研究等業績 - 原著論文 - 宮腰　尚久

Intradural extramedullary tumor in the stenotic cervical spine resected through open-door laminoplasty with hydroxyapatite spacers: Report of two cases

Miyakoshi N.

BMC Surgery ( BMC Surgery )  18 ( 1 ) 38   2018年06月

研究論文（学術雑誌）  

Background: Safe excision of spinal cord tumors depends on sufficient visualization of the tumor and surrounding structures. In patients with spinal cord tumor adjacent to a stenotic spinal canal, extensive bony decompression proximal and distal to the tumor should be considered for safer excision of the tumor. Extensive wide laminectomy is one choice for such cases, but postoperative problems such as kyphotic deformity remain a concern. Case presentation: A 76-year-old man and a 60-year-old woman presented with symptomatic intradural extramedullary spinal cord tumors in the cervical spine. Both patients showed a combination of spondylotic changes in the cervical spine and stenotic condition at the level of the tumor. Both tumors were successfully resected through open-door laminoplasty with hydroxyapatite (HA) spacers, with the tumor located on the side of the laminoplasty. Histological diagnosis was schwannoma for both tumors. HA spacers completely bonded to the host bone and did not interfere with postoperative magnetic resonance imaging (MRI) of the inside of the spinal canal. Cervical spine alignment was maintained at the final follow-up of 6 years in both cases. Conclusion: Laminoplasty with HA spacers enabled successful tumor extirpation, reliable MRI follow-up after surgery, and maintenance of normal cervical spine alignment. Laminoplasty with HA spacers represents a good option for the treatment of cervical spinal cord tumor in patients combined with spinal stenosis.

DOI PubMed

Limaprost or Pregabalin: Preoperative and Postoperative Medication for Pain due to Lumbar Spinal Stenosis

Kasukawa Y.

Pain Practice ( Pain Practice )  18 ( 5 ) 625 - 630   2018年06月

研究論文（学術雑誌）  

Purpose: We aimed to evaluate the incidence of (and risk factors for) postoperative pregabalin and/or limaprost to treat persistent numbness and/or pain of the lower extremities after lumbar spinal stenosis (LSS) surgery. Methods: Medical records of 329 patients (168 men, 161 women
average age 70 years) were retrospectively reviewed for data on the duration of LSS diagnosis
LSS disease
preoperative medication (limaprost, pregabalin, or combined limaprost/pregabalin
duration)
symptoms
preoperative/postoperative intermittent claudication (IC)
operation type
and postoperative medication and period. Results: Limaprost, pregabalin, and combined limaprost/pregabalin were prescribed preoperatively for 43%, 7%, and 5% of patients, respectively. At an average of 21 months postoperatively, limaprost, pregabalin, and combined therapy were prescribed in 11%, 8%, 4% of patients, respectively. Medication requirement was significantly lower postoperatively than preoperatively (P &lt
 0.0001). Significant risk factors for required postoperative medication were required preoperative medication (odds ratio [OR] 3.088, 95% confidence interval [CI] 1.679 to 5.681]
postoperative period (OR 1.063, 95% CI 1.031 to 1.096)
and postoperative IC (OR 3.868, 95% CI 1.481 to 10.103). A negative impact from postoperative medication was seen in patients who had undergone decompression surgery (OR 0.589, 95% CI 0.377 to 0.918). Conclusions: Overall, 23% of LSS patients required medication for pain and/or numbness at 21 months postoperatively. Significant factors portending required postoperative medication were preoperative medication, longer postoperative period, and postoperative IC. A negative influence from postoperative medication was seen in patients who had undergone decompression surgery without fusion.

DOI PubMed

Reconstruction of a chronically ruptured Achilles tendon using an internal brace: A case report

Chida S.

Journal of Medical Case Reports ( Journal of Medical Case Reports )  12 ( 1 ) 54   2018年03月

研究論文（学術雑誌）  

Background: We reconstructed a chronically ruptured Achilles tendon and the associated scar tissue using braided polyblend polyethylene sutures (FiberWire
Arthrex Inc.
Naples, FL, USA) and anchors. Case presentation: A 68-year-old Japanese man, who was being treated for right Achilles tendinosis, felt pain in his Achilles tendon when walking and started to find plantar flexion of his ankle joint difficult. As his symptoms persisted, he visited us after 4 weeks. Surgery and orthotic therapy were recommended, but he did not want to undergo these treatments. However, he began to find walking difficult and so underwent surgery 6 months after suffering the injury. The interior of the tendon was curetted, and the ruptured region was subjected to plication using the surrounding scar tissue. Using the percutaneous Achilles repair system (Arthrex Inc.), FiberWire sutures were inserted, and two skin incisions were made on the medial and lateral sides of his calcaneus in the region surrounding the Achilles tendon attachment. SutureLasso (Arthrex Inc.) was passed through, and the proximal FiberWire suture was relayed and fixed with 4.75-mm SwiveLock (Arthrex Inc.). After surgery, his foot was fixed in plaster at 20° plantar flexion of his ankle joint. The plaster was removed 1 week after surgery, and after-treatment was initiated with active dorsiflexion training. No orthosis was used after surgery. As of 16 postoperative months, no re-rupture had occurred. Conclusions: This method might allow post-treatment rehabilitation, and so on, to occur earlier, and, hence, could become an option for the reconstruction of chronically ruptured Achilles tendons.

DOI PubMed

Relationship between clinical results of total hip replacement and postoperative activities including weeding and snow shovelling

Kijima H.

HIP International ( HIP International )  28 ( 2 ) 145 - 147   2018年03月

研究論文（学術雑誌）  

DOI PubMed

Repeated Low Back Pain Caused by Regional Migratory Osteoporosis of the Sacroiliac Joint.

Unoki E, Miyakoshi N, Shimada Y

Journal of orthopaedic case reports   8 ( 2 ) 54 - 56   2018年03月

研究論文（学術雑誌）  

DOI PubMed

特集 創外固定でなければできない治療 脆弱性骨折における創外固定の有用性

野坂 光司, 宮腰 尚久, 齊藤 英知, 木島 泰明, 土江 博幸, 島田 洋一

整形・災害外科 ( 金原出版 )  61 ( 2 ) 191 - 198   2018年02月

研究論文（学術雑誌）  

DOI CiNii Research

特集 すべてわかる　足・足関節外科で用いられる最新デバイスカタログ 足・足関節に対するリング型創外固定器の各種比較

野坂 光司, 宮腰 尚久, 齊藤 英知, 木島 泰明, 土江 博幸, 斉藤 公男, 柴田 暢介, 島田 洋一

関節外科 ( (株)メジカルビュー社 )  37 ( 1 ) 97 - 106   2018年01月

研究論文（学術雑誌）  

DOI CiNii Research

経験と考察 脳性麻痺児における足部変形の成因と治療に関する検討

河野 哲也, 坂本 仁, 三澤 晶子, 石原 芳人, 遠藤 博之, 宮腰 尚久, 島田 洋一

整形外科 ( 南江堂 )  69 ( 1 ) 17 - 21   2018年01月

研究論文（学術雑誌）  

DOI CiNii Research

Ahlbäck分類4-5の内側型変形性膝関節症に対する膝周囲骨切り術とtotal knee arthroplastyの短期臨床成績の比較

齊藤 英知, 斉藤 公男, 島田 洋一, 赤川 学, 塚本 泰朗, 宮腰 尚久

東日本整形災害外科学会雑誌 ( 東日本整形災害外科学会 )  30 ( 2 ) 155 - 163   2018年

研究論文（学術雑誌）  

<p>生理的関節面傾斜を再獲得できるdouble level osteotomy（DLO）や沈下した脛骨内側プラトー（MTP）を矯正する脛骨顆外反骨切り術（TCVO）により，進行した内側型変形性膝関節症（膝OA）でも生理的関節面傾斜を再獲得できる．本研究の目的は，Ahlbäck分類4-5の膝OAに対する膝周囲骨切り術（around the knee osteotomy, AKO）とTotal Knee Arthroplasty（TKA）の観察期間22.4ヵ月における短期臨床成績を比較すること．対象は36膝で，AKO群（14膝）とTKA（22膝）の臨床スコアを比較した．new knee society scoreでは，活動性と応用動作でAKO群が，Knee Injury and Osteoarthritis Outcome Score（KOOS）の痛みで，TKA群で有意に高値であった．</p>

DOI

Analgesic effects of minodronate in a rat chronic pain model

Kasukawa Y.

Biomedical Research (Japan) ( Biomedical Research (Japan) )  39 ( 5 ) 261 - 268   2018年

研究論文（学術雑誌）  

<p>We evaluated the analgesic effects of minodronate, alendronate and pregabalin on mechanical and thermal allodynia, as well as changes in bone mineral density and skeletal muscle volume caused by chronic constriction injury (CCI) in an ovariectomized rat. Ovariectomy was performed on four-week-old female Wistar rats. Thereafter, at 8-weeks of age, the left sciatic nerve was ligated to create the chronic pain model (CCI limb), and sham surgery was performed on the right hindlimb. In all rats, either minodronate (0.15 mg/kg/week), alendronate (0.15 mg/kg/week), pregabalin (10 mg/kg/week), or their vehicle was administered for 2 weeks starting on the 0th day of CCI. Behavioral evaluations, with von Frey testing and the hot plate test, were performed on days 0, 7 and 14. After 2 weeks, bilateral femurs and tibialis anterior muscles were harvested for bone mineral density and cross sectional area measurements, respectively. Two weeks treatment with minodronate significantly improved mechanical and thermal allodynia evaluated by the von Frey and hot plate tests in the CCI limb (<i>P</i> < 0.05). Minodronate and alendronate treatment for 2 weeks significantly increased total femoral bone mineral density in the CCI limb compared with pregabalin or vehicle treatment (<i>P</i> < 0.01). Cross sectional area of the CCI limb in the minodronate group was significantly larger than that of the alendronate group (<i>P</i> < 0.05) and pregabalin group (<i>P</i> < 0.05). Two-week treatment with minodronate, but not alendronate or pregabalin, improved mechanical and thermal allodynia caused by CCI in ovariectomized rats.</p>

DOI PubMed

AORAレジストリーにおける関節リウマチに対するトシリズマブ治療の効果不十分による脱落症例の検討

浦山 雅和, 阿部 秀一, 加茂 啓志, 杉村 祐介, 宮腰 尚久, 島田 洋一, 秋田整形外科リウマチグループ（AORA）, 青沼 宏, 柏倉 剛, 伊藤 博紀, 小林 志, 櫻場 乾, 谷 貴行, 相澤 俊朗, 河野 哲也

臨床リウマチ ( 一般社団法人 日本臨床リウマチ学会 )  30 ( 2 ) 114 - 119   2018年

研究論文（学術雑誌）  

<p>目的：秋田整形外科リウマチグループ（Akita Orthopedic group on Rheumatoid Arthritis: AORA）レジストリーにおける，関節リウマチ（rheumatoid arthritis, RA）に対するトシリズマブ（tocilizumab, TCZ）治療の効果不十分による脱落症例を調査し，本薬剤の有用な使用の可能性を検討する．対象・方法：TCZ使用累積症例177例，ナイーブ群（N群）95例，スイッチ群（S群）82例を対象とした．患者背景，脱落までの使用期間，脱落後の治療，疾患活動性を後ろ向きに調査した．結果：効果不十分による脱落症例は12例（７%）であった．平均58歳（44～82歳）で，罹病期間は平均120ヵ月（６～366ヵ月）であった．N群が４例，S群が８例で，全てTNF (tumor necrosis factor)阻害薬からのスイッチであった．TCZ使用開始から脱落までの期間は平均30ヵ月（６～67ヵ月）であった．脱落後に他の生物学的製剤にスイッチした症例は10例で，TNF阻害薬が２例，abatacept（ABT）が８例であった．最終調査時，S群かつABTにスイッチした３例がさらにTNF阻害薬にスイッチした．CDAIは，使用開始時が平均±標準偏差20.3±13.4で，脱落時は12.4±8.1であり，６例は低疾患活動性を達成した．最終調査時は9.5±8.4で，８例は低疾患活動性を達成した．結論：効果不十分による脱落症例は，TNF阻害薬からのスイッチ症例が多かった.脱落後のスイッチは，TNF阻害薬，ABTともに有用であった．総合的な効果不十分の判断により，TCZの有用な使用継続の可能性がある．</p>

DOI

Comparison of Atypical and Osteoporotic Femoral Shaft Fractures in the Elderly: A Multicenter Study

Miura T.

Advances in Orthopedics ( Advances in Orthopedics )  2018   1068053   2018年

研究論文（学術雑誌）  

Background. In atypical femoral fractures, owing to the high rates of complications and delayed healing that accompany the plate fixation, the most favorable treatment is intramedullary nailing. Although there is insufficient evidence, plate fixation is chosen due to anterolateral bowing of the femur. This study compared the bone healing time and rates of complications in atypical femoral shaft fractures and osteoporotic femoral shaft fractures. Methods. We searched the medical records of 3 institutions in Japan for patients with femoral shaft fractures who visited between 1 January 2010 and 31 December 2015. We identified 65 patients and excluded 37 among these due to high-energy injuries or being younger than 65 years. Among the remaining patients, we identified 17 and 11 women with atypical (AFF group) and osteoporotic femoral shaft fractures (OP group), respectively. Results. In surgical method, there were differences in intramedullary nailing (94.1% versus 27.2%) (p &lt
0.01). The mean bone healing time was 11.1 months versus 6.7 months in 2 groups (p &lt
0.01). Iatrogenic femoral fractures during intramedullary nail insertion were observed in both groups, and reoperation was only seen in atypical femoral fractures treated with a plate fixation, but there was no difference in the rate of complications (23.5% versus 9.1%). Conclusions. In the atypical femoral fracture group, intramedullary nailing was more chosen, but the bone healing time was delayed and plate fixation cases needed reoperation. There was no significant difference in the rate of complications between the 2 groups.

DOI PubMed

Development of a Rehabilitation Robot Combined with Functional Electrical Stimulation Controlled by Non-disabled Lower Extremity in Hemiplegic Gait

Kimura Ryota, Shimada Yoichi, Matsunaga Toshiki, Iwami Takehiro, Kudo Daisuke, Saitoh Kimio, Hatakeyama Kazutoshi, Watanabe Motoyuki, Takahashi Yusuke, Miyakoshi Naohisa

Progress in Rehabilitation Medicine ( 公益社団法人 日本リハビリテーション医学会 )  3 ( 0 )   2018年

研究論文（学術雑誌）  

<p><b>Objective:</b> We developed a rehabilitation robot to assist hemiplegics with gait exercises. The robot was combined with functional electrical stimulation (FES) of the affected side and was controlled by a real-time-feedback system that attempted to replicate the lower extremity movements of the non-affected limb on the affected side. We measured the reproducibility of the non-affected limb movements on the affected side using FES in non-disabled individuals and evaluated the smoothness of the resulting motion. <b>Method:</b> Ten healthy men participated in this study. The left side was defined as the non-affected side. The measured hip and knee joint angles of the non-affected side were reproduced on the pseudo-paralytic side using the robot's motors. The right quadriceps was stimulated with FES. Joint angles were measured with a motion capture system. We assessed the reproducibility of the amplitude from the maximum angle of flexion to extension during the walking cycle. The smoothness of the motion was evaluated using the angular jerk cost (AJC). <b>Results:</b> The amplitude reproduction (%) was 87.9 ± 6.2 (mean ± standard deviation) and 71.5 ± 10.7 for the hip and knee joints, respectively. The walking cycle reproduction rate was 99.9 ± 0.1 and 99.8 ± 0.2 for the hip and knee joints, respectively. There were no statistically significant differences between results with FES versus those without FES. The AJC of the robot side was significantly smaller than that of the non-affected side. <b>Conclusions:</b> A master–slave gait rehabilitation system has not previously been attempted in hemiplegic patients. Our rehabilitation robot showed high reproducibility of motion on the affected side.</p>

DOI

hybrid closed wedge high tibial osteotomyのアプローチ法による前脛骨筋に対する侵襲性の検討

赤川 学, 齊藤 英知, 斉藤 公男, 佐々木 香奈, 宮腰 尚久, 島田 洋一

東日本整形災害外科学会雑誌 ( 東日本整形災害外科学会 )  30 ( 1 ) 86 - 88   2018年

研究論文（学術雑誌）  

<p>hybrid CWHTOの2つのアプローチ法（Open法，MIS法）による手術侵襲の違いを検討した．結果，Open法に比較してMIS法で有意に術後CK，CRPが高い結果だった．これらは手術侵入時の前脛骨筋の損傷を反映していると考えられた．hybrid CWHTO施行時は前脛骨筋損傷に留意する必要があると考えられる．</p>

DOI

MRI所見からみた若年性変形性膝関節症の特徴

赤川 学, 齊藤 英知, 斉藤 公男, 塚本 泰朗, 木島 泰明, 宮腰 尚久, 島田 洋一, 佐々木 香奈

東北膝関節研究会会誌 ( 東北膝関節研究会 )  27 ( 0 ) 17 - 22   2018年

研究論文（学術雑誌）  

DOI

mRNA expressions of peroxisome proliferator-activated receptor gamma coactivator 1α, tumor necrosis factor-α, and interleukin-6 in paraspinal muscles of patients with lumbar kyphosis: A preliminary study

Kudo D.

Clinical Interventions in Aging ( Clinical Interventions in Aging )  13   1633 - 1638   2018年

研究論文（学術雑誌）  

DOI PubMed

Pyogenic Spondylitis Caused by Methicillin-Resistant <i>Staphylococcus aureus</i> Associated with Tracheostomy followed by Resection of Ossification of the Anterior Longitudinal Ligament.

Hongo M, Miyakoshi N, Fujii M, Kasukawa Y, Ishikawa Y, Kudo D, Shimada Y

Case reports in orthopedics   2018   9076509   2018年

研究論文（学術雑誌）  

DOI PubMed

Utilizing a Cortical Bone Trajectory Pedicle Screw for Lumbar Flexion-Distraction Injury.

Miyakoshi N, Maekawa S, Urayama M, Shimada Y

Case reports in orthopedics   2018   8185051   2018年

研究論文（学術雑誌）  

DOI PubMed

前十字靱帯損傷膝における変形性膝関節症発症の危険因子の検討

佐々木 香奈, 島田 洋一, 片岡 洋一, 齊藤 英知, 高橋 靖博, 塚本 泰朗, 赤川 学, 藤井 昌, 斉藤 公男, 木島 泰明, 宮腰 尚久

東北膝関節研究会会誌 ( 東北膝関節研究会 )  27 ( 0 ) 23 - 27   2018年

研究論文（学術雑誌）  

DOI

変形性膝関節症におけるbone marrow lesionsと骨強度パラメーターとの関連

藤井 昌, 木島 泰明, 齊藤 英知, 野坂 光司, 宮腰 尚久, 島田 洋一

東日本整形災害外科学会雑誌 ( 東日本整形災害外科学会 )  30 ( 1 ) 52 - 56   2018年

研究論文（学術雑誌）  

<p>変形性膝関節症（膝OA）におけるbone marrow lesions（BMLs）と骨強度パラメーターとの関連を検討した．BMLsを有する群で進行関節症の割合，DPD，Penが有意に高く，多変量解析では，KL分類 grade Ⅲ以上のOAと Pen高値がBMLs発生のリスク因子であることがわかった．骨切り術などの外科治療に加え，骨代謝に焦点を当てたテーラーメイドの薬物治療を併用することは，関節温存のための新たな治療戦略になりうると考えられた．</p>

DOI