Publications by authors named "Nobuyuki Fujita"

249 Publications

Clinical outcomes and a therapeutic indication of intramedullary spinal cord astrocytoma.

Spinal Cord 2021 Jul 26. Epub 2021 Jul 26.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Study Design: Retrospective cohort study.

Objectives: Although intramedullary astrocytoma is associated with a high mortality rate, the optimal treatment has not reached a consensus. This study aimed at evaluating neurologic function and overall survival rate (OSR) in the treatment of this tumor.

Setting: The single institution in Japan.

Methods: This study enrolled 67 subjects who underwent surgical treatment for intramedullary astrocytoma. Demographic, imaging, and surgical information were collected from each participant. Tumors were histologically categorized using the World Health Organization classification, and subjects were divided into low-grade (I and II; n = 40) and high-grade (III and IV; n = 27) groups. Neurologic status was evaluated using the modified McCormick scale (MMS). OSR was assessed using Kaplan-Meier methods.

Results: The OSR decreased when the pathological grade increased (p < 0.01). Regarding the therapeutic efficacy for low-grade astrocytomas, subjects who underwent gross total resection (GTR) showed a higher OSR than those who did not (p = 0.02). GTR prevented worsening of MMS score, while non-GTR increased the MMS score (p < 0.01). In the high-grade group, 19 and 10 underwent radiation therapy and chemotherapy, respectively. However, both treatments did not improve OSR. Cordotomy was performed for subjects whose lesional area was at the thoracic level, but the OSR did not significantly increase.

Conclusions: The most beneficial therapeutic strategy for low-grade astrocytomas was GTR, whereas that for the high-grade tumors was unclear. Further studies with a larger sample size are warranted to validate the effective treatment for malignant astrocytomas.
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http://dx.doi.org/10.1038/s41393-021-00676-8DOI Listing
July 2021

Idification and structural characterisation of a catecholate-type siderophore produced by K279a.

Microbiology (Reading) 2021 Jul;167(7)

Department of Ecological Symbiotic Science, Graduate school of Agriculture, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan.

Siderophores are produced by several bacteria that utilise iron in various environments. Elucidating the structure of a specific siderophore may have valuable applications in drug development. , a Gram-negative bacterium that inhabits a wide range of environments and can cause pneumonia, produces siderophores. However, the structure was unknown, and therefore, in this study, we aimed to elucidate it. We purified siderophores from cultures of K279a using preparative reversed-phase HPLC. The structure was analysed through LC-MS and H and C NMR. The results demonstrated that K279a produces 2,3-dihydroxybenzoylserine (DHBS), a monomer unit of enterobactin. We suggested the uptake of Iron(III) by the DHBS complex. DHBS production by K279a could be attributed to an incomplete enterobactin pathway. Drugs targeting DHBS synthesis could prevent infection.
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http://dx.doi.org/10.1099/mic.0.001071DOI Listing
July 2021

Polygenic Risk Score of Adolescent Idiopathic Scoliosis for Potential Clinical Use.

J Bone Miner Res 2021 Jun 22. Epub 2021 Jun 22.

Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Adolescent idiopathic scoliosis (AIS) is a common disease causing three-dimensional spinal deformity in as many as 3% of adolescents. Development of a method that can accurately predict the onset and progression of AIS is an immediate need for clinical practice. Because the heritability of AIS is estimated as high as 87.5% in twin studies, prediction of its onset and progression based on genetic data is a promising option. We show the usefulness of polygenic risk score (PRS) for the prediction of onset and progression of AIS. We used AIS genomewide association study (GWAS) data comprising 79,211 subjects in three cohorts and constructed a PRS based on association statistics in a discovery set including 31,999 female subjects. After calibration using a validation data set, we applied the PRS to a test data set. By integrating functional annotations showing heritability enrichment in the selection of variants, the PRS demonstrated an association with AIS susceptibility (p = 3.5 × 10 with area under the receiver-operating characteristic [AUROC] = 0.674, sensitivity = 0.644, and specificity = 0.622). The decile with the highest PRS showed an odds ratio of as high as 3.36 (p = 1.4 × 10 ) to develop AIS compared with the fifth in decile. The addition of a predictive model with only a single clinical parameter (body mass index) improved predictive ability for development of AIS (AUROC = 0.722, net reclassification improvement [NRI] 0.505 ± 0.054, p = 1.6 × 10 ), potentiating clinical use of the prediction model. Furthermore, we found the Cobb angle (CA), the severity measurement of AIS, to be a polygenic trait that showed a significant genetic correlation with AIS susceptibility (rg = 0.6, p = 3.0 × 10 ). The AIS PRS demonstrated a significant association with CA. These results indicate a shared polygenic architecture between onset and progression of AIS and the potential usefulness of PRS in clinical settings as a predictor to promote early intervention of AIS and avoid invasive surgery. © 2021 American Society for Bone and Mineral Research (ASBMR).
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http://dx.doi.org/10.1002/jbmr.4324DOI Listing
June 2021

Upper End Vertebra of Proximal Thoracic Curve At T1 is a Novel Risk Factor of Postoperative Shoulder Imbalance in Lenke Type 2 Adolescent Idiopathic Scoliosis.

Global Spine J 2021 Jun 14:21925682211023049. Epub 2021 Jun 14.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Study Design: Retrospective single-center study.

Objective: We investigated the risk factors of postoperative shoulder imbalance (PSI) in patients with Lenke type 2 adolescent idiopathic scoliosis (AIS) including the position of preoperative upper end vertebra (UEV).

Methods: Seventy-five patients with Lenke type 2 AIS who underwent posterior correction and fusion surgeries from 2008 to 2018 were included. We included only patients whose upper instrumented vertebrae were at T2. The patients were divided into 2 groups based on radiographic shoulder height (RSH) at final follow-up, namely PSI group and non-PSI group, and PSI was defined as RSH > 10 mm. UEV, RSH, Cobb angle, curve flexibility, T1 and T2 tilt, correction rate, Risser grade, Scoliosis Research Society-22 scores, and demographic data were compared between the groups using independent tests or chi-square tests. Variables with value < 0.20 in univariate analysis were assessed in logistic regression analysis.

Results: Thirty-four patients in the PSI group and 37 patients in the non-PSI group were analyzed. Univariate analysis revealed that there were more patients with UEV at T1 (PSI: 85%, non-PSI: 54%, < 0.01) and Risser grade ≥ 3 (PSI: 88%, non-PSI: 62%; < 0.05) in the PSI group than in the non-PSI group. Logistic regression analysis revealed that UEV at T1 (odds ratio [OR] = 4.1 [1.2-14.4], < 0.05) and Risser grade ≥ 3 (OR = 3.9 [1.1-14.5], < 0.05) are significantly associated with PSI.

Conclusions: UEV at T1 and Risser grade ≥ 3 at the time of surgery are significant risk factors of PSI.
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http://dx.doi.org/10.1177/21925682211023049DOI Listing
June 2021

Spontaneous Reduction of Chiari Malformation and Syringomyelia After Posterior Spinal Fusion for Scoliosis: A Case Report.

JBJS Case Connect 2021 06 11;11(2). Epub 2021 Jun 11.

Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Case: A 22-year-old skeletally mature man with scoliosis accompanied by syringomyelia associated with Chiari malformation type 1 was presented to our hospital. Because the maximal syrinx/cord ratio was small, and he had no neurological deficit, he underwent corrective surgery without the treatment of the syringomyelia.

Conclusion: The scoliosis was corrected without any neurological complications. Magnetic resonance imaging taken 8 days after the surgery showed the reduction of the size of the syringomyelia. The syringomyelia almost disappeared at the 8-year follow-up.
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http://dx.doi.org/10.2106/JBJS.CC.20.00779DOI Listing
June 2021

Preoperative prevalence of deep vein thrombosis in patients scheduled to have surgery for degenerative musculoskeletal disorders.

BMC Musculoskelet Disord 2021 Jun 4;22(1):513. Epub 2021 Jun 4.

Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Aichi, Toyoake, Japan.

Background: Although the incidence of symptomatic pulmonary thromboembolism after elective surgery for degenerative musculoskeletal disorders is comparatively low, it is extremely detrimental to both patients and health-care providers. Therefore, its prevention is mandatory. We aimed to perform a cross-sectional analysis of deep venous thrombosis (DVT) before elective surgery for degenerative musculoskeletal disorders, including total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal surgery, and identify the factors associated with the incidence of preoperative DVT.

Methods: The clinical data of patients aged ≥ 30 years who underwent TKA or THA, and spine surgery for lumbar or cervical degenerative disorders at our institution were retrospectively collected. D-dimer levels were measured preoperatively in all the patients scheduled for surgery. For the patients with D-dimer levels ≥ 1 µg/mL or who were determined by their physicians to be at high risk of DVT, the lower extremity vein was preoperatively examined for DVT on ultrasonography.

Results: Overall, we retrospectively evaluated 1236 consecutive patients, including 701 men and 535 women. Of the patients, 431 and 805 had D-dimer levels ≥ 1 and < 1 µg/mL, respectively. Of 683 patients who underwent lower extremity ultrasonography, 92 had proximal (n = 7) and distal types (n = 85) of DVT. The preoperative prevalence of DVT was 7.4 %. No patient had the incidence of postoperative symptomatic venous thromboembolism. A multivariate analysis revealed that age ≥ 80 years (odds ratio [OR], 95 % confidence interval [CI]: 2.8, 1.1-7.3), knee surgery (2.1, 1.1-4.0), American Society of Anesthesiologists (ASA) grade 2 (2.8, 1.2-6.8), ASA grades 3 or 4 (3.1, 1.0-9.4), and malignancy (1.9, 1.1-3.2) were significantly associated with DVT incidence.

Conclusions: This is the first study to conduct a cross-sectional analysis of preoperative DVT data of patients scheduled for elective surgery for degenerative musculoskeletal disorders. Although whether screening for preoperative DVT is needed to prevent postoperative symptomatic pulmonary thromboembolism remains to be clarified, our data suggested that DVT should be noted before surgery in the patients with advanced age, knee surgery, high ASA physical status, and malignancy.
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http://dx.doi.org/10.1186/s12891-021-04405-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178884PMC
June 2021

Draft genome sequencing of Sporolactobacillus terrae SBT-1, an efficient bacterium to ferment concentrated sugar to D-lactic acid.

Arch Microbiol 2021 Aug 7;203(6):3577-3590. Epub 2021 May 7.

Research Unit in Bioconversion/Bioseparation for Value-Added Chemical Production, Institute of Biotechnology and Genetic Engineering, Chulalongkorn University, Phayathai Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand.

Recently, the industrial-scale development of microbial D-lactic acid production has been discussed. In this study, the efficiency of the new isolate Sporolactobacillus terrae SBT-1 for producing D-lactic acid under challenge conditions was investigated. The isolate SBT-1 exhibited superior activity in fermenting a very high glucose or sucrose concentration to D-lactic acid compared to the other S. terrae isolates previously reported in the literature; therefore, SBT-1 could overcome the limitations of effective lactic acid production. In batch cultivation using 360 g/L glucose, SBT-1 produced 290.30 g/L D-lactate with a sufficiently high glucose conversion yield of 86%, volumetric productivity of 3.02 g/L h, and optical purity of 96.80% enantiomer excess. SBT-1 could also effectively utilize 440 g/L sucrose as a sole carbon source to produce 276.50 g/L lactic acid with a conversion yield of 90%, a production rate of 2.88 g/L h, and an optical purity of 98%. D-Lactic acid fermentation by two other related producers, S. inulinus NRIC1133 and S. terrae NRIC0357, was compared with fermentation by isolate SBT-1. The experimental data revealed that SBT-1 possessed the ability to ferment relatively high glucose or sucrose concentrations to D-lactic acid without obvious catabolite repression and byproduct formation compared to the two reference strains. In draft genome sequencing of S. terrae SBT-1, the results provided here can promote further study to overcome the current limitations for the industrial-scale production of D-lactic acid.
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http://dx.doi.org/10.1007/s00203-021-02352-0DOI Listing
August 2021

Coronal Plane Gap Increases Postoperative Pseudoarthrosis after Lateral Interbody Fusion for Adult Spinal Deformity.

Asian Spine J 2021 May 6. Epub 2021 May 6.

Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Japan.

Study Design: This is a retrospective study.

Purpose: This study aims to evaluate the risk factor associated with pseudoarthrosis after placement of lateral interbody fusion (LIF) cages for adult spinal deformity (ASD) treatment.

Overview Of Literature: LIF technique is widely used for ASD correction. Furthermore, pseudoarthrosis is a major complication of fusion surgery required for revision surgery.

Methods: This study included 42 patients with ASD (two men and 40 women; 112 segments; mean, 68.5±8.4 years; and mean follow-up, 31.6±17.0 months) who underwent LIF and posterior correction surgery. The concave slot of the LIF cage was filled with an autologous iliac crest bone graft (IBG), and the convex slot with a porous hydroxyapatite/collagen (HAp/Col) composite was soaked with bone marrow aspirate. Endplate injury, the gap between vertebral endplate and cage in the coronal or sagittal plane, and fusion status were evaluated using computed tomography multiplanar reconstruction at 12 months after surgery. Moreover, the associated risk factors for pseudoarthrosis were analyzed.

Results: Fusion at LIF segments were observed in 71.4% segments at 12 months after surgery. Fusion on the concave slot (autologous IBG side), convex slot (porous HAp/Col composite side), and both concave and convex slots were observed in 66.1%, 37.5%, and 36.6% of patients, respectively. Moreover, pseudoarthrosis was observed in 28.6% at 12 months after surgery. Consequently, logistic regression analysis of the fusion at the LIF segment revealed that the gap between the LIF cage and endplate in the coronal plane (p=0.030; odds ratio, 0.183; 95% confidence interval, 0.030-0.183) was significantly associated with pseudoarthrosis at the LIF segments.

Conclusions: ASD surgery fusion rate using LIF cages was 71.4% at 12 months after surgery. The fusion rate was higher on the concave slot filled with autologous IBG than on the convex slot filled with a porous HAp/Col composite. The gap in the coronal plane was a risk factor for pseudoarthrosis at the LIF segment.
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http://dx.doi.org/10.31616/asj.2020.0336DOI Listing
May 2021

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review.

Authors:
Nobuyuki Fujita

Spine Surg Relat Res 2021 20;5(2):61-67. Epub 2020 Aug 20.

Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Aichi, Japan.

Patients with lumbar spinal canal stenosis (LSS) have impaired activities of daily living because of pain or motor paralysis, but no effective preventive treatment is currently available. The number of patients with LSS is predicted to continually increase as the average age of the global population increases. To provide a conceptual framework for improving healthy life expectancy, the Japanese Orthopaedic Association introduced the concept of locomotive syndrome, to which LSS is related. Ours and other studies have shown that LSS exacerbates locomotive syndrome and that surgical treatment is one method for improving it. Furthermore, we propose that the two-step test, a locomotive syndrome risk test, is effective for assessing the risk for falls and severity of LSS. Meanwhile, lumbar spinal epidural lipomatosis (LSEL), which is a manifestation of LSS, has been shown to be related to metabolic syndrome. Previous studies have suggested that the whole LSS can be also associated with metabolic syndrome. Although locomotive syndrome is very different from metabolic syndrome, which involves lipid metabolism, these two syndromes overlap, such as in LSS. Conducting research on LSS from the perspectives of both locomotive syndrome and metabolic syndrome may lead to novel methods for prevention and treatment of LSS and, conversely, may yield clues for resolving symptoms of the two syndromes. This review provides an overview of LSS from the perspective of locomotive syndrome and metabolic syndrome, along with findings from our research group.
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http://dx.doi.org/10.22603/ssrr.2020-0112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026207PMC
August 2020

Which is better? Anterior or posterior referencing for femoral component position in total knee arthroplasty.

J Orthop Surg (Hong Kong) 2021 Jan-Apr;29(1):23094990211002325

Department of Orthopedic Surgery, 12695Fujita Health University School of Medicine, Toyoake, Aichi, Japan.

When sizing the femoral component or determining its placement in total knee arthroplasty (TKA), if the anterior-posterior diameter of the femoral condyle is between component sizes, the selected size will differ depending on whether anterior referencing (AR) or posterior referencing (PR) is used. As a result, the amount of resected bone will also vary. In the present prospective study, we compared the two referencing methods to determine which is more suitable for individual patients. We recruited 58 patients (92 joints) who received TKA using the standard technique with intermediate-size components. AR was used in 26 joints, and PR in 23 joints. Seventeen of the patients underwent same-day bilateral TKA in which components of different sizes were used for the left and right joints. AR resulted in significantly smaller anterior and posterior offsets than PR. Preoperative clinical evaluation revealed no significant differences among cases in which intermediate-size components were indicated, or those in which components of different sizes were indicated. When an intermediate-sized component was indicated using the AR method, moving the sizer forward resulted in a larger posterior gap, but this technique was nevertheless considered acceptable. AR is likely to be more suitable than PR as it achieves more physiological anterior clearance.
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http://dx.doi.org/10.1177/23094990211002325DOI Listing
July 2021

Posterior and Anterior Fusion for Severe Cervical Kyphosis in a Patient with Chondrodysplasia Punctata: A Case Report.

JBJS Case Connect 2021 03 16;11(1). Epub 2021 Mar 16.

Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.

Case: A 4-year-old girl with spastic gait and hand clumsiness who was diagnosed with cervical myelopathy caused by atlantoaxial dislocation and midcervical severe kyphosis associated with chondrodysplasia punctata (CDP). The patient underwent posterior instrumentation and anterior spinal fusion and successful correction with osseous fusion was obtained 8 months after surgery. In addition, the preoperative neurological symptoms were completely recovered.

Conclusion: Owing to the characteristics of CDP, the treatment for the cervical lesion is extremely complicated. Successful stabilization and improvement of the neurological symptom were achieved by combining posterior and anterior fusion with instrumentation in this case.
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http://dx.doi.org/10.2106/JBJS.CC.20.00646DOI Listing
March 2021

Imaging Characteristics and Surgical Outcomes in Patients With Intraspinal Solitary Fibrous Tumor/Hemangiopericytoma: A Retrospective Cohort Study.

Global Spine J 2021 Mar 11:2192568221994799. Epub 2021 Mar 11.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Study Design: Retrospective cohort study.

Objectives: Intraspinal solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is often misdiagnosed preoperatively as schwannoma or meningioma because its imaging characteristics are not well understood. As postoperative prognosis differs among the 3 lesions, predicting the probability of SFT/HPC preoperatively is essential. Thus, this study investigates the imaging characteristics of SFT/HPC compared with those of schwannoma or meningioma and evaluates surgical outcomes.

Methods: The preoperative imaging findings, tumor resection extent, recurrence and regrowth rates, and neurological improvement were compared between 10 patients with SFT/HPC and 42 patients with schwannoma or 40 patients with meningioma.

Results: Most patients with SFT/HPC showed isointensity on both T1- and T2-weighted images compared with patients with schwannoma ( = 0.011 and 0.029, respectively) and no significant difference compared with patients with meningioma ( = 0.575 and 0.845, respectively). Almost all patients with SFT/HPC showed highly uniformizing enhancement patterns, similar to those with meningioma ( = 0.496). Compared with meningioma, SFT/HPC lacked the dural tail sign and intratumoral calcification and exhibited irregular shape. Of the 5 patients who underwent partial resection, 60% exhibited tumor recurrence and regrowth following surgery.

Conclusions: Complete surgical resection should be attempted in patients with intraspinal SFT/HPC to prevent postoperative recurrence or regrowth. As this tumor is often preoperatively misdiagnosed, we recommend that the imaging findings exhibited in this study should be used to positively suspect SFT/HPC. This will enhance patient outcomes by enabling more appropriate preoperative surgical planning.
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http://dx.doi.org/10.1177/2192568221994799DOI Listing
March 2021

Gorham-Stout Disease Resulting in Spinal Deformity Treated by Fusion Surgery Combined With Everolimus Therapy: A Case Report.

JBJS Case Connect 2021 03 3;11(1). Epub 2021 Mar 3.

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.

Case: Gorham-Stout disease (GSD) is a rare disorder characterized by progressive localized osteolysis and lymphatic malformation. A 26-year-old woman with GSD presented to our hospital with a Cobb angle of 100° and a kyphosis angle of 88°. Everolimus therapy was initiated to control the disease prior to surgery. After halo-gravity traction for 4 weeks, we performed anterior and posterior spinal fusion. Postoperative computed tomography revealed satisfactory bone union and no significant loss of correction 1 year post-surgery.

Conclusion: This case suggests that anterior and posterior spinal fusion combined with everolimus therapy can be a therapeutic option for GSD.
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http://dx.doi.org/10.2106/JBJS.CC.20.00296DOI Listing
March 2021

T2 mapping of the median nerve in patients with carpal tunnel syndrome and healthy volunteers.

Muscle Nerve 2021 05 23;63(5):774-777. Epub 2021 Feb 23.

Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Japan.

Introduction: We investigated the changes in MRI T2 mapping values in subjects with carpal tunnel syndrome (CTS) compared to healthy controls.

Methods: We enrolled 71 patients with CTS and 26 healthy controls. Median nerve T2 values were measured at the distal carpal tunnel, hamate bone, proximal carpal tunnel, and forearm levels. These were compared between patients and controls and correlated with median nerve cross-sectional area (CSA) and nerve conduction measurements.

Results: The mean T2 values at the proximal carpal tunnel levels were higher in the CTS group (56.7 ms) than in the control group (51.2 ms, P = .02) and also were higher than at the distal carpal tunnel (51.0 ms, P < .001) and forearm levels (47.6 ms, P < .001). T2 values were not significantly associated with CSA or nerve conduction measurements.

Discussion: T2 mapping of the carpal tunnel provides qualitative information on median nerve pathology but does not reflect CTS severity.
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http://dx.doi.org/10.1002/mus.27205DOI Listing
May 2021

Does Selective Posterior Correction and Fusion Surgery Influence Cervical Sagittal Alignment In Patient With Lenke Type 5 Adolescent Idiopathic Scoliosis? - A 5-Year Follow Up Retrospective Cohort Study.

Spine (Phila Pa 1976) 2021 Jan 25. Epub 2021 Jan 25.

Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, Tokyo, Japan Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan.

Study Design: A retrospective comparative study.

Objective: To examine the changes in cervical sagittal alignment (CSA) following surgical correction in a patient with Lenke type 5 adolescent idiopathic scoliosis (AIS) and evaluate any possible factors influencing postoperative CSA.

Summary Of Background Data: Few studies have assessed the association between CSA and thoracic or lumbar sagittal alignment in AIS patients with major thoracolumbar/lumbar curve who underwent posterior correction and fusion surgery.

Methods: 66 patients with Lenke type 5 AIS (2 males and 64 females, the mean age at surgery of 16.2 years) were included in this study. They were followed up for minimum 5 years after surgery. Multiple linear regression analysis was used to evaluate possible factors influencing the postoperative CSA. To determine the influence of upper end vertebra (UEV) level on postoperative CSA, the subjects were divided into two groups according to UEV level of ≥ T9 or ≤ T10. The outcome variables were compared between the two groups and analyzed for changes in various spinal sagittal profiles using radiographic outcomes.

Results: Multiple linear regression analysis revealed that preoperative T10-L2 kyphosis and LL were significantly correlated with postoperative C2-7 lordosis. However, CSA did not significantly change at 5 years after surgery. Sub-analysis of the cohort revealed that in the UEV ≥ T9 group, the mean thoracic kyphosis significantly increased from 20.3 ± 10.6° to 24.0 ± 8.9° and the mean C2-7 lordosis also significantly increased from -12.5 ± 8.3° to -4.3 ± 10.3° at 5-year postoperatively. SRS-22 outcomes were comparable between the groups.

Conclusion: We indicated that the CSA was not influenced by surgical correction in most Lenke type 5 AIS patients. However, in a patient whose UEV was located at T9 or higher levels, CSA was influenced through the changes in thoracic kyphosis following posterior correction surgery.Level of Evidence: 4.
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http://dx.doi.org/10.1097/BRS.0000000000003967DOI Listing
January 2021

Characterization of Patients with Poor Risk for Clinical Outcomes in Adult Symptomatic Lumbar Deformity Surgery.

Spine (Phila Pa 1976) 2021 Jun;46(12):813-821

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku City, Tokyo, Japan.

Study Design: Retrospective review of 159 surgically treated consecutive adult symptomatic lumbar deformity (ASLD) (65 ± 9 years, female: 94%) from a multicenter database.

Objective: The aim of this study was to provide a comprehensive analysis of the risk of a poor clinical outcome in ASLD surgery.

Summary Of Background Data: Poor-risk patients with ASLD remain poorly characterized.

Methods: ASLD was defined as age >40 years with a lumbar curve ≥30° or C7SVA ≥5 cm and Scoliosis Research Society 22 (SRS22) pain or function <4. Poor outcome was defined as 2y SRS22 total <4 or pain, function or satisfaction ≤3. The outcomes of interest included age, sex, body mass index, bone mineral density, Schwab-SRS type, frailty, history of arthroplasty, upper-instrumented vertebral, lower-instrumented vertebral, levels involved, pedicle subtraction osteotomy, lumbar interbody fusion, sagittal alignment, global alignment and proportion (GAP) score, baseline SRS22r score, estimated blood loss, time of surgery, and severe adverse event (SAE). Poisson regression analyses were performed to identify the independent risks for poor clinical outcome. A patient was considered at poor risk if the number of risks was >4.

Results: All SRS22 domains were significantly improved after surgery. In total, 21% (n = 34) reported satisfaction ≤3 and 29% (n = 46) reported pain or function ≤3. Poisson regression analysis revealed that frailty (odds ratio [OR]: 0.2 [0.1-0.8], P = .03), baseline mental-health (OR: 0.6 [0.4-0.9], P = .01) and function (OR: 1.9 [1.0-3.6], P < .01), GAP score (OR: 4.6 [1.1-18.7], P = .03), and SAE (OR: 3.0 [1.7-5.2], P < .01) were identified as independent risk for poor clinical outcome. Only 17% (n = 6) of the poor-risk patients reached SRS22 total score >4.0 at 2 years.

Conclusion: The overall clinical outcome was favorable for ASLD surgery. Poor-risk patients continue to have inferior outcomes, and alternative treatment strategies are needed to help improve outcomes in this patient population. Recognition and optimization of modifiable risk factors, such as physical function and mental health, and reduced SAEs may improve overall clinical outcomes of ASLD surgery.Level of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000003927DOI Listing
June 2021

The Long-term Impact of Whiplash Injuries on Patient Symptoms and the Associated Degenerative Changes Detected Using MRI: A Prospective 20-year Follow-up Study Comparing Patients with Whiplash-associated Disorders with Asymptomatic Subjects.

Spine (Phila Pa 1976) 2021 Jun;46(11):710-716

Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.

Study Design: A longitudinal, 20-year comparative study of patients with whiplash-associated disorders (WAD).

Objective: The aim of this study was to clarify the long-term impact of WAD on patient symptoms and on magnetic resonance imaging (MRI) findings of the cervical spine, in comparison with asymptomatic volunteers.

Summary Of Background Data: The long-term impact of WAD has not been fully elucidated.

Methods: Between 1993 and 1996, we conducted a cross-sectional comparative study of 508 acute WAD patients and 497 asymptomatic volunteers, all of whom underwent MRI on cervical spine and physical examinations. For this 20-year follow-up comparative study, 75 WAD patients and 181 control subjects aged <60 years were recruited from the original cohort. The MRI findings, including discs' signal intensities, posterior disc protrusions, anterior dural compressions, spinal cord disc space narrowing, and foraminal stenoses, were evaluated using two to four numerical grades. The results of the WAD patients and control subjects were compared.

Results: In this follow-up, the prevalence of shoulder stiffness (72.0% vs. 45.9%), headache (24.0% vs. 12.2%), and arm pain (13.3% vs. 3.9%) were significantly greater in WAD patients than in control subjects. The multiregression analysis revealed that a history of WAD was associated with shoulder stiffness (odds ratio [OR]: 3.36), headache (OR: 2.39), and arm pain (OR: 3.82). Although MRI findings in WAD patients were more degenerated than in control subjects in the initial study, all MRI findings were similar at the 20-year follow-up. There were no significant correlations between clinical cervical symptoms and progression in each MR finding in either group.

Conclusion: After 20 years, whiplash injuries significantly impacted the residual symptoms of shoulder stiffness, headache, and arm pain when compared with initially asymptomatic volunteers. The progression of degenerative changes in the cervical intervertebral discs after 20 years revealed no association with existing whiplash injuries, neither did the residual cervical-related symptoms.Level of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000003901DOI Listing
June 2021

Efficacy of hyaluronic acid on intervertebral disc inflammation: An in vitro study using notochordal cell lines and human disc cells.

J Orthop Res 2020 Nov 29. Epub 2020 Nov 29.

Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

Hyaluronic acid (HA) is widely recognized as a therapeutic target and currently used in medicine. However, HA metabolism during intervertebral disc degeneration (IVDD) has not been completely elucidated. This study aimed to evaluate the efficacy of HA on intervertebral disc (IVD) inflammation and identify the main molecules modulating HA degradation in IVDs. To assess HA function in IVD cells in vitro, we treated human disc cells and U-CH1-N cells, a notochordal nucleus pulposus cell line, with HA or hyaluronidase. Real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis showed that tumor necrosis factor alpha (TNF-α)-mediated induction of the expression of TNF-α and cyclooxygenase-2 (COX2) was clearly neutralized by HA treatment, and the expression of TNF-α and COX2 was significantly induced by hyaluronidase treatment in both cell types. Additionally, Western blot analysis showed that hyaluronidase-induced phosphorylation of p38 and Erk1/2, and that TNF-α-mediated phosphorylation of p38 and Erk1/2 was clearly reduced by HA addition. In degenerating human IVD samples, immunohistochemistry for hyaluronidase showed that the expression of hyaluronidases including HYAL1, HYAL2, and cell migration-inducing protein (CEMIP) tended to increase in accordance with IVDD. In particular, HYAL1 showed statistically significant differences. In vitro study also confirmed a similar phenomenon that TNF-α treatment increased both messenger RNA and protein expression in both cell types. Our results demonstrated that HA could potentially suppress IVDD by regulating p38 and Erk1/2 pathways, and that the expression of HYAL1 was correlated with IVDD progression. These findings indicated that HYAL1 would be a potential molecular target for suppressing IVDD by controlling HA metabolism.
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http://dx.doi.org/10.1002/jor.24933DOI Listing
November 2020

Residual lumbar curvature that developed during adolescence accelerates intervertebral disc degeneration in adulthood.

Spine Deform 2021 May 27;9(3):711-720. Epub 2020 Nov 27.

Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.

Purpose: To elucidate the influence of spinal deformity in adolescent idiopathic scoliosis (AIS) on lumbar intervertebral disc (IVD) degeneration in adulthood using magnetic resonance imaging (MRI).

Methods: A total of 102 patients (8 men, 94 women; mean age, 31.4 years) who had developed idiopathic scoliosis at the age of 10-18 years and underwent preoperative lumbar spine MRI at the age of ≥ 20 were included in the study. Twenty volunteers (3 men, 17 women; mean age, 33.6 years) without scoliosis were assessed as controls. We divided the adult scoliosis patients into two groups: Group A consisted of patients with lumbar modifier A, and Group BC consisted of those with modifiers B and C. IVD degeneration from L1/2 to L5/S1 was assessed by MRI. The Scoliosis Research Society-22 (SRS-22) patient questionnaire was used in the patients' clinical assessment.

Results: There were 40 patients in the Group A and 62 in the Group BC. Compared to the control groups, significant IVD degeneration was observed at L2/3 and L3/4 in Group A, and at all levels except for L5/S1 in Group BC. The proportion of degenerated IVDs patients (Grades 1c and 2) was significantly higher in Group BC than those in Group A at L3/L4 and L4/L5. Furthermore, the severity of IVD degeneration was significantly greater in the group BC than in the group A at all levels, except for L5/S1, especially in patients aged > 30 years. The mean scores of all subdomains in the SRS-22 questionnaire were comparable between the two groups.

Conclusion: Our study showed that the residual lumbar curvature from AIS may have accelerated IVD degeneration in adulthood, especially in patients aged > 30 years.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s43390-020-00252-9DOI Listing
May 2021

Metabolic Syndrome is a Predisposing Factor for Diffuse Idiopathic Skeletal Hyperostosis.

Neurospine 2021 Mar 17;18(1):109-116. Epub 2020 Nov 17.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Objective: Diffuse idiopathic skeletal hyperostosis (DISH) causes spinal ankylosis, which can result in patients suffering specific spinal fractures that lead to a reduction in the activities of daily life in older patients. Currently, DISH is associated with diabetes mellitus and cardiovascular disease; however, the association between DISH and metabolic syndrome has not been established. The purpose of this study was to investigate a potential association between DISH and metabolic syndrome.

Methods: We retrospectively reviewed clinical data from consecutive subjects undergoing the musculoskeletal health medical checkups, and enrolled 327 subjects (174 men and 153 women; mean, 63.4 ± 13.7-years). Subjects who had spinal ankylosis at least 4 contiguous vertebral bodies were classified as the DISH group (n = 39) while the others were part of the non-DISH group (n = 288). The definition of the metabolic syndrome comes from diagnostic criteria used by the Japanese Society for Internal Medicine. Age, sex, body max index (BMI), hematological evaluation, blood pressure, presence of metabolic syndrome, the visceral fat area on abdominal computed tomography, and spinal epidural lipomatosis (SEL) on magnetic resonance imaging were evaluated.

Results: Compared to the non-DISH group, in the DISH group, mean age (DISH group, 74.3 years; non-DISH group, 1.9 years; p < 0.001), male prevalence were higher (DISH group, 82.1%; non-DISH group, 49.3%; p < 0.001), and BMI was greater (DISH group, 24.8; non-DISH group, 23.0; p = 0.006). the metabolic syndrome was more frequently observed in DISH group (28.9%) than in the non-DISH group (16.0%) (p = 0.045). The visceral fat area was significantly larger in the DISH group than in the non-DISH group (DISH group, 130.7 ± 58.2 cm2; Non-DISH group, 89.0 ± 48.1 cm2; p < 0.001). The prevalence of SEL was similar between the 2 groups (10.3% in the DISH group vs. 8.7% in the nonDISH group; p = 0.464). Poisson regression analysis revealed that the metabolic syndrome was significantly associated with DISH with odds ratio of 2.0 (95% confidence interval, 1.0-3.7; p = 0.004).

Conclusion: Metabolic syndrome was significantly associated with DISH. Our data showed metabolic syndrome is potentially related to DISH.
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http://dx.doi.org/10.14245/ns.2040350.175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021843PMC
March 2021

Clinical Effects of Anterior Cervical Spondylolisthesis on Cervical Spondylotic Myelopathy After Posterior Decompression Surgery: A Retrospective Multicenter Study of 732 Cases.

Global Spine J 2020 Nov 18:2192568220966330. Epub 2020 Nov 18.

Keio Spine Research Group (KSRG), Tokyo, Japan.

Study Design: Multicenter retrospective study.

Objectives: We aim to investigate features of cervical spondylotic myelopathy (CSM) associated with anterior cervical spondylolisthesis (ACS) during posterior decompression surgery.

Methods: A total of 732 patients with CSM were enrolled, who underwent posterior decompression surgery between July 2011 and November 2015 at 17 institutions. The patients with ACS (group A), defined as an anterior slippage of ≥2 mm on plain radiographs, were compared with those without ACS (group non-A). Also, the characteristics of patients with ACS progression (group P), defined as postoperative worsening of ACS ≥2 mm or newly developed ACS, were investigated. Moreover, kyphosis was defined as C2-C7 angle in neutral position ≤-5°. The Japanese Orthopedic Association (JOA) scoring system was used for clinical evaluation.

Results: Group A consisting of 62 patients (8.5%) had worse preoperative clinical status but comparable surgical outcomes to group non-A. Furthermore, ACS was associated with greater age, and the degree of slippage did not affect myelopathy grades. Seventeen patients (2.3%) were observed in group P, and preoperative ACS was a significant predisposing factor for the progression without clinical impact. Among the patients in group A, preoperative cervical kyphosis was a risk factor for lower JOA recovery rate.

Conclusions: Although the presence of ACS increases the risk of postoperative progression, it is not a contraindication for posterior decompression. However, surgeons need to consider the indication of fusion surgery for the patients who have ACS accompanied by kyphosis because of the poor surgical outcomes.
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http://dx.doi.org/10.1177/2192568220966330DOI Listing
November 2020

Transcriptome profile of carbon catabolite repression in an efficient l-(+)-lactic acid-producing bacterium Enterococcus mundtii QU25 grown in media with combinations of cellobiose, xylose, and glucose.

PLoS One 2020 17;15(11):e0242070. Epub 2020 Nov 17.

Department of Bioscience, Tokyo University of Agriculture, Tokyo, Japan.

Enterococcus mundtii QU25, a non-dairy lactic acid bacterium of the phylum Firmicutes, is capable of simultaneously fermenting cellobiose and xylose, and is described as a promising strain for the industrial production of optically pure l-lactic acid (≥ 99.9%) via homo-fermentation of lignocellulosic hydrolysates. Generally, Firmicutes bacteria show preferential consumption of sugar (usually glucose), termed carbon catabolite repression (CCR), while hampering the catabolism of other sugars. In our previous study, QU25 exhibited apparent CCR in a glucose-xylose mixture phenotypically, and transcriptional repression of the xylose operon encoding initial xylose metabolism genes, likely occurred in a CcpA-dependent manner. QU25 did not exhibit CCR phenotypically in a cellobiose-xylose mixture. The aim of the current study is to elucidate the transcriptional change associated with the simultaneous utilization of cellobiose and xylose. To this end, we performed RNA-seq analysis in the exponential growth phase of E. mundtii QU25 cells grown in glucose, cellobiose, and/or xylose as either sole or co-carbon sources. Our transcriptomic data showed that the xylose operon was weakly repressed in cells grown in a cellobiose-xylose mixture compared with that in cells grown in a glucose-xylose mixture. Furthermore, the gene expression of talC, the sole gene encoding transaldolase, is expected to be repressed by CcpA-mediated CCR. QU25 metabolized xylose without using transaldolase, which is necessary for homolactic fermentation from pentoses using the pentose-phosphate pathway. Hence, the metabolism of xylose in the presence of cellobiose by QU25 may have been due to 1) sufficient amounts of proteins encoded by the xylose operon genes for xylose metabolism despite of the slight repression of the operon, and 2) bypassing of the pentose-phosphate pathway without the TalC activity. Accordingly, we have determined the targets of genetic modification in QU25 to metabolize cellobiose, xylose and glucose simultaneously for application of the lactic fermentation from lignocellulosic hydrolysates.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242070PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671544PMC
January 2021

Effectiveness of Duloxetine for Postsurgical Chronic Neuropathic Disorders after Spine and Spinal Cord Surgery.

Asian Spine J 2020 Nov 16. Epub 2020 Nov 16.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Study Design: This is a retrospective observational study with an outpatient setting.

Purpose: This study aimed to describe the effects of duloxetine (DLX) administration for postsurgical chronic neuropathic disorders (both pain and numbness) following spinal surgery in patients without depression.

Overview Of Literature: Although several reports indicated the potential of DLX to effectively treat postoperative symptoms as a perioperative intervention, there have been no reports of its positive effect on postsurgical chronic neuropathic disorders.

Methods: A total of 24 patients with postsurgical chronic pain and/or numbness numeric rating scale (NRS) scores of ≥4 were enrolled. All patients underwent spine or spinal cord surgery at Keio University Hospital and received daily administration of DLX for more than 3 months. The mean postoperative period before the first administration of DLX was 35.5±57.0 months. DLX was administered for more than 3 months at a dose of 20, 40, or 60 mg/day, and the degree of pain and numbness was evaluated using the NRS before administration and 3 months after administration. Effectiveness was defined as more than a 2-point decrease in the NRS score following administration.

Results: In terms of the type of symptoms, 15 patients experienced only numbness, eight experienced both pain and numbness, and one experienced only pain. Of the 24 patients, 19 achieved effective relief with DLX. DLX was effective for all patients with postsurgical chronic pain (n=9), and it reduced postsurgical chronic numbness in 18 of 23 patients. No significant difference was observed in background spinal disorders. DLX was not effective for five patients who complained only of postsurgical chronic numbness.

Conclusions: This study reports the effectiveness of DLX for postsurgical chronic neuropathic disorders. Although DLX reduced postsurgical chronic pain (efficacy rate=100%) and numbness (78.3%) in certain patients, further investigation is needed to determine its optimal use.
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http://dx.doi.org/10.31616/asj.2020.0191DOI Listing
November 2020

Chin on Chest Deformity Caused by Upper Cervical Kyphosis Associated With Ankylosing Spondylitis: A Case Report.

Neurospine 2020 09 30;17(3):666-671. Epub 2020 Sep 30.

Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Chin on chest deformity caused by upper cervical kyphosis associated with ankylosing spondylitis is rare. A 66-year-old woman presented at our institute with chief complaints of difficulty in horizontal gaze and opening her mouth. Cervical radiographs showed a C0-2 angle of 1° on flexion and 7° on extension, and her chin-brow vertical angle was 49°. We planned fixation surgery at C0-5 posteriorly to prevent the progression of kyphosis, with slight correction of the kyphosis at C0-2. The correction was performed by pushing down the over lordotically contoured titanium rods connected to an occipital plate onto the C3-5 lateral mass screws, just like cantilever technique. No palpable cracking or loss of resistance was noticed during the correction. However, intraoperative radiographs revealed apparent anterior separation of the vertebral bodies between C3 and C4. Postoperative computed tomography images at the C3/4 level suggested hemorrhage from the fracture site. Tracheostomy was performed because of massive edema around the pharynx. To secure solid bone fusion, staged surgery to extend the fusion to T3 and to graft an additional iliac bone was performed. Fortunately, the C2-7 angle was corrected to 40°, and her chin-brow vertical angle was restored to 17° without any catastrophic complications. Although the patient finally obtained an ideal sagittal alignment, the surgeon should be aware that the technique had a higher perioperative risk for iatrogenic fracture, resulting in neurological and vascular injuries.
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http://dx.doi.org/10.14245/ns.2040502.251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538344PMC
September 2020

Impact of Tobacco Smoking on Outcomes After Posterior Decompression Surgery in Patients With Cervical Spondylotic Myelopathy: A Retrospective Multicenter Study.

Clin Spine Surg 2020 12;33(10):E493-E498

Keio Spine Research Group (KSRG), Tokyo.

Study Design: This was a case-control study.

Objective: The objective of this study was to clarify the surgical outcomes after cervical posterior decompression in patients who smoked.

Summary Of Background Data: Smoking is associated with poor outcomes in the field of spinal surgery. However, the impact of tobacco smoking on the outcomes after posterior decompression surgery has not been fully evaluated in patients with cervical spondylotic myelopathy.

Materials And Methods: In this retrospective multicenter study, 587 patients with cervical spondylotic myelopathy were enrolled at 17 institutions in Japan. Patients underwent cervical laminoplasty or laminectomy and were followed up for at least 1 year after surgery. Outcome measures were: preoperative smoking status, perioperative complications, the Japanese Orthopedic Association scale, and the Visual Analog Scale for neck pain. After adjusting for age and sex by exact matching, smoking and nonsmoking groups were compared using an unpaired t test for continuous variables or a χ test for categorical variables.

Results: There were 182 (31%) current smokers and 405 (69%) nonsmokers including previous smokers. After matching, 158 patients were extracted from each group. Demographic data and surgical information were almost the same between the groups. Regarding postoperative complications, there was no significant difference in the rate of surgical site infection, cerebrospinal fluid leakage, hematoma, segmental motor paralysis, or neurological deficit. However, smokers showed a significantly higher risk for delirium (3.8% vs. 0.0%, P=0.039). Smokers and nonsmokers showed comparable changes in functional recovery according to Japanese Orthopedic Association scores (3.2±2.1 vs. 3.0±2.1, P=0.425) and in neck pain reduction using the Visual Analog Scale (-1.7±3.1 vs. -1.4±2.8, P=0.417) at the final follow-up.

Conclusions: Smokers exhibited functional restoration and neck pain reduction after cervical posterior decompression. Attention is required, however, for the postoperative complication of delirium, which could be caused by the acute cessation of tobacco smoking after admission.

Level Of Evidence: Level III.
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http://dx.doi.org/10.1097/BSD.0000000000000984DOI Listing
December 2020

Limited Cost Benefit of Lateral Interbody Fusion for Adult Spinal Deformity Surgery.

Spine (Phila Pa 1976) 2021 Jan;46(1):48-53

Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

Study Design: Retrospective case series.

Objective: The aim of this study was to compare the utility and cost-effectiveness of multilevel lateral interbody fusion (LIF) combined with posterior spinal fusion (PSF) (L group) and conventional PSF (with transforaminal lumbar interbody fusion) (P group) in adult spinal deformity (ASD) surgery.

Summary Of Background Data: The clinical and radiographic outcomes of multilevel LIF for ASD have been reported favorable; however, the cost benefit of LIF in conjunction with PSF is still controversial.

Methods: Retrospective comparisons of 88 surgically treated ASD patients with minimum 2-year follow-up from a multicenter database (L group [n = 39] and P group [n = 49]) were performed. Demographic and radiographic data, health-related quality of life (HRQoL), and the direct hospitalization cost for the initial surgery and 2-year total hospitalization cost were analyzed.

Results: Analyses of sagittal spinal alignment showed no significant difference between the two groups at baseline and 2 years post-operation. Surgical time was longer in the L group (L vs. P: 354 vs. 268 minutes, P < 0.01), whereas the amount of blood loss was greater in the P group (494 vs. 678 mL, P = 0.03). The HRQoL was improved similarly at 2 years post-operation (L vs. P: SRS-22 total score, 3.86 vs. 3.80, P = 0.54), with comparable revision rates (L vs. P: 18% vs. 10%, P = 0.29). The total direct cost of index surgery was significantly higher in the L group (65,937 vs. 49,849 USD, P < 0.01), which was mainly due to the operating room cost, including implant cost (54,466 vs. 41,328 USD, P < 0.01). In addition, the 2-year total hospitalization cost, including revision surgery, was also significantly higher in the L group (70,847 vs. 52,560 USD, P < 0.01).

Conclusion: LIF with PSF is a similarly effective surgery for ASD when compared with conventional PSF. However, due to the significantly higher cost, additional studies on the cost-effectiveness of LIF in different ASD patient cohorts are warranted.

Level Of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000003703DOI Listing
January 2021

sp. nov., a plant growth-promoting bacterium isolated from yam ( species).

Int J Syst Evol Microbiol 2020 Sep 17;70(9):5054-5062. Epub 2020 Aug 17.

Laboratory of Tropical Crop Science, Department of International Agricultural Development, Faculty of International Agriculture and Food Studies, Tokyo University of Agriculture, Tokyo, Japan.

This study investigated endophytic nitrogen-fixing bacteria isolated from two species of yam (water yam, L.; lesser yam, L.) grown in nutrient-poor alkaline soil conditions on Miyako Island, Okinawa, Japan. Two bacterial strains of the genus , S-93 and S-62, were isolated. The phylogenetic tree, based on the almost-complete 16S rRNA gene sequences (1476 bp for each strain), placed them in a distinct clade, with CCBAU 41251, I66, HAMBI 2975, PRF 81 and CIAT 899 being their closest species. Their bacterial fatty acid profile, with major components of C cyclo 8 and summed feature 8, as well as other phenotypic characteristics and DNA G+C content (59.65 mol%) indicated that the novel strains belong to the genus . Pairwise average nucleotide identity analyses separated the novel strains from their most closely related species with similarity values of 90.5, 88.9, 88.5, 84.5 and 84.4 % for HAMBI 2975, CIAT 899, CCBAU 57015, HAMBI 2971 and PRF 81, respectively; digital DNA-DNA hybridization values were in the range of 26-42 %. Considering the phenotypic characteristics as well as the genomic data, it is suggested that strains S-93 and S-62 represent a new species, for which the name is proposed. The type strain is S-93 (=NRIC 0988=NBRC 114257=DSM 110498).
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http://dx.doi.org/10.1099/ijsem.0.004381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656272PMC
September 2020
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