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Article: Osteoradionecrosis of the occipitocervical junction: A rare case of C1 anterior arch disruption.

Sakamoto, Masaki / Shimizu, Takayoshi / Suehiro, Atsushi / Matsuda, Shuichi

Journal of craniovertebral junction & spine

2023 Volume 14, Issue 1, Page(s) 93–96

Abstract: We report the case of a 57-year-old man who developed osteoradionecrosis (ORN) at the occipitocervical (OC) junction after radiation therapy for nasopharyngeal carcinoma. During soft-tissue debridement using a nasopharyngeal endoscope, the anterior arch ... ...

Abstract	We report the case of a 57-year-old man who developed osteoradionecrosis (ORN) at the occipitocervical (OC) junction after radiation therapy for nasopharyngeal carcinoma. During soft-tissue debridement using a nasopharyngeal endoscope, the anterior arch of the atlas (AAA) was spontaneously disrupted, which was later spat out. Radiographic examination revealed complete disruption of the AAA that caused OC instability. We performed posterior OC fixation. The patient experienced successful postoperative pain relief. AAA disruption secondary to ORN at OC junction can cause severe instability. Posterior OC fixation alone may be an effective procedure if the necrotic pharyngeal region is mild and endoscopically controllable.
Language	English
Publishing date	2023-03-13
Publishing country	India
Document type	Case Reports
ZDB-ID	2573344-8
ISSN	0976-9285 ; 0974-8237
ISSN (online)	0976-9285
ISSN	0974-8237
DOI	10.4103/jcvjs.jcvjs_145_22
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Article ; Online: Blade-Related Vertebral Fracture After Anterior Cervical Discectomy and Fusion with a Zero-Profile Cage: A Case Report.

Shimizu, Takayoshi / Otsuki, Bungo / Sono, Takashi / Matsuda, Shuichi

JBJS case connector

2023 Volume 13, Issue 4

Abstract: Case: We present a case of a 79-year-old man with degenerative cervical myelopathy treated with anterior cervical discectomy and fusion (ACDF) using a zero-profile cage. Postoperatively, the patient experienced a rare complication of anchoring blade- ... ...

Abstract	Case: We present a case of a 79-year-old man with degenerative cervical myelopathy treated with anterior cervical discectomy and fusion (ACDF) using a zero-profile cage. Postoperatively, the patient experienced a rare complication of anchoring blade-related adjacent vertebral fracture leading to construct failure and recurrence of myelopathic symptoms, necessitating revision surgery. Conclusion: This case emphasizes the importance of precision in the surgical technique, specifically in the placement of Caspar pins and anchoring blades. It also underscores the need for a high index of suspicion for potential hardware-related complications in patients presenting with recurring symptoms post-ACDF, contributing to the understanding of such rare complications.
MeSH term(s)	Male ; Humans ; Aged ; Spinal Fractures/etiology ; Spinal Fractures/surgery ; Cervical Vertebrae/surgery ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Diskectomy/adverse effects ; Diskectomy/methods ; Spinal Cord Diseases/etiology ; Bone Nails
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	10.2106/JBJS.CC.23.00417
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Article ; Online: S2 Alar Screw Insertion Accuracy and Factors Associated With Screw Loosening and Lumbosacral Nonunion.

Shima, Koichiro / Fujibayashi, Shunsuke / Otsuki, Bungo / Murata, Koichi / Shimizu, Takayoshi / Sono, Takashi / Matsuda, Shuichi

World neurosurgery

2024 Volume 184, Page(s) e129–e136

Abstract: Objective: To investigate S2 alar screw (S2AS) accuracy and factors associated with S2AS loosening and lumbosacral nonunion.: Methods: We retrospectively reviewed patients who underwent lumbosacral fusion surgery with S2AS addition under fluoroscopy. ...

Abstract	Objective: To investigate S2 alar screw (S2AS) accuracy and factors associated with S2AS loosening and lumbosacral nonunion. Methods: We retrospectively reviewed patients who underwent lumbosacral fusion surgery with S2AS addition under fluoroscopy. S2AS loosening and lumbosacral nonunion were analyzed using a 1-year postoperative computed tomography. S2AS insertion accuracy was originally classified as accurate, short, anterior perforation, lateral perforation, and sacroiliac joint (SIJ) deviation among lateral perforation. Clinical data including sex, age, body mass index, fused segments, fusion procedure, primary or revision surgery, Japanese Orthopedic Association scores and complications were collected. Factors associated with S2AS loosening and lumbosacral nonunion were analyzed. Results: A total of 37 patients (74 screws, age: 63.78 ± 13.57 years, female/male: 14/23 patients, body mass index: 23.11 ± 2.53, fused segments: 1-4 levels, revision: 38%) were included. S2AS loosening and lumbosacral nonunion were observed in 18 screws (13%) and 8 patients (22%) respectively. Only 35 screws (47%) were inserted accurately in our classification. Short, lateral perforation, and anterior perforation were observed in 14 screws (19%), 22 screws (30%), and 3 screws (4.1%). SIJ deviation was seen in 15 screws (20%) Factors associated with S2AS loosening were older age (P = 0.038), fusion levels (P = 0.011), and SIJ deviation (P < 0.001). S2AS loosening affects S1 pedicle screw (S1PS) loosening (P = 0.001). Furthermore, S2AS loosening is a risk factor for lumbosacral nonunion (P = 0.046). Conclusions: S2AS insertion under fluoroscopy is inaccurate. S2AS loosening induces S1PS loosening and lumbosacral nonunion. Surgeons should avoid deviating to SIJ, especially in older patients and relatively longer fusion.
MeSH term(s)	Humans ; Male ; Female ; Aged ; Middle Aged ; Retrospective Studies ; Pedicle Screws ; Tomography, X-Ray Computed ; Spinal Fusion/methods ; Fluoroscopy
Language	English
Publishing date	2024-01-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.01.071
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Article ; Online: Pressure Dynamics on Intervertebral Disc Cages in Transforaminal Lumbar Interbody Fusion: A Cadaver Study.

Takaki, Yoshiyama / Tanida, Shimei / Murata, Koichi / Shimizu, Takayoshi / Matsuda, Shuichi / Otsuki, Bungo

World neurosurgery

2024

Abstract: Objective: This study aimed to quantify the change in pressure on the cage during compression manipulation in lumbar interbody fusion. While the procedure involves applying compression between pedicle screws to press the cage against the endplate, the ... ...

Abstract	Objective: This study aimed to quantify the change in pressure on the cage during compression manipulation in lumbar interbody fusion. While the procedure involves applying compression between pedicle screws to press the cage against the endplate, the exact compression force remains elusive. We hypothesize that an intact facet joint might serve as a fulcrum, potentially reducing cage pressure. Methods: Pressure on the intervertebral disc cage was measured during compression manipulation in 4 donor cadavers undergoing lumbar interbody fusion. Unilateral facetectomy models with both normal and parallel compression and bilateral facetectomy models were included. A transforaminal lumbar interbody fusion cage with a built-in load cell measured the compression force. Results: Pressure data from 14 discs indicated a consistent precompression pressure average of 68.16 N. Following compression, pressures increased to 125.99 N and 140.84 N for normal and parallel compression postunilateral facetectomy, respectively, and to 154.58 N and 150.46 N for bilateral models. A strong linear correlation (correlation coefficient: 0.967, P < 0.0001) between precompression and postcompression pressures emphasized the necessity of sufficient precompression pressure for achieving desired postcompression outcomes. None of the data showed a decrease in compression force to the cage with the compression maneuver. Conclusions: Both normal and parallel compression maneuvers effectively increased the pressure on the cage, irrespective of the facet joint resection status. Compression manipulation consistently enhanced compressive force on the cage. However, when baseline pressure is low, the manipulation might not yield significant increases in compression force. This underlines the essential role of meticulous precompression preparation in enhancing surgical outcomes.
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.03.080
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Article: Sagittal Section Hounsfield Units of the Upper Instrumented Vertebrae as a Predictor of Proximal Junctional Vertebral Fractures Following Adult Spinal Deformity Surgery.

Murata, Koichi / Otsuki, Bungo / Shimizu, Takayoshi / Sono, Takashi / Fujibayashi, Shunsuke / Matsuda, Shuichi

Asian spine journal

2024

Abstract: Study design: A retrospective observational study.: Purpose: This study aimed to determine an accurate and convenient screening method for predicting proximal junctional fractures (PJFr) following surgery for adult spinal deformity (ASD) using ... ...

Abstract	Study design: A retrospective observational study. Purpose: This study aimed to determine an accurate and convenient screening method for predicting proximal junctional fractures (PJFr) following surgery for adult spinal deformity (ASD) using computed tomography (CT)-based measurement of Hounsfield units (HUs). Overview of literature: CT-based measurement of HUs is an alternative tool for assessing bone mineral density. However, the optimal method for predicting adjacent vertebral fractures following spinal fusion using HUs remains unclear. Methods: This retrospective observational study included 42 patients who underwent reconstructive surgery for ASD. Elliptical regions of interest (ROIs) on the axial section and rectangular ROIs on the sagittal section were placed at the upper instrumented vertebrae (UIV), UIV+1, and UIV+2. In addition, the HU value of the L2 vertebra was used as the representative. Results: PJFr occurred in 28.6% of patients within 2 years following surgery. The HU values obtained from the axial sections of L2, UIV, UIV+1, and UIV+2 were not significantly associated with the incidence of PJFr within 2 years, except for the ROI set in the lower region of the L2 vertebra. However, the HU value of the anterior third of the UIV in the sagittal section was significantly lower in the PJFr group than in the nonPJFr group (87.0 vs. 160.3, p =0.001). A UIV HU value of <100 was associated with a higher incidence of PJFr than an HU vaue of >100 (p <0.05). Conclusions: Measurements of HU in the anterior one-third of the UIV in the sagittal section demonstrated predictive ability for PJFr following ASD surgery. A UIV HU value of <100 emerged as a risk factor for PJFr.
Language	English
Publishing date	2024-04-23
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.31616/asj.2023.0339
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Zs.A 6861: Show issues

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Article ; Online: Low hounsfield unit values at sagittal section on computed tomography predicts vertebral fracture following short spinal fusion.

Murata, Koichi / Fujibayashi, Shunsuke / Otsuki, Bungo / Shimizu, Takayoshi / Matsuda, Shuichi

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

2023

Abstract: Background: Preoperative identification of osteoporosis during spine surgery is of critical importance. Additionally, the Hounsfield units (HU) measured using computed tomography (CT) have gained considerable attention. This study aimed to propose a ... ...

Abstract	Background: Preoperative identification of osteoporosis during spine surgery is of critical importance. Additionally, the Hounsfield units (HU) measured using computed tomography (CT) have gained considerable attention. This study aimed to propose a more accurate and convenient screening method for predicting vertebral fractures after spinal fusion in elderly patients by analyzing the HU value of different range of interests of thoracolumbar spine. Methods: Our sample pool for analysis consisted of 137 elderly female patients aged >70 years who underwent one- or two-level spinal fusion surgery with a diagnosis of adult degenerative lumbar disease. The HU values of the anterior 1/3 of the vertebral bodies based on sagittal plane and those of vertebral bodies based on axial plane at T11-L5 were measured using the perioperative CT. The incidence of postoperative vertebral fractures with respect to the HU value was investigated. Results: Vertebral fractures were identified in 16 patients during the mean follow-up period of 3.8 years. While no significant association was found between HU value of L1 vertebral body or minimum HU value from axial plane and the incidence of the postoperative vertebral fracture, the minimum vertebral HU value of the anterior 1/3 of vertebral body from sagittal plane was associated with the incidence of the postoperative vertebral fracture. Patients with a minimum anterior 1/3 vertebral HU value of <80 had a higher incidence of postoperative vertebral fractures. The adjacent vertebral fractures occurred at the level of the vertebra with the lowest HU value, with a high probability. The existence of the vertebra with a minimum HU value of <80 within two levels of upper instrumented vertebrae was a risk factor for adjacent vertebral fracture. Conclusion: HU measurement of the anterior 1/3 of vertebral body predicts the risk of vertebral fracture after short spinal fusion surgery.
Language	English
Publishing date	2023-03-21
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1314243-4
ISSN	1436-2023 ; 0949-2658
ISSN (online)	1436-2023
ISSN	0949-2658
DOI	10.1016/j.jos.2023.03.008
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Article ; Online: Sacral Nerve-Sparing Piecemeal Spondylectomy for Giant Cell Tumor of Bone in the Sacrum: Surgical Strategy and Accurate Tumor Location Identification.

Otsuki, Bungo / Sakamoto, Akio / Fujibayashi, Shunsuke / Shimizu, Takayoshi / Murata, Koichi / Noguchi, Takashi / Matsuda, Shuichi

Spine surgery and related research

2023 Volume 8, Issue 1, Page(s) 110–113

Language	English
Publishing date	2023-09-04
Publishing country	Japan
Document type	Journal Article
ISSN	2432-261X
ISSN (online)	2432-261X
DOI	10.22603/ssrr.2023-0145
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Article ; Online: Preoperative and Postoperative Factors Affecting Patient Satisfaction with Double-Door Laminoplasty for Cervical Spondylotic Myelopathy.

Yoshiyama, Takaki / Fujibayashi, Shunsuke / Otsuki, Bungo / Shimizu, Takayoshi / Murata, Koichi / Matsuda, Shuichi

Spine surgery and related research

2023 Volume 7, Issue 5, Page(s) 421–427

Abstract: Introduction: Few articles have investigated patient satisfaction with laminoplasty in patients with cervical spondylotic myelopathy (CSM) alone, excluding other diseases, such as ossification of the posterior longitudinal ligament. In this study, we ... ...

Abstract	Introduction: Few articles have investigated patient satisfaction with laminoplasty in patients with cervical spondylotic myelopathy (CSM) alone, excluding other diseases, such as ossification of the posterior longitudinal ligament. In this study, we aimed to investigate patient satisfaction after double-door laminoplasty for CSM and determine the preoperative and postoperative factors that affect patient satisfaction. Methods: We retrospectively reviewed cases of laminoplasty for CSM. We measured sagittal imaging parameters (cervical lordosis [CL], C2-C7 cervical sagittal vertical axis [cSVA], and T1 slope [T1S]), Japanese Orthopaedic Association (JOA) score, and patient-reported outcomes (PROs) such as the neck disability index (NDI) and visual analog scale (VAS) preoperatively, 3 months postoperatively, and 1 year postoperatively. In addition, a multiple regression analysis was performed to investigate factors affecting patient satisfaction. Results: Ninety patients were included in the analysis. After surgery, CL decreased significantly (p<0.01), whereas cSVA increased significantly (p<0.01). No significant differences were observed in the preoperative and postoperative T1S values (p=0.61). The JOA, NDI, and VAS scores significantly improved postoperatively (p<0.01). The median patient satisfaction was 85 (range, 12-100) at 1 year postoperatively and 80 (range, 25-100) at 3 months postoperatively. In the multiple regression analysis, lower-extremity sensory disorder in the JOA score at 1 year postoperatively (p<0.01) and VAS scores for neck pain preoperatively and 1 year postoperatively (p=0.01 and p<0.01, respectively) were determined as factors affecting patient satisfaction. Conclusions: Cervical laminoplasty is a useful and satisfactory surgical procedure to restore patient function. However, patients with severe preoperative and postoperative neck pain and those with severe postoperative sensory disorders of the lower extremities may be less satisfied with the procedure. It is important to keep these things in mind when treating patients.
Language	English
Publishing date	2023-04-21
Publishing country	Japan
Document type	Journal Article
ISSN	2432-261X
ISSN (online)	2432-261X
DOI	10.22603/ssrr.2023-0022
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Article ; Online: Feasibility of total and partial uncinectomy during anterior cervical approach: MRI-based analysis of 176 patients regarding vertebral artery location.

Shima, Koichiro / Shimizu, Takayoshi / Fujibayashi, Shunsuke / Murata, Koichi / Matsuda, Shuichi / Otsuki, Bungo

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2023 Volume 32, Issue 10, Page(s) 3540–3546

Abstract: Purpose: To determine the technical feasibility of uncinate process (UP) resection (uncinectomy) during anterior cervical approach with risk-avoidance of vertebral artery (VA) injury.: Methods: One hundred and seventy-six magnetic resonance imaging ... ...

Abstract	Purpose: To determine the technical feasibility of uncinate process (UP) resection (uncinectomy) during anterior cervical approach with risk-avoidance of vertebral artery (VA) injury. Methods: One hundred and seventy-six magnetic resonance imaging images with cervical spondylosis were evaluated. The diameter between UP and VA (UP-VA distance), the presence of a fat plane, and the VA's anterior-posterior position relative to UP (anterior[A], middle[M], posterior[P]) at C3-4 to C6-7 segments were investigated. Subsequently, easy-to-use classifications were developed according to the feasibility of total and partial uncinectomy. Total uncinectomy: easy (distance: > 2 mm); moderate (distance: ≤ 2 and fat plane: +); advanced (no fat plane). Partial uncinectomy: easy (distance: > 2 mm and P, A, or M position); moderate (distance: ≤ 2; fat plane: + and P position), and advanced (no fat plane and P position). Results: UP-VA distance of C5-6 on the right side (left/right: 0.41/0.31 mm) was the smallest. The ratio of no fat plane of C5-6 (46.6%/49.4%) was the highest. C5-6 had a high rate of P position (7.4%/8.5%) while C6-7 had a high rate of A position (19.3%/18.2%). More than 90% individuals were classified as easy for partial uncinectomy at any vertebral segment (C3-7), while more than 30% were classified as advanced at C4-7 with the highest rate at C5-6 for total uncinectomy. Conclusion: When performing uncinectomy during the anterior cervical approach, the C5-6 segment may be at the greatest risk of VA injury. Hence, preoperative MR images should be thoroughly evaluated to avoid VA injury.
MeSH term(s)	Humans ; Vertebral Artery/diagnostic imaging ; Vertebral Artery/surgery ; Feasibility Studies ; Neck ; Spinal Cord ; Magnetic Resonance Imaging ; Neck Injuries ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery
Language	English
Publishing date	2023-08-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-023-07888-x
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Article ; Online: Risk of further surgery after decompression in patients with diffuse idiopathic skeletal hyperostosis extending to the lumbar segments: focus on the number of residual lumbar/lumbosacral and sacroiliac mobile segments.

Tanaka, Atsushi / Shimizu, Takayoshi / Kawai, Toshiyuki / Fujibayashi, Shunsuke / Murata, Koichi / Matsuda, Shuichi / Otsuki, Bungo

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2023 Volume 32, Issue 7, Page(s) 2336–2343

Abstract: Purpose: Patients with diffuse idiopathic skeletal hyperostosis (DISH) that extends to the lumbar segments (L-DISH) have a high risk of further surgery after lumbar decompression. However, few studies have focused on the ankylosis status of the residual ...

Abstract	Purpose: Patients with diffuse idiopathic skeletal hyperostosis (DISH) that extends to the lumbar segments (L-DISH) have a high risk of further surgery after lumbar decompression. However, few studies have focused on the ankylosis status of the residual caudal segments, including the sacroiliac joint (SIJ). We hypothesized that patients with more ankylosed segments beside the operated level, including the SIJ, would be at a higher risk of further surgery. Methods: A total of 79 patients with L-DISH who underwent decompression surgery for lumbar stenosis at a single academic institution between 2007 and 2021 were enrolled. The baseline demographics and radiological findings by CT imaging focusing on the ankylosing condition of the residual lumbar segments and SIJ were collected. Cox proportional hazard analysis was conducted to investigate the risk factors for further surgery after lumbar decompression. Results: The rate of further surgery was 37.9% during an average of 48.8 months of follow-up. Cox proportional hazard analysis demonstrated that the presence of fewer than three segments of non-operated mobile caudal segments was an independent predictor for further surgery (including both the same and adjacent levels) after lumbar decompression (adjusted hazard ratio 2.53, 95%CI [1.12-5.70]). Conclusions: L-DISH patients with fewer than three mobile caudal segments besides index decompression levels are at a high risk of further surgery. Ankylosis status of the residual lumbar segments and SIJ should be thoroughly evaluated using CT during preoperative planning.
MeSH term(s)	Humans ; Hyperostosis, Diffuse Idiopathic Skeletal/complications ; Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging ; Hyperostosis, Diffuse Idiopathic Skeletal/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Constriction, Pathologic/surgery ; Ankylosis ; Decompression
Language	English
Publishing date	2023-05-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-023-07773-7
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