1.Usefulness of Multislice CT with 64 Data Acquisition System for Examination Arteriosclerosis obliterans: Report on Two Cases
Hiroshi MIURA ; Makoto FUJIWARA ; Tatsuhiko TSUCHIYA ; Masatoshi OGA ; Kouji SUZUKI ; Hirohumi ZAIZEN
Journal of the Japanese Association of Rural Medicine 2007;56(5):725-729
In recent years, arteriosclerosis obliterans (ASO) has become one of the most common diseases with obesity, high blood pressure and other lifestyle-related diseases such as hyperlipemia. Westernization of the eating habits of the Japanese and progress of the aging society accounts for the increasing occurrence of these health problems. Early detection and early treatment of ASO help not only improve the quality of life of the patients but also get off without amputation of lower limbs and better the prognosis for survival. It is necessary to evaluate the narrowing of blood vessels or the form of occlusion for treatment of ASO. It is particularly important to know the state of the peripheral arteries below the obstructed region in cases with the complete occlusion. Lately, with the addition of many lines to multislice CT (MSCT) and the improvement of the performance of the workstation, angiography for diagnostic purposes has gradually been replaced by MSCT. In this paper, we report two cases of ASO and the successful application of MSCT using 64 Data Acquisition System (DAS) in the examination prior to ASO bypass surgery.
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2.Incidence and Characteristics of Clinical L5–S1 Adjacent Segment Degeneration after L5 Floating Lumbar Fusion: A Multicenter Study
Norihiko TAKEGAMI ; Koji AKEDA ; Junichi YAMADA ; Takao IMANISHI ; Tatsuhiko FUJIWARA ; Tetsushi KONDO ; Kenji TAKEGAMI ; Akihiro SUDO
Asian Spine Journal 2023;17(1):109-117
Methods:
In total, 306 patients who received L5 floating lumbar fusion were included in this study. Clinical L5–S1 ASD was defined as newly developed radiculopathy in relation to the L5–S1 segment. Patients’ medical records and imaging data were retrospectively analyzed. The risk factors for clinical ASD were assessed by an inverse probability of treatment weighting-adjusted logistic regression analysis.
Results:
Clinical L5–S1 ASD occurred in 17 patients (5.6%). The mean onset time of L5–S1 ASD was 12.9±7.5 months after the primary surgery. Among these patients, 10 (58.8%) presented with clinical L5–S1 ASD within 12 months. Reoperation was performed in three patients (1.0%). The severity of L5–S1 disk degeneration did not affect the occurrence of L5–S1 ASD. Logistic regression analysis showed that the number of fusion levels was a significant risk factor for clinical L5–S1 ASD.
Conclusions
The incidence and characteristics of clinical L5–S1 ASD after L5 floating lumbar fusion were retrospectively investigated. This study established that the number of fusion levels was a significant candidate factor for clinical L5–S1 ASD. Careful clinical follow-up is deemed necessary after L5 floating lumbar fusion surgery, especially for patients who received multiple-level fusions.