著者

佐々木 学 貴島 晴彦

出版者

医学書院

巻号頁・発行日

pp.1257-1270, 2021-11-10

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Point・固定術は椎骨間に骨移植を行って癒合させる手術である.インストゥルメンテーションの役割は椎骨間の制動により骨癒合を得やすくすることである.・腰椎固定術は,骨移植を行う部位により椎体間固定術と後側方固定術に大別される.椎体間固定術には,椎弓間を経由する後方椎体間固定術と,後腹膜腔から直接椎体に到達する前方椎体間固定術がある.・後方椎体間固定術は脊柱管,椎間孔の直接的な神経除圧と椎体間固定が行いやすい.前方椎体間固定は脊柱変形の矯正が行いやすく,間接的な神経除圧が期待できる.

著者

佐々木 学 梅垣 昌士 鶴薗 浩一郎 松本 勝美 芝野 克彦 呉村 有紀 米延 策雄

出版者

日本脊髄外科学会

雑誌

脊髄外科 (ISSN:09146024)

巻号頁・発行日

vol.30, no.2, pp.170-175, 2016 (Released:2016-09-03)

参考文献数

14

被引用文献数

2

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Objective : Surgical site infection (SSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) after spinal instrumentation surgery is often intractable, and removal of the implants is frequently necessary for infection control. Although vancomycin (VCM) has been most frequently used against SSI caused by MRSA, recent literatures questioned its efficacy because of its low tissue penetration. Some experts recommend combination therapy with anti-MRSA agents possessing higher tissue penetration or an anti-biofilm effect. The present report shows outcomes of antibiotic therapy for SSI caused by MRSA after spinal instrumentation surgery.  Materials and methods : From January 2011 to December 2013, four patients developed SSI caused by MRSA after spinal instrumentation surgery. Posterior lumbar interbody fusion was used in all patients. As initial therapy, VCM was given to one patient, and combined teicoplanin (TEIC) and rifampicin (RFP) were administered to the other three. These patients subsequently received therapy with TEIC, linezolid, or daptomycin combined with RFP, sulfamethoxazole-trimethoprim, or clindamycin. These agents were stopped sequentially if C-reactive protein remained negative for more than a week.  Results : Infection was uncontrolled in one patient initially treated with VCM, and removal of the posterior instrumentation and interbody cages was required for infection control. Combined therapy was given postoperatively, with complete cure by 13 weeks after removal of the implants. Infection was controlled and the implants could be retained in the other three patients who were initially treated with TEIC and RFP ; cure was achieved with subsequent combined therapy for 3-15 weeks.  Conclusion : The present study suggests that SSI caused by MRSA is treatable with retention of the implant by using combined therapy with anti-MRSA agents possessing higher tissue penetration than VCM or those with an anti-biofilm effect.

著者

佐々木 学

出版者

日本建築学会

雑誌

日本建築学会計画系論文集 (ISSN:13404210)

巻号頁・発行日

vol.71, no.606, pp.93-98, 2006

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The purpose of this research paper is to discuss the characteristics of the modifications carried out on the Piazza Mattei fountain during 1584-1658. The results of my research were as follows: in accordance with the bloom of baroque art and the shift in the role of fountains in Rome, it became evident that there were fountain restorations carried out before 1658, and that a great number of the forms of the constitutive components of fountains, and the pathways of water flow, were transformed.

著者

宮尾 泰慶 佐々木 学 青木 正典 梅垣 昌士 嶋田 延光

出版者

日本脊髄外科学会

雑誌

脊髄外科 (ISSN:09146024)

巻号頁・発行日

vol.32, no.1, pp.56-60, 2018 (Released:2018-06-20)

参考文献数

23

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Introduction : Lumbosacral perineural (Tarlov) cysts (TCs) are rare and usually asymptomatic. However, these cysts occasionally cause neuralgia or bowel/bladder dysfunction. We surgically treated symptomatic TCs with occlusion of the cyst orifice using autologous fat tissue. This report presents the long-term surgical outcomes using this method.  Materials and Methods : Six consecutive cases with symptomatic TCs were included in this study. Patients were initially examined with magnetic resonance imaging (MRI) and treated conservatively for at least 1 month. Preoperative CT myelograms in all patients showed pooling of contrast medium in the cyst. Surgery was performed as follows : after laminectomy at the S1-S2 level, the cyst wall was dissected and penetrated. The orifice of the cyst operated as a ball valve for cerebrospinal fluid and was occluded with autologous fat tissue that was sutured to the cyst wall. The visual analogue scale (VAS) score for pain in the buttock and/or posterior thigh was recorded before and after surgery.  Results : All patients were female, and the mean age was 63.3 years. Preoperative symptoms were sacrococcygeal pain in 5 cases, sciatic pain in 2, and bladder dysfunction in 1. The mean duration between onset and definitive diagnosis was 23.7 months. All cysts were located at the sacral level including S2. Three cases had solitary lesions and the other 3 had multiple lesions. Cyst sizes ranged from 7 to 30 mm. The average postoperative follow-up period was 37.8 months. The mean preoperative VAS score was 91.7, and gradually decreased to 33.3 at 6 months. The score was stable from the 6-month examination to the final follow-up. Postoperative MRI showed that the cysts decreased in size. A complication of surgery was mild bowel/bladder dysfunction in 1 case. During follow-up, no recurrence of symptoms or cyst regrowth was observed.  Conclusion : For symptomatic TCs, closing the orifice with fat tissue provides good surgical outcomes.

著者

佐々木 学 松本 勝美 鶴薗 浩一郎 芳村 憲泰 柳澤 琢史 藤原 翔 青木 正典 秋山 智洋 吉峰 俊樹

出版者

日本脊髄外科学会

雑誌

脊髄外科 (ISSN:09146024)

巻号頁・発行日

vol.26, no.3, pp.319-321, 2012 (Released:2017-05-11)

著者

佐々木 学

出版者

日本建築学会

雑誌

日本建築学会計画系論文集 (ISSN:13404210)

巻号頁・発行日

vol.72, no.611, pp.117-122, 2007

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Viterbo public fountains may be classified into three types: rectangular basin fountains (fontane a vasca rettangolare), cast fountains (fontane a fuso), and overlapping caps fountains (fontane a coppe sovrapposte). I measured multiple fountains structured in Viterbo during the 13th century to compare their shapes. The results of these measurements show that many apparent similarities exist in the basin and water pipe shapes used in rectangular basin fountains, cast fountains and overlapping caps fountains. The results from this research indicate that the fountain basins and water pipes structured in Viterbo in the 13th century were specifically designed to portray the important function of drawing water, even though the fountains were more commemorative than anything else.