1.Bone Mineral Density and Physical Performance of Female Patients 27 Years or Longer after Surgery for Adolescent Idiopathic Scoliosis.
Tsutomu AKAZAWA ; Toshiaki KOTANI ; Tsuyoshi SAKUMA ; Takehide KATOGI ; Shohei MINAMI ; Hisateru NIKI ; Yoshiaki TORII ; Shigeta MORIOKA ; Sumihisa ORITA ; Kazuhide INAGE ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2017;11(5):780-786
STUDY DESIGN: Retrospective cohort study. PURPOSE: To assess bone mineral density (BMD) and bone metabolism ≥27 years after surgery in female patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) during adolescence and to determine their associations with physical performance. OVERVIEW OF LITERATURE: There are no studies investigating postsurgical BMD in middle-aged AIS patients. METHODS: This study included 23 patients who provided informed consent among 229 female patients with AIS who underwent spinal fusion from 1968 until 1988. Average age at the time of observation was 48.8 years. BMD was measured at the left femoral neck, and the levels of two bone metabolism markers–procollagen type 1 N-terminal propeptide (P1NP) and tartrate-resistant acid phosphatase 5b (TRACP-5b)–were measured from blood samples. Physical performance was measured using grip strength, sit-ups, sit-and-reach, side step, and standing long jump. RESULTS: Mean BMD was 0.784 g/cm2. According to the World Health Organization diagnostic criteria, one subject (4.3%) had osteoporosis, whereas nine subjects (39.1%) had osteopenia. In patients with osteoporosis or osteopenia, P1NP and TRACP-5b levels were high, and BMD loss was because of high metabolic turnover. All calculated standard scores for physical performance were lower in the study cohort than in healthy individuals. There was a positive correlation between BMD and the standard score for grip strength, whereas there were weak positive correlations between BMD and the standard scores for side step and standing long jump. CONCLUSIONS: In female AIS patients who underwent spinal fusion in adolescence, 4.3% and 39.1% had osteoporosis and osteopenia, respectively, ≥27 years after surgery. Exercise performance of these patients was poor compared with the national standards. In these patients, increased physical activity should be encouraged to prevent BMD loss in middle age.
Acid Phosphatase
;
Adolescent*
;
Bone Density*
;
Bone Diseases, Metabolic
;
Cohort Studies
;
Female*
;
Femur Neck
;
Hand Strength
;
Humans
;
Informed Consent
;
Metabolism
;
Middle Aged
;
Motor Activity
;
Osteoporosis
;
Retrospective Studies
;
Scoliosis*
;
Spinal Fusion
;
World Health Organization
2.Erratum: Correction of Figures. The Time Course Changes in Bone Metabolic Markers after Administering the Anti-Receptor Activator of Nuclear Factor-Kappa B Ligand Antibody and Drug Compliance among Patients with Osteoporosis.
Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yoshihiro SAKUMA ; Go KUBOTA ; Yasuhiro OIKAWA ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2015;9(6):999-1000
There were some mistakes in the numerical values of the graphs.
3.The Time Course Changes in Bone Metabolic Markers after Administering the Anti-Receptor Activator of Nuclear Factor-Kappa B Ligand Antibody and Drug Compliance among Patients with Osteoporosis.
Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yoshihiro SAKUMA ; Go KUBOTA ; Yasuhiro OIKAWA ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2015;9(3):338-343
STUDY DESIGN: Retrospective study. PURPOSE: We conducted a study to investigate the time course changes in bone metabolic markers after the administration of the anti-receptor activator of nuclear factor-kappa B ligand (RANKL) antibody and to assess drug compliance among osteoporotic patients. OVERVIEW OF LITERATURE: The anti-RANKL antibody is expected to provide an improvement in those with a bone metabolism disorder. However there are only a few clinical reports available on the effect of treatment. METHODS: We included 40 post-menopausal osteoporotic patients who received the anti-RANKL antibody. To determine the time course changes in the bone metabolic markers, we measured the serum tartrate-resistant acid phosphatase 5b (TRACP 5b; a bone resorption marker) and the serum N-terminal propeptide of type 1 collagen (P1NP; a bone formation marker) levels prior to and 1 month after administrating the anti-RANKL antibody. To evaluable drug compliance, we assessed the dropout rate during treatment and at 6 months after treatment. RESULTS: The average TRACP 5b level significantly decreased from 574.8 mU/dL before treatment to 153.2 mU/dL 1 month after treatment (p<0.05). There was no significant difference in the average P1NP level, which was 56.9 microG/L and 35.1 microG/L before and 1 month after treatment, respectively (p>0.05). As for drug compliance, we did not have any dropouts during the treatment or after 6 months (dropout rate: 0%). CONCLUSIONS: Our study suggests that anti-RANKL antibody treatment suppresses bone resorption and maintains bone formation.
Acid Phosphatase
;
Bone Resorption
;
Collagen Type I
;
Compliance*
;
Humans
;
Metabolism
;
Osteogenesis
;
Osteoporosis*
;
Patient Dropouts
;
RANK Ligand
;
Retrospective Studies
4.Elevated Levels of Serum Pentosidine Are Associated with Dropped Head Syndrome in Older Women
Yawara EGUCHI ; Toru TOYOGUCHI ; Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Miyako SUZUKI ; Hirohito KANAMOTO ; Koki ABE ; Masaki NORIMOTO ; Tomotaka UMIMURA ; Masao KODA ; Takeo FURUYA ; Yasuchika AOKI ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2019;13(1):155-162
STUDY DESIGN: A retrospective observational study was performed. PURPOSE: We investigated the prevalence of sarcopenia in dropped head syndrome (DHS), and the relationship between biochemical markers, including major advanced glycation end products (AGEs), pentosidine, and DHS in older women. OVERVIEW OF LITERATURE: AGEs have been implicated in the pathogenesis of sarcopenia. METHODS: We studied 13 elderly women with idiopathic DHS (mean age, 77.2 years) and 20 healthy volunteers (mean age, 74.8 years). We used a bioelectrical impedance analyzer to analyze body composition, including appendicular skeletal muscle mass index (SMI; appendicular lean mass [kg]/[height (m)]2). Cervical sagittal plane alignment, including C2–C7 sagittal vertical axis (C2–C7SVA), C2–C7 angle, and C2 slope (C2S), was measured. Biochemical markers, such as serum and urinary pentosidine, serum homocysteine, 1, 25-dihydroxyvitamin D, and 25-hydroxyvitamin D, were measured. The level of each variable was compared between DHS and controls. The relationship between biochemical markers and DHS was examined. RESULTS: Sarcopenia (SMI < 5.75) was observed at a high prevalence in participants with DHS (77% compared to 22% of healthy controls). Height, weight, femoral bone mineral density, appendicular lean mass, total lean mass, and SMI all had significantly lower values in the DHS group. Serum and urinary pentosidine, and serum homocysteine were significantly higher in the DHS group compared to controls. Analysis of cervical alignment revealed a significant positive correlation of serum pentosidine with C2–C7SVA and C2S. CONCLUSIONS: Sarcopenia was involved in DHS, and high serum pentosidine levels are associated with severity of DHS in older women.
Aged
;
Biomarkers
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Body Composition
;
Bone Density
;
Electric Impedance
;
Female
;
Glycosylation End Products, Advanced
;
Head
;
Healthy Volunteers
;
Homocysteine
;
Humans
;
Muscle, Skeletal
;
Neck Muscles
;
Observational Study
;
Prevalence
;
Retrospective Studies
;
Sarcopenia
5.Relationship between Skeletal Muscle Mass, Bone Mineral Density, and Trabecular Bone Score in Osteoporotic Vertebral Compression Fractures
Soichiro TOKESHI ; Yawara EGUCHI ; Munetaka SUZUKI ; Hajime YAMANAKA ; Hiroshi TAMAI ; Sumihisa ORITA ; Kazuhide INAGE ; Yasuhiro SHIGA ; Shigeo HAGIWARA ; Junichi NAKAMURA ; Tsutomu AKAZAWA ; Hiroshi TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2021;15(3):365-372
A retrospective observational study was performed. We investigated the relationships between skeletal muscle mass, bone mineral density (BMD), and trabecular bone score (TBS) in patients with osteoporotic vertebral compression fractures (VCFs). The TBS has attracted attention as a measurement of trabecular bone microarchitecture. It is derived from data obtained using dual-energy X-ray absorptiometry (DXA) and is a reported indicator of VCFs, and its addition to the Fracture Risk Assessment Tool increases the accuracy of fracture prediction. BMD, skeletal muscle mass, and TBS were measured in 142 patients who visited Shimoshizu National Hospital from April to August 2019. Patients were divided into a VCF group and a non-VCF group. Whole-body DXA scans were performed to analyze body composition, including appendicular skeletal muscle mass index (SMI; lean mass [kg]/height [m2]) and BMD. The diagnostic criteria for sarcopenia was an appendicular SMI <5.46 kg/m2. A logistic regression analysis was conducted to identify the risk factors for VCFs. The significant ( Patients with VCFs had low BMD, a low TBS, and low skeletal muscle mass. Lower femoral BMD and decreased leg muscle mass were identified as risk factors for VCFs independent of age, whereas the TBS was not identified as a risk factor for VCFs.
6.Relationship between Skeletal Muscle Mass, Bone Mineral Density, and Trabecular Bone Score in Osteoporotic Vertebral Compression Fractures
Soichiro TOKESHI ; Yawara EGUCHI ; Munetaka SUZUKI ; Hajime YAMANAKA ; Hiroshi TAMAI ; Sumihisa ORITA ; Kazuhide INAGE ; Yasuhiro SHIGA ; Shigeo HAGIWARA ; Junichi NAKAMURA ; Tsutomu AKAZAWA ; Hiroshi TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2021;15(3):365-372
A retrospective observational study was performed. We investigated the relationships between skeletal muscle mass, bone mineral density (BMD), and trabecular bone score (TBS) in patients with osteoporotic vertebral compression fractures (VCFs). The TBS has attracted attention as a measurement of trabecular bone microarchitecture. It is derived from data obtained using dual-energy X-ray absorptiometry (DXA) and is a reported indicator of VCFs, and its addition to the Fracture Risk Assessment Tool increases the accuracy of fracture prediction. BMD, skeletal muscle mass, and TBS were measured in 142 patients who visited Shimoshizu National Hospital from April to August 2019. Patients were divided into a VCF group and a non-VCF group. Whole-body DXA scans were performed to analyze body composition, including appendicular skeletal muscle mass index (SMI; lean mass [kg]/height [m2]) and BMD. The diagnostic criteria for sarcopenia was an appendicular SMI <5.46 kg/m2. A logistic regression analysis was conducted to identify the risk factors for VCFs. The significant ( Patients with VCFs had low BMD, a low TBS, and low skeletal muscle mass. Lower femoral BMD and decreased leg muscle mass were identified as risk factors for VCFs independent of age, whereas the TBS was not identified as a risk factor for VCFs.
7.Differences in Risk Factors for Decreased Cervical Lordosis after Multiple-Segment Laminoplasty for Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Pilot Study
Takaki INOUE ; Satoshi MAKI ; Takeo FURUYA ; Sho OKIMATSU ; Atsushi YUNDE ; Masataka MIURA ; Yuki SHIRATANI ; Yuki NAGASHIMA ; Juntaro MARUYAMA ; Yasuhiro SHIGA ; Kazuhide INAGE ; Sumihisa ORITA ; Yawara EGUCHI ; Seiji OHTORI
Asian Spine Journal 2023;17(4):712-720
Methods:
This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2–7 Cobb angles. Radiographic parameters included preoperative neutral C2–7 Cobb angles, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively.
Results:
C2–7 SVA (p =0.018) and DER (p =0.002) were significantly correlated with decreased CL in CSM, while C2–7 Cobb angle (p =0.012) and C2–7 SVA (p =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2–7 SVA (B =0.22, p =0.026) and small DER (B =−0.53, p =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2–7 SVA (B =0.36, p =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (p <0.001).
Conclusions
C2–7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.
8.Association between Osteoporosis and Skeletal Muscle Mass in Men
Masaya MIZUTANI ; Yawara EGUCHI ; Toru TOYOGUCHI ; Sumihisa ORITA ; Kazuhide INAGE ; Yasuhiro SHIGA ; Satoshi MAKI ; Junichi NAKAMURA ; Shigeo HAGIWARA ; Yasuchika AOKI ; Masahiro INOUE ; Masao KODA ; Hiroshi TAKAHASHI ; Tsutomu AKAZAWA ; Seiji OHTORI
Asian Spine Journal 2024;18(1):73-78
Methods:
This study included 99 men (mean age, 74.9 years; range, 28–93 years) who visited Qiball Clinic for BMD and body composition examinations. The osteoporosis group consisted of 24 patients (mean age, 72.5 years; range, 44–92 years), and the control group consisted of 75 individuals (mean age, 74.9 years; range, 28–93 years). Whole-body skeletal muscle mass was measured using a bioelectrical impedance analyzer. BMD was measured by dual X-ray absorptiometry. Skin autofluorescence (SAF), a marker of dermal AGE accumulation, was measured using a spectroscope. Osteoporosis was defined as a bone density T score of –2.5 or less. Physical findings, skeletal muscle mass, BMD, grip strength, and SAF were compared between the osteoporosis and control groups.
Results:
The osteoporosis group had significantly lower trunk muscle mass (23.1 kg vs. 24.9 kg), lower leg muscle mass (14.4 kg vs. 13.0 kg), and skeletal mass index (7.1 kg/m2 vs. 6.7 kg/m2) than the control group (all p<0.05). Lower limb muscle mass was identified as a risk factor for osteoporosis in men (odds ratio, 0.64; p=0.03).
Conclusions
Conservative treatment of osteoporosis in men will require an effective approach that facilitates the maintenance or strengthening of skeletal muscle mass, including exercise therapy with a focus on lower extremities and nutritional supplementation.
9.Does Discontinuing Teriparatide Treatment and Replacing It with Bisphosphonate Maintain the Volume of the Bone Fusion Mass after Lumbar Posterolateral Fusion in Women with Postmenopausal Osteoporosis?.
Seiji OHTORI ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Yasuchika AOKI ; Junichi NAKAMURA ; Miyako SUZUKI ; Gou KUBOTA ; Kazuhide INAGE ; Yasuhiro SHIGA ; Koki ABE ; Kazuki FUJIMOTO ; Hirohito KANAMOTO ; Masahiro INOUE ; Hideyuki KINOSHITA ; Takeo FURUYA ; Masao KODA
Asian Spine Journal 2017;11(2):272-277
STUDY DESIGN: Retrospective case series. PURPOSE: The purpose of this study was to determine whether discontinuing teriparatide treatment and replacing it with bisphosphonate treatment maintains the volume of the fusion mass after posterolateral fusion (PLF) in women with postmenopausal osteoporosis. OVERVIEW OF LITERATURE: Clinical data support the efficacy of parathyroid hormone (PTH) for lumbar PLF. However, the use of PTH is limited to 2 years. METHODS: We treated 19 women diagnosed with osteoporosis and degenerative spondylolisthesis with teriparatide (20 µg daily subcutaneously). All patients underwent one-level instrumented PLF. Teriparatide was used during 2 months prior to surgery and more than 8 months after surgery. After discontinuing teriparatide treatment, all patients used bisphosphonate (17.5 mg risedronate weekly, oral administration). Area of the fusion mass across the transverse processes at one segment was determined on an anteroposterior radiograph at 1, 2, and 3 years after surgery. RESULTS: We followed 19 patients for 3 years. The average duration of teriparatide treatment was 11.5 months. The bone union rate was 95%. The average area of the bone fusion mass was not significantly different between the right and left sides at 1, 2, or 3 years after surgery (p>0.05). CONCLUSIONS: This study showed that replacing teriparatide treatment with bisphosphonate maintained the bone fusion mass volume after PLF in women with postmenopausal osteoporosis.
Female
;
Humans
;
Osteoporosis
;
Osteoporosis, Postmenopausal*
;
Parathyroid Hormone
;
Retrospective Studies
;
Risedronate Sodium
;
Spine
;
Spondylolisthesis
;
Teriparatide*
10.Long-Term Outcomes of In Situ Fusion for Treating Dysplastic Spondylolisthesis.
Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Miyako SUZUKI ; Yoshihiro SAKUMA ; Go KUBOTA ; Yasuhiro OIKAWA ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Koki ABE ; Hirohito KANAMOTO ; Masahiro INOUE ; Hideyuki KINOSHITA ; Masaki NORIMOTO ; Tomotaka UMIMURA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2017;11(2):213-218
STUDY DESIGN: Retrospective, observational, single-center study. PURPOSE: To investigate the long-term outcomes of in situ fusion procedures for treating dysplastic spondylolisthesis. OVERVIEW OF LITERATURE: In situ fusion performed in patients with dysplastic spondylolisthesis avoids the development of nerve complications. METHODS: In total, 12 of 28 patients who underwent in situ fusion for treating dysplastic spondylolisthesis at Chiba University Hospital from 1974 to 2004 were followed up in August 2013. Surgical complications were evaluated. Low back pain and leg pain were assessed using a visual analog scale (VAS). Vertebral alignment, including the lumbosacral angle and lumbar lordosis angle measurement on radiographic images (profile view in the neutral standing position), was evaluated during preoperative, postoperative, and final examinations. RESULTS: The mean follow-up duration, patient age at the final examination, and patient age at operation were 20.0±7.2, 42.3±13.3, and 22.3±11.4 years, respectively. No complications were reported. Mean VAS scores for low back pain and leg pain were significantly lower at the final examination than at the preoperative examination (p<0.05). At the preoperative, postoperative, and final examinations, the mean lumbosacral angle was 32.3°±14.2°, 33.7°±11.8°, and 36.5°±16.4°, while the mean lumbar lordosis angle was 51.0°±14.8°, 48.6°±18.8°, and 49.6°±15.5°, respectively. No significant differences were noted among these values across the different time periods (p<0.05). CONCLUSIONS: In situ fusion performed in patients with dysplastic spondylolisthesis avoids the development of nerve complications such as nerve paralysis that may occur after repositioning operation and maintains appropriate long-term sagittal alignment, even 20 years after operation.
Animals
;
Follow-Up Studies
;
Humans
;
Leg
;
Lordosis
;
Low Back Pain
;
Paralysis
;
Retrospective Studies
;
Spondylolisthesis*
;
Visual Analog Scale