著者

加藤 仲幸 藤原 淳 本田 俊夫 種市 洋 Nakayuki Kato Atsushi Fujiwara Toshio Honda Hiroshi Taneichi 獨協医科大学整形外科学 獨協医科大学整形外科学 獨協医科大学整形外科学 獨協医科大学整形外科学 Dept. of Orthop. Dokkyo Medical University School of Medicine Dept. of Orthop. Dokkyo Medical University School of Medicine Dept. of Orthop. Dokkyo Medical University School of Medicine Dept. of Orthop. Dokkyo Medical University School of Medicine

雑誌

Dokkyo journal of medical sciences (ISSN:03855023)

巻号頁・発行日

vol.34, no.2, pp.85-93, 2007-07-01

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【目的】腰椎可動性の評価は腰痛性疾患の診断や治療効果判定に際し重要である.簡単な取り付け器具で体幹に装着し, X線撮影なしに腰椎可動域を評価できる簡易腰椎可動域測定器を開発し,測定データの正確性および信頼性を評価したので報告する.【方法】簡易腰椎可動域測定器は,金属製の固定板,その中央に垂直に取り付けられた計測バー,固定板を体幹に確実に固定するゴムバンドより構成されている.第12胸椎と仙骨上の体幹背面に装着した測定器による可動域と実際の腰椎可動域をX線およびCTを用いて計測し,正確性,測定者間および測定者内の一致度および再現性を検討した.【結果】前後屈および回旋可動域に関しては測定値とX線計測値はよく相関し,かつ,その平均値に有意差はないことから正確性は良好であった.一方,前後屈の各体位における測定値とX線計測値には有意差があること,各回旋位の計測値の相関関係にはばらつきが多かったことから,本測定器は腰椎の肢位をX線と同様に捉えていなかった.また,側屈可動域に関しては,測定値とX線計測値の相関は前後屈や回旋より劣り,かつ,その計測値にも有意差が見られたことから,側屈可動域に関する本測定器の正確性は不十分であった.さらに,測定者間および測定者内一致度はすべての項目で高く再現性も認められた.【結論】前後屈および回旋可動域は簡易腰椎可動域測定器により低コストで簡便に測定でき,その正確性や信頼性も優れていた.

著者

Mitsuru Yagi Nobuyuki Fujita Tomohiko Hasegawa Gen Inoue Yoshihisa Kotani Seiji Ohtori Sumihisa Orita Yasushi Oshima Daisuke Sakai Toshinori Sakai Hiroshi Taneichi Daisuke Togawa Kazuo Nakanishi Hiroaki Nakashima Toshitaka Yoshii Masaya Nakamura Motoki Iwasaki Masahiko Watanabe Hirotaka Haro Tokumi Kanemura Naobumi Hosogane New Technology Assessment Committee of The Japanese Society for Spine Surgery and Related Research

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

pp.2022-0194, (Released:2022-12-12)

被引用文献数

1

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IntroductionLateral lumbar interbody fusion (LLIF) has been introduced in Japan in 2013. Despite the effectiveness of this procedure, several considerable complications have been reported. This study reported the results of a nationwide survey performed by the Japanese Society for Spine Surgery and Related Research (JSSR) on the complications associated with LLIF performed in Japan.MethodsJSSR members conducted a web-based survey following LLIF between 2015 and 2020. Any complications meeting the following criteria were included: (1) major vessel, (2) urinary tract, (3) renal, (4) visceral organ, (5) lung, (6) vertebral, (7) nerve, and (8) anterior longitudinal ligament injury; (9) weakness of psoas; (10) motor and (11) sensory deficit; (12) surgical site infection; and (13) other complications. The complications were analyzed in all LLIF patients, and the differences in incidence and type of complications between the transpsoas (TP) and prepsoas (PP) approaches were compared.ResultsAmong the 13,245 LLIF patients (TP 6,198 patients [47%] and PP 7,047 patients [53%]), 389 complications occurred in 366 (2.76%) patients. The most common complication was sensory deficit (0.5%), followed by motor deficit (0.43%) and weakness of psoas muscle (0.22%). Among the patient cohort, 100 patients (0.74%) required revision surgery during the survey period. Almost half of the complications developed in patients with spinal deformity (183 patients [47.0%]). Four patients (0.03%) died from complications. Statistically more frequent complications occurred in the TP approach than in the PP approach (TP vs. PP, 220 patients [3.55%] vs. 169 patients [2.40%]; p < 0.001).ConclusionsThe overall complication rate was 2.76%, and 0.74% of the patients required revision surgery because of complications. Four patients died from complications. LLIF may be beneficial for degenerative lumbar conditions with acceptable complications; however, the indication for spinal deformity should be carefully determined by the experience of the surgeon and the extent of the deformity.

著者

Gen Inoue Takashi Kaito Yukihiro Matsuyama Toshihiko Yamashita Mamoru Kawakami Kazuhisa Takahashi Munehito Yoshida Shiro Imagama Seiji Ohtori Toshihiko Taguchi Hirotaka Haro Hiroshi Taneichi Masashi Yamazaki Kotaro Nishida Hiroshi Yamada Daijiro Kabata Ayumi Shintani Motoki Iwasaki Manabu Ito Naohisa Miyakoshi Hideki Murakami Kazuo Yonenobu Tomoyuki Takura Joji Mochida

出版者

The Japanese Society for Spine Surgery and Related Research

雑誌

Spine Surgery and Related Research (ISSN:2432261X)

巻号頁・発行日

pp.2020-0083, (Released:2020-11-20)

被引用文献数

2

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Introduction: Chronic low back pain (CLBP) is a leading cause of disability, yet there is limited high-quality evidence to identify the most suitable pharmacological therapy. The purpose of this Japanese nationwide, multicenter, prospective study was to compare the effectiveness of four representative drug therapies—acetaminophen, celecoxib, loxoprofen, and a tramadol and acetaminophen (T+A) combination drug—to establish evidence for a drug of choice for CLBP.Methods: Patients with CLBP (N = 471) received one of the four treatments and were evaluated, prospectively and comprehensively, once every month for six months using a visual analog scale (VAS) for LBP, the Japanese Orthopedic Association (JOA) score, the JOA Back Pain Evaluation Questionnaire (JOABPEQ), the Roland–Morris Disability Questionnaire (RDQ), the EuroQol five-dimensions three-levels (EQ-5D-3L), and the Short Form-8 item health survey (SF-8). We conducted multivariable linear regression analyses of the four drugs at 1 and 6 months after drug allocation. Differences with P < 0.05 were considered statistically significant.Results: Patients who received acetaminophen showed a significant improvement from baseline in the mental health subscale of the JOABPEQ at one month (P = 0.02) and the JOA score at six months (P < 0.01). None of the other outcome measures among the four drugs differed significantly. Across groups, all outcome measures, except the mental component summary (MCS) score of the SF-8, improved equivalently, although most measurements showed no obvious cumulative effect over six months. The MCS score of the SF-8 decreased gradually over six months in all groups.Conclusions: Most of the outcome measures among the treated groups were not significantly different, indicating similar treatment effects of the four drugs for CLBP. Our study indicated the limit of each outcome measure for evaluating the patient status, suggesting that a single outcome measure is insufficient to reflect treatment effectiveness.