but the muscle weakness remained unchanged. One and a half years postoperatively, the muscle weakness has improved to ⅘ on the manual muscle strength test, but he could not walk without an aid because of spasticity. Conclusion This report demonstrates the catastrophic epidural extrusion of PMMA following PVP. Extravasated PMMA can be removed through a working space created by means of laminectomy and subtraction of the affected pedicle. Spine surgeons should recognize the possible neurologic complications of PVP and be prepared to treat them using suitable approaches.
Kenichiro Kita, Kazuta Yamashita, Mitsunobu Abe, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : Eight-year follow-up findings of surgical treatment for severe dystrophic changes in the cervical spine associated with neurofibromatosis type I: a case report., Journal of Pediatric Orthopaedics. Part B, Vol.26, No.1, 91-94, 2017.
(Summary)
Long-term follow-up findings for dystrophic changes in the cervical spine caused by neurofibromatosis type 1 have been rarely reported. A 13-year-old boy with severe dural ectasia in the cervical spine underwent cervical posterior fusion from C1 to C5 for prevention of cervical spine fracture and spinal injury. We followed him up for 8 years after surgery. We measured the progression of the destruction on yearly MRI. The dural ectasia gradually progressed until 3 years postoperatively. Subsequently, no further enlargement of the dural sac occurred. At the 8-year follow-up examination, the patient had no limitations in the activities of daily life.
Kousaku Higashino, Kazuta Yamashita, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai and Koichi Sairyo : 非特異的腰痛診断に陥りやすい椎間板性腰痛, Japanese Journal of Orthopaedic Sports Medicine, Vol.37, No.1, 2-6, 2017.
38.
Kosuke Sugiura, Toshinori Sakai, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults., Spine Surgery and Related Research, Vol.1, No.3, 140-145, 2017.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Akihiro Nagamachi and Koichi Sairyo : The reduction and direct repair of isthmic spondylolisthesis using the smiley face rod method in adolescent athlete: Technical note., The Journal of Medical Investigation : JMI, Vol.64, No.1.2, 168-172, 2017.
(Summary)
Presently, lumbar spondylolisthesis did not have the indication of direct repair surgery because of the difficulty to reduce the slippage. In this report, we presented a case and described a minimally invasive direct repair surgery to reduce and repair the pars interarticularis defects of lumbar spondylolisthesis. First, curettage and removal of the synovium of the pars interarticularis and decompression of nerve root are conducted. Next, cancellous bone is harvested from the iliac crest. And then the Percutaneous Pedicle Screws are inserted bilaterally. A rod is bended and placed just caudal to the spinous process. We can make reposition of slipped vertebra and stabilize the loose lamina more firmly using a reduction tool and a rod pusher. Finally, bone grafts are implanted onto the pars defects. The Smiley face rod method is very useful to reduce the slippage and repair the pars defects in the lumbar spondylolisthesis especially in adolescent athletes. J. Med. Invest. 64: 168-172, February, 2017.
(Keyword)
Adolescent / Baseball / Bone Nails / Humans / Lumbar Vertebrae / Male / Minimally Invasive Surgical Procedures / Orthopedic Procedures / Pedicle Screws / Spondylolisthesis
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Akihiro Nagamachi and Koichi Sairyo : Natural Correction and Adaptation of a Severely Deformed Sacral Dome in an Adolescent with Isthmic Spondylolisthesis: A Case Report., JBJS Case Connector, Vol.7, No.2, e26, 2017.
(Summary)
Vertebral deformity in children can be reversible. Orthopaedic surgeons should be aware that pediatric patients with a severe deformity of the sacral dome and vertebral slippage can be managed nonoperatively.
Kenji Yokoyama, Kazuta Yamashita, Masatoshi Morimoto, Fumitake Tezuka, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi and Koichi Sairyo : Accurate diagnosis of chronic low back pain in a high-level college athlete: a case report., The Journal of Medical Investigation : JMI, Vol.64, No.3.4, 313-316, 2017.
(Summary)
A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1. Her persistent low back pain disappeared immediately after the facet block. We diagnosed left-sided facet arthritis at L6-S1. Due to her multiple congenital anomalies, excessive loading occurred at the facet joint. Therefore, we opted for conservative management, including mobilization of the thoracic spine and stretching of hamstrings and quadriceps. This case report underscores the importance of accurate diagnosis of low back pain and of the diagnostic utility of short tau inversion recovery magnetic resonance imaging and lumbar facet block in young athletes with chronic spinal pain. J. Med. Invest. 64: 313-316, August, 2017.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Percutaneous full endoscopic lumbar foraminoplasty for adjacent level foraminal stenosis following vertebral intersegmental fusion in an awake and aware patient under local anesthesia: A case report., The Journal of Medical Investigation : JMI, Vol.64, No.3.4, 291-295, 2017.
(Summary)
Percutaneous endoscopic surgery for the lumbar spine has become established in the last decade. It requires only an 8 mm skin incision, causes minimal damage to the paravertebral muscles, and can be performed under local anesthesia. With the advent of improved equipment, in particular the high-speed surgical drill, the indications for percutaneous endoscopic surgery have expanded to include lumbar spinal canal stenosis. Transforaminal percutaneous endoscopic discectomy has been used to treat intervertebral stenosis. However, it has been reported that adjacent level disc degeneration and foraminal stenosis can occur following intervertebral segmental fusion. When this adjacent level pathology becomes symptomatic, additional fusion surgery is often needed. We performed minimally invasive percutaneous full endoscopic lumbar foraminoplasty in an awake and aware 50-year-old woman under local anesthesia. The procedure was successful with no complications. Her radiculopathy, including muscle weakness and leg pain due to impingement of the exiting nerve, improved after the surgery. J. Med. Invest. 64: 291-295, August, 2017.
Akihiro Nagamachi, Mitsuhiko Takahashi, Noriaki Mima, Keisuke Adachi, Kazumasa Inoue, C Subash Jha, Akihiro Nitta, Masatoshi Morimoto, Tomoya Takasago, Toshiyuki Iwame, Keizo Wada, Fumitake Tezuka, Kazuta Yamashita, Fumio Hayashi, Ryo Miyagi, Toshihiko Nishisho, Ichiro Tonogai, Tomohiro Goto, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Takashi Chikawa and Koichi Sairyo : Radiographic changes of cervical destructive spondyloarthropathy in long-term hemodialysis patients: A 9-year longitudinal observational study., The Journal of Medical Investigation : JMI, Vol.64, No.1.2, 68-73, 2017.
(Summary)
Analyses of radiographic changes and clinical symptom of destructive spondyloarthropathy (DSA) on consecutive 42 patients managed with long-term hemodialysis were performed to elucidate radiographic changes of DSA and the factors that influence to the destructive changes. Patients underwent plain radiographs of the cervical spine with 9 years interval. Grading of radiological feature from lateral view was classified into grade 0 to grade 3. Clinical symptom was evaluated using modified Japanese Orthopaedic Association scoring system for cervical myelopathy (mJOA score). Destructive changes were observed in 3 patients at the first examination, and those were observed in 15 patients 9 years after the first examination. There is no statistically significant difference between the duration of hemodialysis and the grade. The mean age at the onset of hemodialysis, however, was significantly higher in patients of grade 2 and 3 than those of grade 1. Older patients with long-term hemodialysis had destructive changes. Destructive changes commonly observed in lower cervical spine. The average numbers of the involved disc level were 1.6 in grade 2 and 1.0 in grade 3. Clinical symptoms were varied in each grade and there was no statistically significant difference in total mJOA score among these grades. J. Med. Invest. 64: 68-73, February, 2017.
C Subash Jha, Yoichiro Takata, Mitsunobu Abe, Kazuta Yamashita, Fumitake Tezuka, Toshinori Sakai, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : High intensity zone in lumbar spine and its correlation with disc degeneration., The Journal of Medical Investigation : JMI, Vol.64, No.1.2, 39-42, 2017.
(Summary)
Purpose; To investigate the prevalence, clinical significance of high intensity zone (HIZ), and associated disc degeneration. Materials and methods; We undertook retrospective analysis of 228 patients, aged from 15 to 55 years, who had undergone magnetic resonance (MR) imaging of lumbar spine in outpatient clinic from 2013 to 2014. HIZ was defined as a presence of high intensity signal in the annulus on T2-weighted images. All HIZ positive discs were classified according to Pfirrmann grading system for presence of disc degeneration. Results; Forty-three patients (18.8%) with 53 intervertebral discs demonstrated HIZ. There was no significant predominance about age and gender for the presence of HIZ. HIZ occurred mainly at L4-5 (43.3%) and L5-S1 (30.2%) levels, infrequently at L3-4 (17%) and rarely at upper levels. The prevalence of disc degenerations with Pfirrmann grade 3, 4, and 5 were significantly higher in HIZ positive patients than in randomly selected 35 HIZ negative patients (64% vs. 46%, respectively). Conclusion; In this study we identified that the presence of HIZ was directly proportional to increased incidence of disc degeneration in remaining lumbar discs. The prevalence of significant degeneration was significantly higher in HIZ positive patient at lower three lumbar levels. J. Med. Invest. 64: 39-42, February, 2017.
Koichi Sairyo, Kousaku Higashino, Kazuta Yamashita, Fumio Hayashi, Keizo Wada, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Masatoshi Morimoto, Tomoya Terai, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi and Yoshihiro Fukui : A new concept of transforaminal ventral facetectomy including simultaneous decompression of foraminal and lateral recess stenosis: Technical considerations in a fresh cadaver model and a literature review., The Journal of Medical Investigation : JMI, Vol.64, No.1.2, 1-6, 2017.
(Summary)
Percutaneous endoscopic surgery for the lumbar spine, which was established in the last decade, requires only an 8-mm skin incision and causes minimal damage to the paravertebral muscles; thus, it is considered to be a minimally invasive technique for spinal surgery. It has been used to perform percutaneous endoscopic discectomy via two main approaches: the TF approach is a posterolateral one through the intervertebral foramen and can be done under local anesthesia; the IL approach is a more traditional one through the interlaminar space and is difficult to perform under local anesthesia. Recently, these techniques have been applied for lumbar spinal stenosis (LSS), the TF method for foraminal stenosis under local anesthesia, and the IL method for central and lateral recess stenosis under general anesthesia. In this study, using a fresh human cadaver model, we performed simultaneous decompression of the lateral recess and foraminal stenosis at L4-5 using the TF approach. Computed tomography confirmed enlargement of the lateral recess and intervertebral foramen. This technique, which can be performed under local anesthesia, should benefit elderly patients with LSS and poor general condition due to multiple comorbidities. Finally, we introduce the concept of percutaneous transforaminal ventral facetectomy using a spinal percutaneous endoscope. J. Med. Invest. 64: 1-6, February, 2017.
Shunsuke Tamaki, Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata and Koichi Sairyo : Lumbar Posterior Apophyseal Ring Fracture Combined with Spondylolysis in Pediatric Athletes: A Report of Three Cases., JBJS Case Connector, Vol.6, No.3, e64, 2016.
(Summary)
In patients with severe low back and radicular pain in whom spondylolysis is suspected, it is important to perform not only magnetic resonance imaging and radiography but also computed tomography for identifying posterior apophyseal ring fractures.
Kazuta Yamashita and Koichi Sairyo : 神経症状・慢性腰痛に対する手術療法 低侵襲手術を中心に, Orthopeadics and Traumatology, Vol.60, No.5(4), 639-648, Apr. 2017.
Proceeding of International Conference:
1.
Ishihama Yoshihiro, Toshinori Sakai, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : Abdominal free air on postoperative CT scans following XLIF, 2nd SOLAS Japan region meeting(November 10,2018), Nagoya, Nov. 2018.
2.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Akihiro Nagamachi and Koichi Sairyo : Percutaneous endoscopic lumbar discectomy(PED)for top athletes, The 16th Japan-Korea Combined Meeting of Orthopaedic Sports Medicine(September 8,2018), Tokushima, Sep. 2018.
3.
Kazuta Yamashita, Higashino Kosaku, Hiroaki Manabe, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Takashi Chikawa and Koichi Sairyo : Reducing mechanical stress in immature pediatric spondylolisthesis can make modification of sacral dome: a study of spondylolisthesis rat model, The 16th Japan-Korea Combined Meeting of Orthopaedic Sports Medicine(September 8,2018), Tokushima, Sep. 2018.
4.
Hiroaki Manabe, Toshinori Sakai, Ryo Miyagi, Morimoto Masatoshi, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : MORPHOLOGICAL EVALUATION OF LUMBAR NERVE ROOT USING USING DIFFUSION-WEIGHTED MR NEUROGRAPHY, Spine Across the Sea 2018(July 29-August 2,2018), Hawaii, Jul. 2018.
5.
Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa, Toshinori Sakai and Koichi Sairyo : Percutaneous endscopic surgery via transforaminal approach for L5/S intra-canal disc herniation- Relation between bone resection volume and pelvic height-, The 18th Annual Meeting of the Pacific and Asian Society of Minimally Inbasive Spine Surgery(PASMISS 2018)(July 19-21,2018), Taiwan, Jul. 2018.
6.
Hiroaki Manabe, Kazuta Yamashita, Kousaku Higashino, Morimoto Masatoshi, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Koichi Sairyo : Reducing mechanical stress in immature pediatric spondylolisthesis can make remodeling of sacral dome: a study of spondylolisthesis rat model, The 18th Annual Meeting of the Pacific and Asian Society of Minimally Inbasive Spine Surgery(PASMISS 2018)(July 19-21,2018), Taiwan, Jul. 2018.
7.
Fumitake Tezuka, Futatsugi Toshimasa, Sugiura Kosuke, Ishihama Yoshihiro, Hiroaki Manabe, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Sairyo Koichi and : Transforaminal percutaneous endoscopic lumbar decompression surgery as the revision surgery, The 18th Annual Meeting of the Pacific and Asian Society of Minimally Inbasive Spine Surgery(PASMISS 2018)(July 19-21,2018), Taiwan, Jul. 2018.
8.
Fumitake Tezuka, Sugiura Kosuke, Ishihama Yoshihiro, Hiroaki Manabe, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Koichi Sairyo : Transforaminal percutaneous endoscopic lumbar discectomy using foraminoplastic outside-in technique under local anesthesia, The 18th Annual Meeting of the Pacific and Asian Society of Minimally Inbasive Spine Surgery(PASMISS 2018)(July 19-21,2018), Taiwan, Jul. 2018.
9.
Fumitake Tezuka, Sugiura Kosuke, Yoshihiro Ishihama, Hiroaki Manabe, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Koichi Sairyo : Percutaneous endoscopic lumbar discectomy for the high school athletes, The 18th Annual Meeting of the Pacific and Asian Society of Minimally Inbasive Spine Surgery(PASMISS 2018)(July 19-21,2018), Taiwan, Jul. 2018.
10.
Hiroaki Manabe, Kazuta Yamashita, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Takashi Chikawa and Koichi Sairyo : Accurate diagnosis of low back pain in adult elite athletes, The 28th Japan Korea Conbined Orthopaedic Symposium(June 14-15,2018), Gifu, Jun. 2018.
11.
Hiroaki Manabe, Toshinori Sakai, Ryo Miyagi, Morimoto Masatoshi, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : MORPHOLOGICAL EVALUATION OF LUMBAR NERVE ROOT USING USING DIFFUSION-WEIGHTED MR NEUROGRAPHY, 49th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff, May 2018.
12.
Hiroaki Manabe, Toshinori Sakai, Morimoto Masatoshi, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : RADIOLOGICAL OUTCOMES OF LUMBAR INTERBODY FUSION USING TITANIUM-COATED PEEK CAGE, 48th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff, May 2018.
13.
Toshinori Sakai, Sugiura Kosuke, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : Signal intensity changes of the posterior elements of the lumbar spine in symptomatic adults., 47th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff,Canada, May 2018.
14.
Toshinori Sakai, Goto Tsuyoshi, Sugiura Kosuke, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Takashi Chikawa and Koichi Sairyo : Bony healing rate of stress fracture occurred in discontinuous lamina due to pars defect or spina bifida occulta., 45th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff, May 2018.
15.
Kazuta Yamashita, Kousaku Higashino, Hiroaki Hayashi, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Hiroaki Manabe, Takashi Chikawa, Yoshihiro Fukui and Koichi Sairyo : A cadaveric study for estimating the dose reduction when using pulsed and collimated x-ray beams in procedures, 45th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff, May 2018.
16.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Hiroaki Manabe, Takashi Chikawa and Koichi Sairyo : Remodeling of the dome deformity in the immature rat lumbar spondylolisthesis model, 45th International Society for the Study of the Lumbar Spine Annual Meeting(May 14-18,2018), Banff, May 2018.
17.
Akihiro Nagamachi, 森本 雅俊, Fumitake Tezuka, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino and Koichi Sairyo : Medical Economic Efficiency of Percutaneous Endoscopic Lumbar Discectomy in Japan., 17th Annual meeting of the Pacific and Asian Society of the Minimally Invasive Spine Surgery(July 27-29, 2017), Sapporo, Jul. 2017.
18.
山屋 誠司, Toshinori Sakai, Fumitake Tezuka, 山﨑 悠平, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : Endoscopic Decompression Surgery via a Transforaminal Approach under Local Anesthesia for Lateral Recess Stenosis Due to Lumbar Degenerative Disease., 17th Annual meeting of the Pacific and Asian Society of the Minimally Invasive Spine Surgery(July 27-29, 2017), Sapporo, Jul. 2017.
19.
山屋 誠司, Toshinori Sakai, Fumitake Tezuka, 山﨑 悠平, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Takashi Chikawa, Akihiro Nagamachi and Koichi Sairyo : The Usefulness of Surgical Techniques and The Management of Local Anesthesia to Avoid Exiting Nerve Root Injury During Percutaneous Endoscopic Lumbar Discectomy., 17th Annual meeting of the Pacific and Asian Society of the Minimally Invasive Spine Surgery(July 27-29, 2017), Sapporo, Jul. 2017.
20.
Fumitake Tezuka, Hiroaki Manabe, Masatoshi Morimoto, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Akihiro Nagamachi and Koichi Sairyo : Risk Assessment of Abdominal and Retroperitoneal Organ Injuries Performing Transforaminal Percutaneous Endoscopic Lumbar Discectomy., 17th Annual meeting of the Pacific and Asian Society of the Minimally Invasive Spine Surgery(July 27-29, 2017), Sapporo, Jul. 2017.
21.
Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino and Koichi Sairyo : Long term results of arthroscopic debridement of osteochondritis dissecans in adolescent athletes, American Orthopaedic Society for Sports Medicine Annual Meeting 2017(July 20-23, 2017), Toronto, Jul. 2017.
22.
Masatoshi Morimoto, Fumitake Tezuka, Fumio Hayashi, Kazuta Yamashita, Yoichiro Takata, Toshinori Sakai, Kousaku Higashino, Akihiro Nagamachi, Koichi Sairyo, Ryosuke Sato, Masato Miyake and Seiichi Oyadomari : ER STRESS AGGRAVATES THE HYPERTROPHY OF THE LIGAMNTUM FLAVUM, International Society for the Study of Lumbar Spine(ISSLS) 2017( May 29June 2, 2017), Athens, May 2017.
23.
Yoichiro Takata, Fumitake Tezuka, Kazuta Yamashita, Toshinori Sakai, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : The correlation between spinal alignments with clinical outcome after lumbar decompression/fusion surgery in patients with lumbar spinal canal stenosis, International Society for the Study of Lumbar Spine(ISSLS) 2017( May 29June 2, 2017), Athens, May 2017.
24.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Yasuyoshi Mase, Akihiro Nagamachi and Koichi Sairyo : Low back pain of the adolescent athletes -The pathology falls into unidentified non-specific low back pain-, The International Society for the Advancement of Spine Surgery (April 12-14,2017), Bocs Raton ,FL, Apr. 2017.
25.
Kazuta Yamashita, Kousaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Akihiro Nagamachi and Koichi Sairyo : Percutaneous endoscopic lumbar discectomy(PED) for top athletes, The International Society for the Advancement of Spine Surgery (April 12-14,2017), Bocs Raton ,FL, Apr. 2017.
26.
Toshinori Sakai, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kousaku Higashino, Akihiro Nagamachi and Koichi Sairyo : Conservative Treatment for Bony Healing in Pediatric Lumbar Spondylolysis., AAOS 2017 Annual meeting(March 14-18, 2017), San Diego, Mar. 2017.