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- 저자 : Gamada Hisanori (검색결과 3 건)
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Gamada Hisanori,Tatsumura Masaki,Okuwaki Shun,Yamazaki Masashi 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
Study Design: Retrospective cohort study.Purpose: To evaluate the clinical outcomes of the conservative treatment of “pre-lysis”-stage lumbar spondylolysis.Overview of Literature: With the widespread use of magnetic resonance imaging (MRI) for early diagnosis of lumbar spondylolysis, a new disease stage called pre-lysis has emerged, in which intensity change is observed only on MRI without a fracture line on computed tomography. This study aimed to evaluate the clinical outcomes and factors unfavorable to bone healing of the conservative treatment of pre-lysis-stage lumbar spondylolysis.Methods: Fifty-three patients with 57 fresh pre-lysis-stage lesions who had completed conservative treatment were included in the study (40 men, 13 women; mean age, 14.3 years). We investigated the rate of bone healing and the relationship between bone healing after conservative therapy and factors such as age, sex, vertebral level, unilateral/bilateral lesions, and presence of spina bifida occulta.Results: The overall bone healing rate was 95% (54/57 lesions). Bilateral lesions had a significantly lower bone healing rate than unilateral lesions (86% vs. 100%, p=0.046). There were no statistically significant differences based on age, sex, vertebral level, or presence of spina bifida occulta.Conclusions: The bone healing rate in unilateral lesions was 100%, which was significantly higher than that in bilateral lesions. It is important to detect and initiate treatment while the lesion is still unilateral, if possible.
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Eto Fumihiko,Tatsumura Masaki,Gamada Hisanori,Okuwaki Shun,Koda Masao,Yamazaki Masashi 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.6
Study Design: Retrospective cohort study. Purpose: To examine bone healing with conservative treatment in cases of adolescent bilateral L5 spondylolysis. Overview of Literature: We classified bilateral L5 spondylolysis, which is the most affected spinal level, by fracture stage and aimed to compare the bone healing rate according to the fracture stage and evaluate the presence of a preexisting contralateral terminal fracture at the diagnosis of fresh spondylolysis. Methods: We evaluated 48 patients (38 boys and 10 girls) with bilateral L5 spondylolysis diagnosed during or before high school. L5 spondylolysis was classified into two groups: fresh group (bilateral fresh spondylolysis cases), and terminal group (cases wherein one side had fresh spondylolysis and the contralateral side had terminal spondylolysis). We investigated the age of examination and bone healing rate in both groups. We investigated progressive-stage lesions and bone healing rate with or without progressive-stage lesions. Results: The bone healing rate in the fresh group was significantly higher than that in the terminal group 72.0% vs. 26.1%, p=0.003). In both the groups, the bone healing rate was significantly higher in patients without progressive-stage lesions than in those with progressive-stage lesions. Conclusions: Bone healing of progressive-stage fresh spondylolysis was not achieved by conservative treatment when contralateral terminal spondylolysis was present in adolescents with bilateral L5 spondylolysis. Our results suggest that bilateral L5 spondylolysis treatment strategies must be determined based on the combination of the stages present.
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( Kuni Shiina ),( Shinpei Yamashita ),( Yuta Tezuka ),( Hiroko Sakurai ),( Hisanori Gamada ),( Toru Yoshida ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Iwate Prefectural Senmaya Hospital (Senmaya Hospital) adjoins the coastal area where seriously damaged by the Tsunami on 2011.3.11. From the disaster, we are working as the second-line hospital. We perform this study to verify the role of the second-line hospital of tsumami disaster, for taking better steps to deal with the future disasters. Methods: The data was obtained from patient record of Senmaya Hospital and assessed. Results: The patient surge started on the day of the tsunami. Overall 136 patients from tsunami swept area (60% from Iwate Prefecture and 40% from Miyagi Prefecture, next to Iwate) was admitted to Senmaya Hospital within 1 month after the disaster. Temporally, the number of inpatients decreased on 16th, the next day of the restoration of electricity, but increased again. The average inpatient per month was 1.0-1.8 fold (average 1.3) compared with that of the previous year (before tsunami). The highest number of the inpatients was found in February 2012, the coldest month in the fi rst winter. Then cost-free pneumococcus vaccination was introduced to the population more than 65 years old. The rate of pneumonia on admission and discharge by death were signifi cantly decreased from 2012-2013 winter. Conclusions: The second-line hospital must receive many patients immediately after the disaster and continuously accept the excess of the inpatients at least 1 year. The pneumococcus vaccination was effective to decrease admission and hospital death by pneumonia. The second-line hospital should store additional space, equipments and goods for the immediate and continuous excess of the patients.
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