Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Review Comparative Study
State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy.
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). ⋯ It was called the percutaneous endoscopic lumbar foraminoplasty (PELF). More recently, this technique was applied to decompress the lateral recess stenosis, and the technique was named percutaneous endoscopic ventral facetectomy (PEVF). In this review article, we explain in detail the development of the surgical technique of with time with showing our typical cases.
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Review Meta Analysis
Effectiveness of various hip preservation treatments for non-traumatic osteonecrosis of the femoral head: A network meta-analysis of randomized controlled trials.
Non-traumatic osteonecrosis of the femoral head (ONFH) is a refractory osteonecrosis disease caused by an abnormal blood supply to bone tissue. However, therapeutic hip preservation strategies are diverse, and the therapeutic outcomes are not ideal. ⋯ CD plus cytotherapy is a relatively superior treatment for reducing treatment failure rates in early and intermediate ONFH patients, and ESWT is the most effective treatment for improving Harris hip scores.
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Multicenter Study
Treatment status and radiographic features of patients with atypical femoral fractures.
The Japanese Orthopaedic Association (JOA) has been surveying approximately 3000 orthopedic surgery hospitals and clinics with inpatient facilities nationwide to collect information on atypical femoral fractures (AFFs) and patient characteristics since 2010. The present study aims to examine radiographic images and clarify the relationship between radiographic and patient characteristics of patients with AFF and treatment status. ⋯ Radiographic beaking was observed more frequently in patients treated with BPs than in patients not treated with BPs.
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Comparative Study
Efficacy of intraoperative lumbar subarachnoid drainage for prevention of cerebrospinal fluid leak after spinal cord tumor resection.
Postoperative cerebrospinal fluid (CSF) leakage is a major clinical problem, and prevention of CSF leakage at the surgical site is an important issue. The goal of the study was to evaluate the efficacy of intraoperative lumbar subarachnoid drainage (LSAD) for prevention of CSF leakage after spinal cord tumor resection. ⋯ Lumbar subarachnoid CSF drainage was associated with a significant decrease in postoperative CRP. In cases in which artificial dura mater was used and in surgery for a cervical lesion, drainage was useful to prevent subcutaneous CSF accumulation.
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Spine injury epidemiology in Japan has not been studied since the 1990s when its incidence was 39.4-40.2 per million and the major cause of injury was motor vehicle crashes. We elucidate the current epidemiological state of spinal injury and spinal injury patients in Japan for the clinicians and public health prevention programs. ⋯ The number of spine injuries has increased in the JTDB between 2004 and 2013. Motor vehicle crashes have been replaced by falls due to various causes as the leading cause of spine injury. Suicides and industrial accidents are becoming a burden. More studies are needed to verify the actual incidence.