研究等業績 - 原著論文 - 宮腰　尚久

Cervical arachnoid cyst mimicking the cause of cervical radiculopathy: A case report

Kobayashi T.

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management ( Interdisciplinary Neurosurgery: Advanced Techniques and Case Management )  10   37 - 39   2017年12月

研究論文（学術雑誌）  

DOI

Relationship between preoperative serum rapid turnover proteins and early-stage surgical wound infection after spine surgery

Kudo D.

European Spine Journal ( European Spine Journal )  26 ( 12 ) 3156 - 3161   2017年12月

研究論文（学術雑誌）  

Malnutrition is one of the important risk factors for postoperative complications. Transferrin, prealbumin, and retinol-binding protein, so-called rapid turnover proteins (RTPs), may be the better indicators for early detection of nutritional deficits. However, few studies have described the impact of serum RTP levels on postoperative surgical site infection (SSI) in spine surgery. The purpose of this study was to investigate the relationship between preoperative serum RTPs and postoperative SSI.
The data of 105 patients (64 male, 41 female; average age 64.4 years; age range 20-88 years) who underwent spine surgery in a single institution between 2014 and 2015 were retrospectively analyzed. Preoperative total lymphocyte count, serum albumin, transferrin, prealbumin, retinol-binding protein, pre-and postopeartive C-reactive protein (CRP), white blood cell count (WBC), and total lymphocyte count were evaluated. Postoperative CRP, WBC, and total lymphocyte count were repeated two or three times/week until hospital discharge. A broad spectrum penicillin or second generation cephalosporin was administered as a prophylactic antibiotic to each patient. When repeated CRP elevation or lymphopenia (no more than 10% or 1000/mu L) after postoperative day 3 or 4 was observed, possible SSI was diagnosed. Variables between possible SSI group and non-SSI group were compared using Mann-Whitney U or Chi square test. All variables on univariate analysis were included in multiple logistic regression analysis to identify risk factors for possible postoperative SSI.
Thirty-five patients were diagnosed with possible SSI. The mean operative time of possible SSI group was significantly longer (p = 0.036), preoperative total lymphocyte count and serum prealbumin level of possible SSI group were significantly lower (p = 0.002, p = 0.048, respectively) than that of non-SSI group. On univariate analysis, operative time (p = 0.012), preoperative total lymphocyte count (p = 0.041), serum albumin level (p = 0.038), and serum prealbumin level (p = 0.044) were significant contributors to possible SSI, and multiple logistic regression analysis revealed that operative time was the significant contributor to possible SSI (odds ratio 1.008, 95% confidence interval (CI) 1.001-1.015, p = 0.024).
A low prealbumin level is a possible risk factor for early-stage SSI in spine surgery, though it was not statistically significant; operative time was the most important indicator of SSI on multivariate analysis.

DOI PubMed

Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers

Miyakoshi N.

Osteoporosis International ( Osteoporosis International )  28 ( 11 ) 3153 - 3160   2017年11月

研究論文（学術雑誌）  

DOI

経験と考察 鎖骨骨折手術に対する第4頚椎神経根ブロックの有用性

木村 竜太, 宮腰 尚久, 石河 紀之, 湯本 聡, 岩本 陽輔, 島田 洋一

整形外科 ( 南江堂 )  68 ( 12 ) 1251 - 1254   2017年11月

研究論文（学術雑誌）  

DOI CiNii Research

Perioperative medical complications after posterior approach spinal instrumentation surgery for osteoporotic vertebral collapse: A comparative study in patients with primary osteoporosis and those with secondary osteoporosis

Miyakoshi N.

Asian Spine Journal ( Asian Spine Journal )  11 ( 5 ) 756 - 762   2017年10月

研究論文（学術雑誌）  

Study Design: A retrospective comparative study. Purpose: To compare perioperative medical complications after posterior approach spinal instrumentation surgery for osteoporotic vertebral collapse (OVC) between patients with primary osteoporosis and those with secondary osteoporosis. Overview of Literature: With increased aging of society, the demand for instrumentation surgery for an osteoporotic spine has been increasing. However, no studies have compared the rates or severities of perioperative complications after spinal instrumentation surgery between patients with primary osteoporosis and those with secondary osteoporosis. Methods: Ninety-one patients with OVC aged =50 years (23 males and 68 females) who underwent posterior approach vertebral replacement with cages or posterior spinal fusion combined with vertebroplasty were divided into primary (n=56) and secondary (n=35) osteoporosis groups. Bone mineral density (BMD), osteoporosis treatment prior to OVC, operative invasiveness, and perioperative medical complications were compared. Results: Diabetes mellitus (51.4%) was the most common cause of secondary osteoporosis, followed by glucocorticoid use (22.9%). No significant differences were seen in terms of age, gender, BMD, osteoporosis treatment, or operative invasiveness, including the number of levels fused, estimated blood loss, and number of patients requiring transfusion. No significant difference in the incidence of perioperative complications were observed between the primary and secondary osteoporosis groups (16.1% vs. 22.9%). However, surgical site infection (SSI) was significantly more frequently seen in the secondary osteoporosis group (11.4%) than in the primary osteoporosis group (1.8%
p &lt
0.05). One patient in the secondary osteoporosis group developed methicillin-resistant Staphylococcus aureus infection that ultimately required instrument removal. Conclusions: The overall incidence of perioperative medical complications after posterior approach spinal instrumentation surgery for OVC was comparable between the primary and secondary osteoporosis groups under conditions of similar background characteristics and operative invasiveness. However, SSI (particularly more severe cases) occurred more frequently in patients with secondary osteoporosis.

DOI PubMed

特集 高齢者(75歳以上)の運動器変性疾患に対する治療 脊椎の変性疾患に対する高齢者治療　胸腰仙椎変性疾患　変形性腰椎症・腰部脊柱管狭窄症　80歳以上の高齢者に対する脊椎固定術

石川 慶紀, 宮腰 尚久, 島田 洋一

別冊整形外科 ( (株)南江堂 )  1 ( 72 ) 97 - 99   2017年10月

研究論文（学術雑誌）  

DOI CiNii Research

特集 高齢者脊椎疾患の診断・治療の最近の進歩 骨粗鬆症性　骨粗鬆症と腰背部痛・脊柱変形・サルコペニア

宮腰 尚久

関節外科 ( (株)メジカルビュー社 )  36 ( 14 ) 90 - 97   2017年10月

研究論文（学術雑誌）  

DOI CiNii Research

Evaluation of sagittal spine-pelvis-lower limb alignment in elderly women with pelvic retroversion while standing and walking using a three-dimensional musculoskeletal modelw

Sasaki K.

Asian Spine Journal ( Asian Spine Journal )  11 ( 4 ) 562 - 569   2017年08月

研究論文（学術雑誌）  

Study Design: In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. Purpose: To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. Overview of Literature: Patients with hip-spine syndrome have concurrent hip-joint and spine diseases. However, the dynamic sagittal alignment between the hip joint and spine has rarely been investigated. We used a 3D musculoskeletal model to evaluate global spinopelvic parameters, including spinal inclination and pelvic tilt (PT). Methods: A total of 32 ambulant females (mean age=78 years) without assistance were enrolled in the study. On the basis of the radiographic measurement for PT, participants were divided into the pelvic retroversion group (R-group
PT=20°) and the normal group (N-group
PT &lt
20°). A 3D musculoskeletal motion analysis system was used to analyze the calculated value for the alignment of spine, pelvis, and lower limb, including calculated (C)-PT, sagittal vertical axis (C-SVA), pelvic incidence, lumbar lordosis, T1 pelvic angle (CTPA), as well as knee and hip flexion angles while standing and walking. Results: While standing, C-PT and C-TPA in the R-group were significantly larger than those in the N-group. Hip angle was significantly smaller in the R-group than in the N-group, unlike knee angle, which did not show difference. While walking, C-SVA and C-TPA were significantly increased, whereas C-PT decreased compared with those while standing. The maximum hip-flexion angle was significantly smaller in the R-group than in the N-group. There was a significant correlation between the radiographic and calculated parameters. Conclusions: The 3D musculoskeletal model was useful in evaluating the sagittal alignment of the spine, pelvis, and leg. Spinopelvic sagittal alignment showed deterioration while walking. C-PT was significantly decreased while walking in the R-group, indicating possible compensatory mechanisms attempting to increase coverage of the femoral head. The reduction in the hip flexion angle in the R-group was also considered as a compensatory mechanism.

DOI PubMed

誌上シンポジウム 創外固定でどこまでできるか? リング型創外固定による外傷治療

野坂 光司, 宮腰 尚久, 山田 晋, 齊藤 英知, 木島 泰明, 土江 博幸, 斉藤 公男, 島田 洋一

臨床整形外科 ( 株式会社医学書院 )  52 ( 8 ) 713 - 717   2017年08月

研究論文（学術雑誌）  

DOI CiNii Research

Comparison of the efficacy of denosumab and bisphosphonates for treating secondary osteoporosis in patients with rheumatoid arthritis

Kinoshita H.

Modern Rheumatology ( Modern Rheumatology )  27 ( 4 ) 582 - 586   2017年07月

研究論文（学術雑誌）  

Objectives: This study aimed to investigate the efficacy of denosumab (compared with that of bisphosphonates) for preventing secondary osteoporosis and inflammation caused by excessive bone resorption in Japanese rheumatoid arthritis (RA) patients never previously treated for osteoporosis.
Methods: Ninety-eight patients with coexisting RA and osteoporosis were enrolled. The patients were subdivided by whether they were treated with denosumab (n=49) or traditional bisphosphonates (n=49). RA disease activity, bone turnover markers, and bone mineral density (BMD) were compared between the two groups before treatment, and after 6 and 12 months of treatment.
Results: There was no significant difference between the groups in any of the disease activity indices and BMD at any of the measured time points. With regard to bone metabolism, denosumab significantly reduced bone-specific alkaline phosphatase at 6 and 12 months compared with pretreatment, but had no effect on tartrate-resistant acid phosphatase 5b levels, suggesting an effect on the bone formation rate, but not on the bone resorption rate.
Conclusions: Neither denosumab nor bisphosphonates could suppress inflammation or RA disease activity, but denosumab significantly suppressed a marker of bone metabolism in Japanese RA patients never previously treated for osteoporosis.

DOI PubMed

Distant metastasis in patients with myxofibrosarcoma

Tsuchie H.

Upsala Journal of Medical Sciences ( Upsala Journal of Medical Sciences )  122 ( 3 ) 190 - 193   2017年07月

研究論文（学術雑誌）  

Purpose: A clinical feature of myxofibrosarcoma is local recurrence, but knowledge about distant metastasis is sparse. We evaluated the tendency of clinical and histological features of metastasis in myxofibrosarcoma patients.
Methods: Fifty-eight patients with myxofibrosarcoma were treated in our hospitals, and a total of 16 consecutive patients with distant metastases were included in this retrospective study (9 males and 7 females, with a mean age of 77 years). Because there was no patient complicated by both lung and lymph node metastases, we compared the age, sex, tumor size and location, French Federation of Cancer Centers Sarcoma Group (FNCLCC) grade, American Joint Committee on Cancer (AJCC) stage, and times of the first metastasis from the initial examination between the lung and lymph node groups. In addition, we examined factors affecting the prognosis.
Results: The median follow-up period was 42.9 months (range 8-142). Eleven of 16 patients developed pulmonary metastases. The sites of extra pulmonary metastases were the lymph nodes in 5 patients, bone in 1, subcutaneous in 1, intramuscular in 1, and peritoneum in 1. The median time for patients to develop distant metastases was 17.4 months (range 0-59). The time until the onset of the first metastasis in the lung metastasis group was significantly shorter than in the lymph node group (p < 0.05). Also, the survival rate in the lymph node metastasis group was better than in the lung metastasis group (p < 0.05).
Conclusions: Not only lung metastasis but also lymph node metastasis occurs frequently in myxofibrosarcoma patients. Myxofibrosarcoma with lung metastasis is more aggressive than the type with lymph node metastasis.

DOI PubMed

特集 非定型大腿骨骨折の病態と治療 非定型大腿骨骨折の危険因子としての大腿骨弯曲変形の要因

土江 博幸, 宮腰 尚久, 島田 洋一

整形・災害外科 ( 金原出版 )  60 ( 8 ) 965 - 972   2017年07月

研究論文（学術雑誌）  

DOI CiNii Research

特集 老化と生体恒常性 Therapy ロコモティブシンドロームに対する予防・治療

宮腰尚久

CLINICAL CALCIUM ( 医薬ジャーナル社 )  27 ( 7 ) 105 - 112   2017年06月

研究論文（学術雑誌）  

DOI CiNii Research

理解を助けるトレーニング問題(本号特集「老化と生体恒常性」関連) ロコモティブシンドロームに関して

宮腰尚久

CLINICAL CALCIUM ( 医薬ジャーナル社 )  27 ( 7 ) 116 - 116   2017年06月

研究論文（学術雑誌）  

DOI CiNii Research

Enhanced bone healing and decreased pain in sacral insufficiency fractures after teriparatide treatment: retrospective clinical-based observational study.

Kasukawa Y, Miyakoshi N, Ebina T, Hongo M, Ishikawa Y, Kudo D, Nozaka K, Shimada Y

Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases   14 ( 2 ) 140 - 145   2017年05月

研究論文（学術雑誌）  

DOI PubMed

特集 医工連携による新たな整形外科治療 脊椎モデルシミュレーションの臨床応用

島田 洋一, 佐々木 研, 巖見 武裕, 本郷 道生, 宮腰 尚久

関節外科 ( (株)メジカルビュー社 )  36 ( 5 ) 534 - 540   2017年05月

研究論文（学術雑誌）  

DOI CiNii Research

特集 高齢者の脊柱変形Up to Date 第2章　治療 高齢者脊柱変形に対する保存療法-胸腰椎部・骨盤:運動療法

本郷 道生, 宮腰 尚久, 島田 洋一

脊椎脊髄ジャーナル ( 三輪書店 )  30 ( 4 ) 339 - 344   2017年04月

研究論文（学術雑誌）  

DOI CiNii Research

骨粗鬆症マネジメントupdate 骨粗鬆症の治療　外科治療

宮腰 尚久

腎と骨代謝 ( 日本メディカルセンター )  30 ( 2 ) 115 - 121   2017年04月

研究論文（学術雑誌）  

DOI CiNii Research

Relationships among spinal mobility and sagittal alignment of spine and lower extremity to quality of life and risk of falls

Ishikawa Y.

Gait and Posture ( Gait and Posture )  53   98 - 103   2017年03月

研究論文（学術雑誌）  

Spinal deformities can affect quality of life (QOL) and risk of falling, but no studies have explored the relationships of spinal mobility and sagittal alignment of spine and the lower extremities simultaneously. Purpose of this study is to clarify the relationship of those postural parameters to QOL and risk of falling. The study evaluated 110 subjects (41 men, 69 women; mean age, 73 years). Upright and flexion and extension angles for thoracic kyphosis, lumbar lordosis, and spinal inclination were evaluated with SpinalMouse. Total-body inclination and hip and knee flexion angles in upright position were measured from lateral photographs. Subjects were divided into Fallers (n= 23, 21%) and Non-fallers (n= 87, 79%) based on past history of falls. QOL was assessed using the Short Form 36 Health Survey (SF-36). Age, total-body inclination, spinal inclination upright and in extension, thoracic kyphosis in flexion, lumbar lordosis upright and in extension, and knee flexion correlated significantly with the SF-36. Multiple regression analysis revealed total-body inclination and knee flexion to have the most significant relationships with the SF-36. SF-36, total-body inclination, spinal inclination in extension, thoracic kyphosis in flexion, lumbar lordosis upright and in extension, and hip and knee flexion angles differed significantly between Fallers and Non-fallers (P<0.05 for all). Multivariate logistic regression analyses revealed lumbar lordosis in extension to be a significant predictor of falling (P= 0.038). Forward-stooped posture and knee-flexion deformity could be important indicator of lower QOL. Moreover, limited extension in the lumbar spine could be a useful screening examination for fall prevention in the elderly. (C) 2017 Elsevier B.V. All rights reserved.

DOI PubMed

連載 注目の海外文献(60) １.椎体楔状変形の病因:２段階の経過によって生じるのか? ２.女性におけるBMIの違いによる椎体強度と推定骨折リスク ３.有痛性の急性期骨粗鬆性椎体骨折に対する椎体形成術の効果と安全性:多施設共同ランダム化二重盲検プラセボ対照試験

宮腰尚久

CLINICAL CALCIUM ( 医薬ジャーナル社 )  27 ( 4 ) 108 - 110   2017年03月

研究論文（学術雑誌）  

DOI CiNii Research