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.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.
3.A Case of Redo-Mitral Valve Replacement for a Björk-Shiley Delrin Valve Implanted 47 Years Previously
Ryo IKEDA ; Chizuo KIKUCHI ; Yusuke TSUBOKO ; Masaaki IKEHARA ; Saeki WATANABE ; Yukiko YAMADA ; Yuki ICHIHARA ; Azumi HAMASAKI ; Kiyotaka IWASAKI ; Hiroshi NIINAMI
Japanese Journal of Cardiovascular Surgery 2023;52(1):29-33
We report a case of redo mitral valve replacement (MVR) for a Björk-Shiley Delrin valve implanted 47 years previously. A 71-year-old man initially underwent MVR for mitral regurgitation at our hospital at the age of 16 years. Following the operation, follow-up examinations were performed at the outpatient clinic and annual transthoracic echocardiogram findings showed only mild mitral regurgitation, with no adverse events noted. However, a transthoracic echocardiogram examination performed 45 years after the operation revealed mild to moderate mitral regurgitation, while dyspnea with exertion was also noted at that time. As part of a more detailed examination, transesophageal echocardiogram results showed moderate transvalvular leakage. Redo MVR was subsequently performed under the diagnosis of prosthetic valve dysfunction. Analysis of the explanted prosthetic valve revealed wear of the Delrin disk, and widening of the gap between the disk and strut, which were presumed to be the cause of transvalvular leakage. A half century has passed since introduction of the Björk-Shiley valve and the present is a rare case of valve malfunction. Presented here are related details, along with a review of existing literature and results of Björk-Shiley valve use at our hospital.


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