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Faculty of Medicine College Hospital Orthopedics department |
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Assistant Professor |
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Related SDGs |
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NAGAI Takuya
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Papers 【 display / non-display 】
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Risk Of Skull Perforation With Halo Vest Skull Pins
Hamanaka Hideaki, Tajima Takuya, Kurogi Syuji, Higa Kiyoshi, Nagai Takuya, Takahashi Takumi, Matsumoto Takayuki, Chosa Etsuo
Spine Surgery and Related Research advpub ( 0 ) 2024
Language：English Publishing type：Research paper (scientific journal) Publisher：一般社団法人 日本脊椎脊髄病学会
<b>Background</b>: A halo vest is an immobilization device widely used to stabilize the cervical spine. Pain and infection at the skull pin insertion site are common complications, but skull perforation is rare, and most published studies are case reports. This study aimed to identify risk factors for skull perforation by comparing patients who did and did not develop perforation.<b>Methods</b>: Overall thickness and the thicknesses of the internal and external laminae of the skull at the skull pin insertion sites were measured on cranial computed tomography scans of 66 patients fitted with a halo vest. The results were compared between patients who did and did not develop perforation.<b>Results</b>: Four patients developed perforations. All patients with perforation were older women, and their external and internal laminae were significantly thinner than those of patients who did not develop perforation.<b>Conclusion</b>: The reported causes of skull pin perforation include infection around the pin, osteoporosis, and an enlarged frontal sinus. However, most patients with perforation in the present study were older women, and the cause was the thinning of the external and external laminae.
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Tmem161a regulates bone formation and bone strength through the P38 MAPK pathway
Nagai T., Sekimoto T., Kurogi S., Ohta T., Miyazaki S., Yamaguchi Y., Tajima T., Chosa E., Imasaka M., Yoshinobu K., Araki K., Araki M., Choijookhuu N., Sato K., Hishikawa Y., Funamoto T.
Scientific Reports 13 ( 1 ) 14639 2023.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Scientific Reports
Bone remodeling is an extraordinarily complex process involving a variety of factors, such as genetic, metabolic, and environmental components. Although genetic factors play a particularly important role, many have not been identified. In this study, we investigated the role of transmembrane 161a (Tmem161a) in bone structure and function using wild-type (WT) and Tmem161a-depleted (Tmem161aGT/GT) mice. Mice femurs were examined by histological, morphological, and bone strength analyses. Osteoblast differentiation and mineral deposition were examined in Tmem161a-overexpressed, -knockdown and -knockout MC3T3-e1 cells. In WT mice, Tmem161a was expressed in osteoblasts of femurs; however, it was depleted in Tmem161aGT/GT mice. Cortical bone mineral density, thickness, and bone strength were significantly increased in Tmem161aGT/GT mice femurs. In MC3T3-e1 cells, decreased expression of alkaline phosphatase (ALP) and Osterix were found in Tmem161a overexpression, and these findings were reversed in Tmem161a-knockdown or -knockout cells. Microarray and western blot analyses revealed upregulation of the P38 MAPK pathway in Tmem161a-knockout cells, which referred as stress-activated protein kinases. ALP and flow cytometry analyses revealed that Tmem161a-knockout cells were resistant to oxidative stress. In summary, Tmem161a is an important regulator of P38 MAPK signaling, and depletion of Tmem161a induces thicker and stronger bones in mice.
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Kuroki H., Nagai T.
Journal of Medical Case Reports 17 ( 1 ) 82 2023.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Medical Case Reports
Background: A nerve root anomaly, typified by a conjoined nerve root, is a rare finding. Conjoined nerve root anomalies are easily missed even in preoperative advanced imaging modalities, which can be potentially troublesome during and after surgery. In this report, we present a case of conjoined right L5–S1 nerve root in a patient with lumbar disc herniation, accompanied by spina bifida occulta, which was undiagnosed on preoperative imaging studies. Case report: A 55-year-old Asian (Japanese) woman presented with low back pain and right leg radiating pain due to lumbar disc herniation at the right L5/S1. Physical examination revealed a positive Lasègue sign and the range of the straight leg raising test was 20° on the right side. The right patellar tendon reflex was normal; however, the right ankle jerk reflex disappeared. Although no obvious hypoesthesia was noted, mild muscle weakness (4/5) was observed in the right leg on the manual muscle test. We planned the lumbar discectomy under a microscope. During surgery, the conjoined right L5–S1 nerve root, which was compressed by herniated nucleus pulposus, was encountered. Although it was very thick and less mobile, some pieces of herniated nucleus pulposus could be removed piece by piece from the axillary part. After sequential decompressive procedures, the tightness of the conjoined right L5–S1 nerve root decreased but its mobility did not improve much. The laterality of the thickness and exit angle of the conjoined right L5–S1 nerve root was retrospectively confirmed on T2 coronal magnetic resonance images and magnetic resonance neurography. Postoperatively, right leg pain was immediately alleviated and complete improvement of muscle weakness was achieved 1 week later (5/5). Conclusions: Magnetic resonance neurography is extremely useful for the accurate diagnosis of anomalous nerve roots because of clear visualization of the neural tissue. Discectomy under a microscope, which enables magnified three-dimensional observation of the surgical field, must provide a valid and safe procedure to achieve not only secure resection of herniated discs but also adequate exposure of anomalous nerve roots.
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頚部傍脊椎領域原発悪性リンパ腫に対し椎弓形成術を施行した小児の1例
飯田 暁人, 濱中 秀昭, 黒木 修司, 比嘉 聖, 永井 琢哉, 黒木 智文, 日髙 三貴, 帖佐 悦男
整形外科と災害外科 72 ( 4 ) 735 - 738 2023.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】非常に稀な小児頚部傍脊椎領域原発悪性リンパ腫に対し，椎弓形成術を施行した症例を報告する．【症例】12歳，男児．1か月前より頚部痛あり，徐々に上肢麻痺（MMT3），巧緻運動障害が出現し紹介となった．MRIでC3-6の椎体から椎弓にかけての腫瘍性病変と脊髄腫大を認めた．受診翌日にC3-6の椎弓形成を行い，前駆B細胞性リンパ芽球性リンパ腫と診断された．小児科にて化学療法施行後，C3-6に対し陽子線を18 Gy照射した．現在術後4年で麻痺なく，寛解を維持している．最終観察時C2-7角は11度であった．陽子線照射にもかかわらず，脂肪髄化した椎体がリモデリングし，椎体高も1椎体平均4.15 mm成長した．【考察】小児に対する頚椎椎弓形成術や陽子線治療後の椎体成長に関する報告は少ない．小児腫瘍は予後が改善してきており，骨成長や変形に対しても長期に経過観察する必要がある．
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鮫島 央, 濱中 秀昭, 黒木 修司, 比嘉 聖, 永井 琢哉, 黒木 智文, 日髙 三貴, 帖佐 悦男
整形外科と災害外科 72 ( 4 ) 749 - 753 2023.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
症例は85歳，男性．近医にて腰部脊柱管狭窄症，腰椎辷り症に対しL4/5の腰椎前外側椎体間固定術（以下，OLIF）を施行された．術直後に発熱と腰痛が出現し，画像検査にてインストゥルメント周囲感染と診断され，後方からの洗浄デブリードマンや固定延長を行うも感染コントロール不良なために術後6か月で当科紹介となった．当科にてケージ抜去・前方掻爬自家骨移植術・後方固定術を施行した．その後，起炎菌は同定できなかったが長期の抗生剤内服を併用したことで感染は沈静化し疼痛も消失しADLも改善した．脊椎インストゥルメンテーション手術後の感染の治療は感染制御と脊椎安定性の維持の2つの柱のバランスを踏まえて行う必要がある．しかし，エビデンスに基づいた治療が確立されていないのが現状である．脊椎インストゥルメント周囲感染について最近の知見を踏まえ当院での治療方針に関して検討したので報告する．
MISC 【 display / non-display 】
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上肢 Roos test Invited
永井琢哉、帖佐悦男
関節外科 38 ( 9 ) 104 - 105 2019.9
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：メディカルビュー
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脊椎-胸椎 腹皮反射 Invited
永井琢哉、帖佐悦男
関節外科 37 ( 5 ) 110 - 111 2018.5
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media) Publisher：メディカルビュー
Presentations 【 display / non-display 】
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Col2A1異常に関連した胸椎後側弯症の1例
永井琢哉、黒木修司、比嘉聖、高橋巧、松本尊行、帖佐悦男
第39回九州小児整形外科集談会 2024.1.13
Event date： 2024.1.13
Presentation type：Oral presentation (general)
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思春期特発性側弯症手術において術前ＣＴは術中の回旋の指標となるか？
永井琢哉、比嘉聖、黒木智文、高橋巧、帖佐悦男
第57回日本側弯症学会学術集会 2023.11.11
Event date： 2023.11.10 - 2023.11.11
Presentation type：Oral presentation (general)
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Lumber modifier BまたはC胸椎特発性側弯症に対する選択的胸椎固定術におけるLIV -サブタイプ別の解析-
森平泰、高田知史、山田勝崇、内野洋介、野尻英俊、志村有永、村上裕介、明田浩司、片柳順也、友利正樹、都島幹人、中村英一郎、永井琢哉、大谷和之、種市洋
第57回日本側弯症学会学術集会 2023.11.11
Event date： 2023.11.10 - 2023.11.11
Presentation type：Oral presentation (general)
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胸腰椎ダブルカーブを有する特発性側弯症に対する術式の検討-後方単独と前後合併の比較-
高田知史、森平泰、山田勝崇、内野洋介、野尻英俊、志村有永、村上裕介、明田浩司、片柳順也、友利正樹、都島幹人、中村英一郎、永井琢哉、大谷和之、種市洋
第57回日本側弯症学会学術集会 2023.11.10
Event date： 2023.11.10 - 2023.11.11
Presentation type：Oral presentation (general)
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Coplanar法におけるロッドの直径や材質による治療成績の検討
村上裕介、森野忠夫、森平泰、高田知史、山田勝崇、内野洋介、野尻英俊、志村有永、明田浩司、片柳順也、友利正樹、都島幹人、中村英一郎、永井琢哉、大谷和之
第57回日本側弯症学会学術集会 2023.11.10
Event date： 2023.11.10 - 2023.11.11
Presentation type：Oral presentation (general)