| 1. |
Tarukado Kiyoshi, Balloon Kyphoplasty -How will preoperative instability be?, THE COMBINED MEETING OF
THE 23rd SPINE SOCIETY OF HCM CITY, VIET NAM THE 8TH KHANH HOA INTERNATIONAL SPINE MEETING THE 7TH SSHV OPERATIVE SPINE COURSE, 2017.03. |
| 2. |
Tarukado Kiyoshi, Balloon Kyphoplasty for the patients with osteoporotic vertebral body fracture, Myanmar Othopaedic Society 48th Annual General Meeting and Annual Scientific Meeting, 2016.11. |
| 3. |
Tarukado Kiyoshi, Do modic change progress as aging?, 37th SICOT Orthopaedic World Congress, 2016.09. |
| 4. |
樽角 清志, Do Modic changes progress as aging?, SPINE WEEK 2016, 2016.05. |
| 5. |
樽角 清志, Does Balloon Kyphoplasty induce the bone union of osteoporotic vertebral compression fractures?, EANS2015 Annual meeting, 2015.10. |
| 6. |
Tarukado Kiyoshi, Toshio Doi, Osamu Tono, Does Balloon Kyphoplasty induce the bone union of osteoporotic vertebral compression fractures?, APOA/RCOST2014, 2014.10, [Background]
Many past literatures reported about the safety and efficacy of Balloon Kyphoplasty (BKP) for vertebral compression fractures (VCF). However, it was not discussed about the bone union in spite of the treatment of the fractures.
[Objectives]
To investigate whether the bone union of the osteoporotic vertebral body treated by BKP is accomplished or not.
[Materials & Methods]
Thirty-nine vertebrae that were followed up more than one year after BKP were recruited. The mean age at surgery was 82 years old. The average duration from the onset of pain to surgery was 6 months.
Image findings assessment was performed by lateral X-ray films both sitting and supine position. Bone union was defined as the disappearance of the instability in the treated vertebral body itself or the treated vertebral body including adjacent vertebrae. The presence of backache before BKP and at final follow-up was evaluated using visual analog scale (VAS). Differences in the mean VAS scores of the accomplishing bone union group (UG) and not accomplishing bone union group (NUG) were analyzed using the t-test. The mean follow-up period was 17 months.
[Results]
Sixteen vertebrae (41%) have accomplished bone union at final follow-up. No significant differences were observed in the VAS scores between UG and NUG.
[Conclusions]
BKP was effective to reduce the VAS score in patients suffered from back pain due to osteoporotic VCF. However, bone union was not accomplished in more than half cases of treated cases by BKP.
. |
| 7. |
Tarukado Kiyoshi, Toshio Doi, Osamu Tono, C2 instrumentation with the strongest fixation power for spinal stabilization, The 21th International Meeting on Advanced Spine Techniques, 2014.07, Several methods have been used to stabilize the cervical spine including the use of C2 pedicle, intralaminar, transarticular screws. In past literatures, biomechanical comparisons of C2 pedicle screws with C2 intralaminar screws were reported. The stabilization technique using C2 intralaminar screws offered similar biomechanical stability to C2 pedicle screws excepting lateral bending. However, fixation methods with both C2 pedicle and intralaminar screws at a time were not reported until now.
Three cases were undergone cervical spine fixation and occipitocervical fixation with C2 pedicle and intralaminar screws at a time.
Case1 was vertical subluxation with rheumatoid arthritis, Case2 was reoperation with cerebral palsy, Case3 was drop head syndrome with severe osteoporosis. Case1 and 2 were undergone occipitocervical fixation, Case3 was undergone cervical spine fixation. Using C2 intralaminar screws technique is a good option because of the reduction of the risk to the vertebral artery injury during C2 screws replacement. If the patient is young with solid bone, intralaminar screw is suitable to consider safety. However, stronger anchors may be required when fusion surgery in patients with osteoporosis or rheumatoid arthritis. Theoretically, fixation with both C2 pedicle and intralaminar screws at a time can get the strongest fixed power. If the patients have a breakable bone by many different conditions, using both C2 pedicle and intralaminar screws at a time might be one of the good choices.
. |
| 8. |
Tarukado Kiyoshi, Toshio Doi, Osamu Tono, Association between a pain and instabilities of the vertebrae immediately after Balloon Kyphoplasty, 15th EFORT Comgress, 2014.06, [Introduction]
The mechanism underlying the pain relief observed following balloon kyphopasty (BKP) to vertebral compression fractures is reported to involve stabilization of the fractured vertebrae. We reported that instabilities of the vertebrae remain after BKP. However, association between a pain and instabilities of the vertebrae after BKP has not been confirmed.
[Objectives]
The purpose of this study is to assess the association between a pain and instabilities of the vertebra immediately after BKP.
[Methods]
Between April 2011 and August 2013, 68 BKP were performed to the unhealed VCF in Kyushu University Beppu Hospital and Karatsu Red Cross Hospital. Fifty-seven of 68 vertebrae (13men and 44women) were recruited which had been evaluated by lateral roentgenkymography or kinematic CT within one week after BKP. The mean age at the surgery was 80 years old. BKP was performed at the T7-10 in 3, T11-L2 in 46 and L3-5 in 8 vertebrae. The average period to the surgery from the time pain occurred was 7 months.
Instabilities were defined using lateral X-ray films in both sitting and supine position or kinematic CT by the following ways. First, the gap was observed between the cement and endplate of the vertebrae in supine position. Second, a posterior wall of the vertebra was reduced in sitting position. Third, the gap was observed in kinematic CT. Instabilities were estimated by 3 orthopaedic surgeons using the kinematic image findings, only consents of all views were judged as having instabilities. Low back pain was evaluated by visual analog scale (VAS). Patients were divided into group with instability (IG) and group with stability (SG) according to the judgment by kinematic image findings. Differences in the mean VAS scores, the mean amount of cement, correction angle and disease duration were analyzed respectively using the t-test between the IG and SG.
[Results]
Instabilities of the vertebrae at early postoperative period after BKP were seen in 32 (57%) vertebrae. There was no significant differences in the mean VAS scores, the mean amount of cement, correction angle and disease duration respectively.
[Conclusions]
Past literature reported intravertebral instability at the site of clefts could disappear after injection of the cement. However, these treated vertebrae were assessed by only lateral standing X-ray films in the literature. As a result of evaluation by kinematic image findings, there were many vertebrae with instability immediately after BKP than we expected. The VAS scores were improved in all cases regardless of the presence of instability.
The VAS scores were rapidly relieved after BKP; however instabilities might be persistent at early postoperative period after BKP. Therefore, the mechanism of pain relief after BKP is not only stabilization but also other things. It was thought that a further study was needed for the mechanism elucidation of pain relief by BKP.
. |
