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Biomedical subjects

K Satomi

Publications and source records attributed to K Satomi.

46 records · Page 3Linked to original sources
PubMed1979

Spinal osteotomy to correct kyphosis in spinal tuberculosis.

Twenty-seven patients with severe tuberculous kyphosis have been treated at the National Murayama Hospital between 1966 and 1977. We have undertaken curettage of the foci and vertebral osteotomy through an anterior approach, followed by gradual correction with a halo pelvic distraction apparatus and subsequent vertebral fusion. Choice of this method depends upon the age of the patient, the degree of kyphosis before correction, and the presence of concomitant lesions. Details of postoperative management are given and their importance is emphasized. The major risks of correction are discussed and precautions suggested.

Adolescent↗
PubMed1979

[Spinal electrogram evoked by peripheral nerve stimulation in man (author's transl)].

Summated evoked responses to peroneal and tibial nerve stimulation were recorded from surface electrodes placed over the lumbar and thoracic spine of twenty normal adults. The responses consisted of triphasic potentials (mainly negative) which progressively increased in latency at more rostal recording sites. These responses were thought to have a common origin with those recorded from the spinal epidural space. The conduction velocity of the responses to peroneal nerve stimulation was 48.5 m/sec from the lower to the upper thoracic recording site. In twenty patients with spinal cord lesions, responses caudal to the lesion were similar to those recorded in normal adults except six patients with cauda lesion. Six completely paralysed patients were examined soon after injuries, and two were noted to have evoked spinal responses above the lesion, followed by returning of the function in the lower extrimities. These suggest that this method is of prognostic value for predicting recovery of neurologic function after injuries.

Adult↗
PubMedDate not supplied

Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy.

BACKGROUND CONTEXT: Laminoplasty has been reported to achieve good operative results for treatment of cervical stenotic myelopathy. However, long-term results and prognostic factors have not been well documented. Among postoperative complications, weakness of the shoulder girdle muscles has been reported as a particular complication of laminoplasty, but the cause is still poorly understood. PURPOSE: Our aim was to clarify the short-term complications and long-term operative results after unilateral open-door laminoplasty and to identify the predictors for operative outcome. STUDY DESIGN: We retrospectively reviewed short-term complications and long-term operative results associated with cervical stenotic myelopathy treated by unilateral open-door laminoplasty. PATIENT SAMPLE: There were 162 men and 42 women with an average age of 57 years who were treated by unilateral open-door laminoplasty in the two institutions. Pathogenesis of myelopathy was cervical spondylosis in 88 patients, cervical disk herniation with a narrow spinal canal in 10, and ossification of the posterior longitudinal ligament in 106. OUTCOME MEASURES: Postoperative complications and their outcomes were examined clinically in 204 patients, and causes of motor paresis were sought with postoperative computed tomography after myelography. Postoperative improvement of clinical symptoms was assessed by recovery rate calculated with the scores of the Japanese Orthopaedic Scoring System in 80 patients. METHODS: The occurrence rate of short-term postoperative complications, causes of motor paresis, and their outcomes were reviewed in 204 patients. Clinical condition was assessed with the Japanese Orthopaedic Scoring System, recovery rate was calculated with the score, and prognostic factors for outcome were studied in 80 patients who were followed up for 5 years or longer (average, 8 years; range, 5-17 years). RESULTS: Occurrence rate of complications, such as muscle weakness, deep infection, closure of opened laminae, and others, was 10.8%. Muscle weakness was observed in 7.8% of the patients. However, this rate decreased in recent years. The cause of motor paresis is not known with certainty, but it may be secondary to operative trauma, posterior shift of the spinal cord, or to displacement of the lamina in the hinge side. Recovery rate of clinical symptoms was 62.1% at the final follow-up. Rates were 63.6% for cervical spondylosis, 87.1% for cervical disk herniation, and 61.3% for ossification of the posterior longitudinal ligament. There was no significant difference between pathologies. Patient age younger than 60 years at the time of operation and less than 1 year's duration of symptoms before surgery were significantly associated with recovery rate of clinical symptoms. Recovery rate was not correlated with either preoperative function judged by the Japanese Orthopaedic Association score or spinal sagittal diameter. CONCLUSIONS: The main cause of postoperative motor paresis of upper extremities is thought to be operative trauma, resulting from such procedures as air-drill and Kerrison rongeur handling. Short-term complications may decrease with the use of nontraumatic procedures. Better operative outcomes may be achieved with careful operative procedures and early operative treatment in the patients with myelopathy.

Adolescent↗
PubMedDate not supplied

Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament.

Although the pathogenesis of ossification of the cervical posterior longitudinal ligament (OPLL) has not yet been clarified, it has come to be widely recognized that severe cervical myelopathy or radiculopathy is caused by OPLL. Fifty-three cases who were operated on for OPLL with myelopathy or radiculopathy in our clinic over the past 16 years were followed up. A recovery rate of approximately 70% was observed. Postoperative progressions of the ossification were observed among 75% of the cases of continuous and mixed type but seldom among those with segmental and other types. As causative factors for these postoperative progressions of the ossification, the authors would like to advocate biological, structural, and mobility-related elements. We concluded that in the ossified stage it is desirable to apply anterior decompression for the segmental and other type, posterior decompression for the continuous and mixed type, and, if necessary, two-stage combined decompression for the mixed type.

Adult↗