1.Impact of car seat recline angle on global spinal alignment and seat belt positioning: a prospective observational study in Japan
Norihiro NISHIDA ; Tomohiro IZUMIYAMA ; Ryusuke ASAHI ; Hidenori SUZUKI ; Masahiro KOIKE ; Masahiro FUNABA ; Kazuhiro FUJIMOTO ; Yusuke ICHIHARA ; Yogesh KUMARAN ; Hiroshi HAMANO ; Shigeru SUGIMOTO ; Takashi SAKAI
Asian Spine Journal 2026;20(2):283-293
Methods:
Lateral radiographs were obtained from 100 healthy adults in standing and seated postures at 25°, 35°, and 45° recline angles. Spinal parameters (cervical lordosis, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and T1 spinopelvic inclination) and seat belt metrics (X-value, Z-value, and lap belt angle) were measured. Multivariate regression was used to assess associations with sex, age, height, and body mass index (BMI).
Results:
Reclining reduced cervical/lumbar lordosis and sacral slope, while thoracic kyphosis and pelvic tilt increased. Higher BMI was associated with a cranially shifted and more horizontal lap belt. Taller individuals showed greater T1 spinopelvic inclination and pelvic parameters. Females exhibited more pronounced thoracic kyphosis and pelvic retroversion across reclining angles.
Conclusions
Car seat recline significantly alters spinal alignment and seat belt positioning, with changes influenced by age, height, and BMI. These findings support ergonomic improvements in seat design and may inform surgical planning for ASD.
2.Correlation between postoperative shoulder imbalance and distal adding-on and distal junctional kyphosis in Lenke type 2 adolescent idiopathic scoliosis: a retospective study
Norihiro ISOGAI ; Satoshi SUZUKI ; Nao OTOMO ; Yohei TAKAHASHI ; Masahiro OZAKI ; Toshiki OKUBO ; Osahiko TSUJI ; Narihito NAGOSHI ; Mitsuru YAGI ; Masaya NAKAMURA ; Morio MATSUMOTO ; Kota WATANABE
Asian Spine Journal 2026;20(2):272-282
Methods:
This study included 62 patients with Lenke type 2 AIS who underwent posterior correction and fusion surgeries. The patients were categorized into the PSI and non-PSI groups based on their radiographic shoulder height 2 years after surgery. Radiographic parameters, lower end vertebra (LEV), lower instrumented vertebra (LIV), sagittal stable vertebra (SSV), postoperative DA and DJK, and Scoliosis Research Society 22 scores were compared between the two groups using unpaired t -tests or Pearson’s chi-square tests.
Results:
Twenty-eight patients in the PSI group and 34 in the non-PSI group were evaluated. Three patients had DA in the PSI group and 10 with DA and four with DJK in the non-PSI group. LIV–LEV was higher in the PSI group than in the non-PSI group. Although the LIV–SSV was not significantly different between the two groups, among the three patients with DJK, two had LIV–SSV of −3, one had −1, and one had 0. No significant differences in other examinations were noted between the two groups.
Conclusions
Although more proximal LIV selection might lead to stable DA and DJK, the LIV selection should not be extended distally to prevent DA and DJK because favorable shoulder balance and clinical outcome can still be achieved.
3.Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results
Akira KUWABARA ; Kazuhide INAGE ; Masaomi YAMASHITA ; Sumihisa ORITA ; Yawara EGUCHI ; Yasuhiro SHIGA ; Masahiro INOUE ; Miyako SUZUKI-NARITA ; Takahisa HISHIYA ; Takahito ARAI ; Noriyasu TOSHI ; Kohei OKUYAMA ; Soichiro TOKESHI ; Susumu TASHIRO ; Shuhei OHYAMA ; Noritaka SUZUKI ; Seiji OHTORI
Yonsei Medical Journal 2025;66(4):226-232
Purpose:
Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.
Materials and Methods:
This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (TCho), and total lymphocyte count], and kidney function (eGFR) was assessed.
Results:
In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.
Conclusion
Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.
4.Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results
Akira KUWABARA ; Kazuhide INAGE ; Masaomi YAMASHITA ; Sumihisa ORITA ; Yawara EGUCHI ; Yasuhiro SHIGA ; Masahiro INOUE ; Miyako SUZUKI-NARITA ; Takahisa HISHIYA ; Takahito ARAI ; Noriyasu TOSHI ; Kohei OKUYAMA ; Soichiro TOKESHI ; Susumu TASHIRO ; Shuhei OHYAMA ; Noritaka SUZUKI ; Seiji OHTORI
Yonsei Medical Journal 2025;66(4):226-232
Purpose:
Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.
Materials and Methods:
This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (TCho), and total lymphocyte count], and kidney function (eGFR) was assessed.
Results:
In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.
Conclusion
Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.
5.Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results
Akira KUWABARA ; Kazuhide INAGE ; Masaomi YAMASHITA ; Sumihisa ORITA ; Yawara EGUCHI ; Yasuhiro SHIGA ; Masahiro INOUE ; Miyako SUZUKI-NARITA ; Takahisa HISHIYA ; Takahito ARAI ; Noriyasu TOSHI ; Kohei OKUYAMA ; Soichiro TOKESHI ; Susumu TASHIRO ; Shuhei OHYAMA ; Noritaka SUZUKI ; Seiji OHTORI
Yonsei Medical Journal 2025;66(4):226-232
Purpose:
Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.
Materials and Methods:
This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (TCho), and total lymphocyte count], and kidney function (eGFR) was assessed.
Results:
In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.
Conclusion
Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.
6.Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results
Akira KUWABARA ; Kazuhide INAGE ; Masaomi YAMASHITA ; Sumihisa ORITA ; Yawara EGUCHI ; Yasuhiro SHIGA ; Masahiro INOUE ; Miyako SUZUKI-NARITA ; Takahisa HISHIYA ; Takahito ARAI ; Noriyasu TOSHI ; Kohei OKUYAMA ; Soichiro TOKESHI ; Susumu TASHIRO ; Shuhei OHYAMA ; Noritaka SUZUKI ; Seiji OHTORI
Yonsei Medical Journal 2025;66(4):226-232
Purpose:
Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.
Materials and Methods:
This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (TCho), and total lymphocyte count], and kidney function (eGFR) was assessed.
Results:
In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.
Conclusion
Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.
7.Predictive Factors for Increased Bone Density Following Romosozumab Administration Based on Pre-Administration Blood Test Results
Akira KUWABARA ; Kazuhide INAGE ; Masaomi YAMASHITA ; Sumihisa ORITA ; Yawara EGUCHI ; Yasuhiro SHIGA ; Masahiro INOUE ; Miyako SUZUKI-NARITA ; Takahisa HISHIYA ; Takahito ARAI ; Noriyasu TOSHI ; Kohei OKUYAMA ; Soichiro TOKESHI ; Susumu TASHIRO ; Shuhei OHYAMA ; Noritaka SUZUKI ; Seiji OHTORI
Yonsei Medical Journal 2025;66(4):226-232
Purpose:
Romosozumab reportedly increases bone density in patients with severe osteoporosis; however, data on its clinical effects are limited. We conducted a multicenter retrospective survey to study the bone density-increasing effects of romosozumab and blood test-based predictive factors in patients with severe osteoporosis, examining its effects in clinical practice.
Materials and Methods:
This was a multicenter retrospective observational study. The subjects were patients with severe osteoporosis who were treated with romosozumab at the participating facilities. The increase in bone density was assessed by comparing bone density changes (as a percentage) in the lumbar spine, femoral neck, and total femur before and 12 months after administration using dual-energy X-ray absorptiometry. The association between changes in bone density at each site and pre-treatment bone metabolism markers (Tracp 5b, P1NP), serum calcium levels, nutritional status [Conut score: albumin, total cholesterol (TCho), and total lymphocyte count], and kidney function (eGFR) was assessed.
Results:
In both naïve patients and those switching from bone resorption inhibitors, the bone density increased significantly. In naïve patients, eGFR were positively associated with bone density in the total femur. In cases of switching from bone resorption inhibitors, correlations were found between Tracp 5b and lumbar spine bone mineral density (BMD), as well as between Tracp 5b, Alb, T-Cho, and eGFR in the total femur BMD.
Conclusion
Romosozumab administration significantly increases bone density in osteoporosis, and assessing key predictive factors is necessary to ensure clinical effectiveness.
8.Patient-specific mechanical analysis of pedicle screw insertion in simulated osteoporotic spinal bone models derived from medical images
Norihiro NISHIDA ; Hidenori SUZUKI ; Hanvey TETSU ; Yuki MORISHITA ; Yogesh KUMARAN ; Fei JIANG ; Masahiro FUNABA ; Kazuhiro FUJIMOTO ; Yusuke ICHIHARA ; Takashi SAKAI ; Junji OHGI
Asian Spine Journal 2024;18(5):621-629
Methods:
Male and female patients with computed tomography data were selected. Dimensions of the first thoracic (T1), fourth lumbar (L4), and fifth lumbar (L5) vertebrae were measured, and bone models consisting of the cancellous and cortical bones made from polyurethane foam were created. PS with diameters of 4.5 mm, 5.5 mm, and 6.5 mm were used. T1 PS were 25 mm long, and L4 and L5 PS were 40 mm long. The bone models were secured with cement, and the MIT was measured using a calibrated torque wrench. After MIT testing, the PS head was attached to the machine’s crosshead. POS was then calculated at a crosshead speed of 5 mm/min until failure.
Results:
The L4 and L5 were notably larger in female bone models, whereas the T1 vertebra was larger in male bone models. Consequently, the MIT and POS for L4 and L5 were higher in female bone models across all PS diameters than in male bone models. Conversely, the MIT for T1 was higher in male bone models across all PS; however, no significant differences were observed in the POS values for T1 between sexes.
Conclusions
The mechanical properties of the proposed bone models can vary based on the vertebral structure and size. For accurate 3D surgical and mechanical simulations in the creation of custom-made medical devices, bone models must be constructed from patientspecific medical images.
9.A Case Where High-intensity Interval Training Helped the Patient to Return to Work after Acute Myeloid Leukemia Treatment
Shin SUZUKI ; Yusuke TERAO ; Tasuku INABA ; Kazumi KASHIWABARA ; Takuya HADA ; Masahiro ABO
The Japanese Journal of Rehabilitation Medicine 2024;61(10):1006-1012
Many post-treatment cancer patients complain of persistent fatigue, which is known to have a significant impact on activities of daily living, quality of life, and reinstatement. We report a case of a 37-year-old man with acute myeloid leukemia (AML) who was able to return to work by performing High-Intensity Interval Training (HIIT) after the remission. The diagnosis of AML was made and the treatment started in January X, and the patient reached remission and discharged in June. However, he developed herpes zoster and was unable to return to his job. The patient was referred to our hospital for rehabilitation treatment in December X. The rehabilitation treatment included 40-min HIIT twice a week and commuting practice, as well as gradual support for return-to-work. Cardiopulmonary function improved from 19.2 to 25.7 mL/min/kg of oxygen uptake at anaerobic metabolic threshold, lower limb muscle strength improved from 0.47/0.48 to 0.60/0.55 kgf/kg of knee extension muscle strength ratio (right/left), physical function improved from 14 to 24 times in 30-second chair stand test, Cancer Fatigue Scale improved from 46 to 25 points, and the patient was able to work full time in May X+1. HIIT improved cardiopulmonary function, muscle strength, physical function, and fatigue, and enabled the patient to return to work. Even after remission, some patients have difficulty returning to work. The results suggest that appropriate follow-up, exercise guidance, and rehabilitation therapy are necessary even after treatment.
10.A Case Where High-intensity Interval Training Helped the Patient to Return to Work after Acute Myeloid Leukemia Treatment
Shin SUZUKI ; Yusuke TERAO ; Tasuku INABA ; Kazumi KASHIWABARA ; Takuya HADA ; Masahiro ABO
The Japanese Journal of Rehabilitation Medicine 2024;():24013-
Many post-treatment cancer patients complain of persistent fatigue, which is known to have a significant impact on activities of daily living, quality of life, and reinstatement. We report a case of a 37-year-old man with acute myeloid leukemia (AML) who was able to return to work by performing High-Intensity Interval Training (HIIT) after the remission. The diagnosis of AML was made and the treatment started in January X, and the patient reached remission and discharged in June. However, he developed herpes zoster and was unable to return to his job. The patient was referred to our hospital for rehabilitation treatment in December X. The rehabilitation treatment included 40-min HIIT twice a week and commuting practice, as well as gradual support for return-to-work. Cardiopulmonary function improved from 19.2 to 25.7 mL/min/kg of oxygen uptake at anaerobic metabolic threshold, lower limb muscle strength improved from 0.47/0.48 to 0.60/0.55 kgf/kg of knee extension muscle strength ratio (right/left), physical function improved from 14 to 24 times in 30-second chair stand test, Cancer Fatigue Scale improved from 46 to 25 points, and the patient was able to work full time in May X+1. HIIT improved cardiopulmonary function, muscle strength, physical function, and fatigue, and enabled the patient to return to work. Even after remission, some patients have difficulty returning to work. The results suggest that appropriate follow-up, exercise guidance, and rehabilitation therapy are necessary even after treatment.


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