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Biomedical subjects

T Fuji

Publications and source records attributed to T Fuji.

At least 19 recordsLinked to original sources
PubMed1998

Intradural spinal hibernoma: case report.

BACKGROUND: Hibernoma is a rare, benign tumor arising from vestigial remnants of brown adipose tissue. It usually affects muscle and subcutaneous tissue and is asymptomatic and slow growing. METHODS: A review of the worldwide literature contains about 110 cases of hibernomas. However, only two cases (including our case) of hibernoma located in the intradural spine have been reported. We present an extremely rare case of intradural extramedullary spinal hibernoma and summarize the magnetic resonance imaging (MRI) findings of the lesion. CASE DESCRIPTION: A 35-year-old woman suffered from motor weakness and numbness of the left upper extremity. Cervical spinal MRI revealed an intradural extramedullary mass at C7. She underwent surgery via the posterior approach and the lesion was completely removed. Histopathologic examination showed multivacuolated cells with centrally placed nuclei, and the diagnosis of hibernoma was made. CONCLUSIONS: Because the CT and MRI findings of hibernoma are almost same as those of other lipomatous tumors, a surgical specimen of this tumor is necessary to establish the correct diagnosis. Early diagnosis and total resection are necessary as some cases showed malignant features or rapid growth. Etiologically, the tumor may have developed by the ectopic growth or migration of adipose tissue.

Adult↗
PubMed1998

Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament.

OBJECT: This retrospective study was performed to assess the long-term results of cervical laminectomy in treating ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. METHODS: The authors reviewed medical records in 44 of 52 patients who underwent cervical laminectomy between 1970 and 1985 (mean follow up 14.1 years). The neurological recovery rate after laminectomy was 44.2% after 1 year and 42.9% after 5 years. The surgical outcome was maintained after 5 years but worsened between 5 and 10 years postsurgery: the recovery rate at the last follow-up review was 32.8%. Using multivariate stepwise analysis, the preoperative factors that affected clinical results were found to be the age at operation, the severity of preexisting myelopathy, and a history of trauma. Late neurological deterioration was observed in 10 (23%) of 44 patients. The earliest deterioration occurred at 1 year and the latest was at 17 years postsurgery (mean 9.5 years). The most frequent cause of deterioration was trauma due to a fall (six patients), followed by ossification of the ligamentum flavum (three patients). Postoperative spread of the OPLL was noted in 70% of the patients, but it was clearly the cause of neurological deterioration in only one of them. After laminectomy, postoperative progression of kyphotic deformity was observed in 47% of patients, but these changes did not cause neurological deterioration. CONCLUSION: The authors recommend early surgical decompression for OPLL because the outcome is better for younger patients and for those with a higher score as measured by the Japanese Orthopedic Association's system.

Accidental Falls↗
PubMed1997

Ectopic bone formation after total hip arthroplasty.

Two hundred and forty consecutive Japanese patients with 280 primary total hip arthroplasties (THA) were analyzed to clarify the incidence of ectopic bone formation and its predisposing factors and to examine its effect on the clinical results. Ectopic bone formation after THA was found in 61 joints (22%). The predisposing factors were male patients and a hypertrophic type of osteoarthritis. It was revealed that extensive ectopic bone formation, class 3 according to Brooker's classification, restricted flexion and abduction motion of the hip joint.

Adult↗
PubMed1996

Sclerosis of lytic metastatic bone lesions during treatment with pamidronate in a patient with adenocarcinoma of unknown primary site.

Pamidronate disodium is a second-generation biphosphonate, a group of compounds that are being used increasingly to inhibit bone resorption in disorders that are characterized by excessive bone loss such, as hypercalcemia of malignancy, osteoporosis, and Paget's disease. The precise mechanisms whereby bisphosphonates inhibit bone resorption are still not completely understood. Pamidronate has previously been reported to induce sclerosis of lytic bone metastases in patients with breast cancer. We have had a similar experience in a patient with multiple bone metastases due to adenocarcinoma of unknown primary site who developed massive consolidation of lytic bone lesions after therapeutic infusions of pamidronate, leading to a satisfactory quality of life.

Adenocarcinoma↗
PubMed1996

Cervical ventral epithelial cyst treated by anterior corpectomy--case report.

A 15-year-old boy presented with a cervical ventral epithelial cyst manifesting as intractable cervical pain. Neurological examination revealed weakness of his left grasp and increased deep tendon reflexes. The anterior approach was selected because the lesion was located directly ventral to the spinal cord. He underwent C4-5 anterior corpectomy and subtotal resection of the cyst wall. He made a good recovery without additional deficits. Most previously reported cases have been treated using the posterior approach despite the ventral location of the lesion. The anterior approach offers a safer and more effective means of treating such lesions because it allows direct access to the lesion without manipulation of the spinal cord.

Adolescent↗
PubMed1995

Vertebral body replacement with a ceramic prosthesis for metastatic spinal tumors.

STUDY DESIGN: This study retrospectively analyzed the clinical outcome of vertebral replacement surgery with our unique ceramic prosthesis for spinal metastases. OBJECTIVES: To indicate the results of vertebral replacement surgery with a ceramic prosthesis. SUMMARY OF BACKGROUND DATA: Spinal metastasis often involves the vertebral bodies, of which abnormal fracture causes intractable pain and paresis. For such conditions, laminectomy or irradiation can have no effect because they do not improve spinal stability. Autogenous bone or bone cement are not durable materials, and fatigue fracture of the implanted material occasionally occurs. We developed a simple prosthesis made of alumina ceramic, a bioinert material, to replace the affected vertebrae. There has not been such a large study to assess vertebral replacement surgery with a ceramic prosthesis. METHODS: From 1972 to 1993, 90 ceramic prostheses were used in 84 patients with spinal metastasis, and the average follow-up period was 26.2 months. The primary tumor was thyroid cancer in 13 patients, breast cancer in 12, multiple myeloma in eight, renal cell cancer in eight, gastrointestinal cancer in eight, and lung cancer in eight. The clinical symptoms were assessed before and after surgery, and the maintenance of operative gain was investigated. RESULTS: Pain relief was achieved in 94%, motor function improved in 81%, and ambulation recovered in 64%. There were no serious complications associated with the procedure, and the operative benefit was maintained until the terminal stage in the vast majority of patients. CONCLUSIONS: In selected patients, vertebral replacement using our prosthesis proved to be a useful procedure, effectively managing the severe spinal pain or neurologic deficits associated with vertebral body destruction.

Adolescent↗
PubMed1995

Clinical application of computed radiography in orthopedic surgery.

Since 1988, Fuji Computed Radiography (FCR) system (Fuji Medical Systems, Tokyo, Japan) has been used at Osaka Prefectural Hospital (Osaka, Japan) for all kinds of images. In this paper, we discuss the advantages and disadvantages of computed radiography (CR) images from the standpoint of an orthopedic surgeon. Contours, which can not be seen on conventional radiographs, are clearly visualized on the CR image. Adequate information for diagnosis can be obtained with a great reduction in x-ray exposure during the screening of scoliosis or congenital dislocation of hip joint. However, because the scale is reduced by one half in antero-posterior views of the bilateral hip joint, CR images are unsuitable for postoperative measurement of total hip arthroplasty (THA). Furthermore, caution is required because the clear zone after THA is emphasized on edge-enhanced CR image.

Absorptiometry, Photon↗
PubMed1995

Orthopaedic management of spinal metastases.

Spinal metastases result in severe spinal pain, neurologic deficits, or both. These symptoms usually are caused by spinal instability, in which conservative therapy can have no effect, and surgical treatment is required to restabilize the destroyed spinal segments. Surgical indications are instability of the spine, pain and/or paresis resistant to radiation therapy, acute progressing paresis, and unknown histologic diagnosis. There are 2 surgical approaches for vertebral metastases: prosthetic replacement and posterior stabilization. Single or 2 consecutive diseased vertebrae should be treated with replacement surgery. In this series, excellent surgical outcome was attained with this procedure, and surgical benefit was maintained until the terminal stage of each patient. Multiple vertebral metastases are treated with posterior stabilization using various instrumentation systems that provide rigid stabilization. To choose the most appropriate procedure for each patient, the local condition of the lesion and general status of the patient, including prediction of life expectancy, should be evaluated fully. Spinal metastases develop early and are not terminal events. Therefore, not only palliative treatment but also surgical intervention should be considered for spinal metastases when indicated.

Humans↗
PubMed1994

Bone mineral assessment by dual-energy X-ray absorptiometry in patients with coxarthrosis.

Forty patients with unilateral osteoarthritis of the hip were studied with dual energy X-ray absorptiometry to quantify disuse osteopenia in their affected leg by examining the proximal femur and tibia. Bone loss was assessed as a percentage of the contralateral value which compares bone mineral density of the affected and normal sides. The percentage contralateral value in the femoral neck and Ward's triangle was 113% and 118% respectively, while that in the tibia was 75%. Bone loss in the proximal tibia of the affected leg could be of value in assessing gait since it correlates with the gait parameters on the hip rating scale. By contrast, bone mineral increase in the proximal femur and correlates only with the degree of valgus deformity of the femoral neck.

Absorptiometry, Photon↗
PubMed1993

Extradural spinal angiolipoma: report of a case studied with MRI.

The current report describes a case of extradural angiolipoma with spinal cord compression that was studied by magnetic resonance imaging. In considering the strategy for the surgical management, it is desirable to determine the histologic type of spinal cord tumors before the operation. The literature of spinal angiolipoma is reviewed, and the possibility of using magnetic resonance imaging to define the histologic type of spinal cord tumors before operation is discussed.

Dura Mater↗
PubMed1991

Reconstruction of the skull base using a silicone plate during transsphenoidal surgery.

Our operative experience of reconstruction of the skull base using a silicone plate during rhinoseptoplastic transsphenoidal surgery is described. A suitably shaped plate can be easily and quickly made from a large silicone block of the type that is widely used in cosmetic surgery. The plates can be distinguished on magnetic resonance images postoperatively. We consider that this technique is of use not only for repairing the sellar floor, but also for closing a wide defect of the skull base.

Adolescent↗
PubMed1991

Esophagocutaneous fistula after anterior cervical spine surgery and successful treatment using a sternocleidomastoid muscle flap. A case report.

An esophagocutaneous fistula following anterior cervical fusion is rare. A 61-year-old man had cervical myelopathy because of ossification of the posterior longitudinal ligament of the cervical spine. Anterior decompression of the cervical spine and anterior fusion with strut bone grafting were performed. A second anterior fusion was done because the graft was dislodged after the patient fell out of bed one month after surgery. An esophagocutaneous fistula occurred three months after the second anterior surgery. One of the causes of this esophagocutaneous fistula was considered to be a pressure necrosis of the esophagus because of to projection of the bone graft. Conservative treatment, which consisted of wound drainage and intravenous administration of antibiotics, was tried but was unsuccessful. A good result was achieved by cancellous bone grafting, closure of the esophageal fistula, and transposition of a sternocleidomastoid muscle flap to the interspace between the esophagus and the cervical spine.

Cervical Vertebrae↗
PubMed1990

Unilateral VATER association.

We describe a case of unilateral "VATER association." In addition to the VATER manifestations, the patient had hemihypoplasia, unilateral congenital paralysis of a leg, and delayed ossification of the femoral head and carpal bones. All of the manifestations involved the left side of the body. The only drug exposure identified was a Chinese herbal medicine taken by the mother during early pregnancy.

Abnormalities, Multiple↗