論文 - 松本　守雄

高齢者軸椎骨折の治療経験

松本守雄，千葉一裕，西澤隆，中村俊康，丸岩博文，藤村祥一，戸山芳昭

日本パラプレジア医学会雑誌 14 （ 1 ） 116-117 2001年

研究論文（学術雑誌）, 共著

Surgical management of idiopathic spinal cord herniation

Watanabe Masahiko, Chiba Kazuhiro, Matsumoto Morio, Maruiwa Hirofumi, Fujlmura Yoshikazu, Toyama Yoshiaki

Journal of Neurosurgery 95 （ 2 SUPPL. ） 169 - 172 2001年

ISSN  0022-3085

　概要を見る

<p>Object. Spinal cord herniation is a rare cause of progressive myelopathy and can be corrected surgically. In most previous reports, closure of the dural defect was the recommended procedure. The object of this paper is to describe a new procedure in which spinal cord constriction is released by enlarging the hiatus; additionally the postoperative results will be discussed. Methods. In nine patients with spinal cord herniation, enlargement of the dural defect was performed. In eight patients, neurological deficits resolved immediately after surgery. In one patient with a severe preoperative neurological deficit whose spinal cord herniated massively, deterioration occurred postoperatively. To date, no recurrence of herniation has been observed. Conclusions. The goals of surgery are to reduce the herniation, return the spinal cord to the normal position, and prevent the recurrence of herniation. The use of sutures to close the dural defect has been the method of choice to date. The surgical space in front of the spinal cord, however, is insufficient to accommodate this procedure safely. Because symptoms are caused by the constriction of the spinal cord at the hiatus, surgical expansion of the hiatus allows the goals of surgery to be achieved. This procedure, which is technically easier and less invasive with regard to the vulnerable spinal cord than the closure of the dural defect, could be a viable alternative for the treatment of this rare disease.</p>

Infantile spinal cord meningioma

Watanabe M., Chiba K., Matsumoto M., Maruiwa H., Fujimura Y., Toyama Y.

Journal of Neurosurgery 94 （ 2 SUPPL. ） 334 2001年

ISSN  0022-3085

仙骨嚢腫の臨床像―その発生機序を中心に―

丸岩博文，千葉一裕，渡辺雅彦，松本守雄，藤村祥一，戸山芳昭

東日本整形災害外科学会雑誌 12 （ 4 ） 414-417 2000年12月

研究論文（学術雑誌）, 共著

Impact of longitudinal distance of the cervical spine on the results of expansive open-door laminoplasty

Chiba Kazuhiro, Toyama Yoshiaki, Watanabe Masahiko, Maruiwa Hirofumi, Matsumoto Morio, Hirabayashi Kiyoshi

Spine 25 （ 22 ） 2893 - 2898 2000年11月

ISSN  0362-2436

　概要を見る

<p>Study Design. A retrospective study in patients who underwent expansive open-door laminoplasty (ELAP) for cervical myelopathy and in whom the cervical alignment was nonlordotic at the final follow-up to analyze the correlation between the longitudinal distance of the cervical spine and surgical results. Objectives. To determine the impact of longitudinal distance of the cervical spine on surgical results of ELAP and to propose a new concept, the redundant spinal cord, that may influence patient selection for ELAP. Summary of Background Data. Results in many studies have demonstrated that postoperative cervical alignment has significant effect on surgical results, and spines that are malaligned are thought to deteriorate. The current surgical data showed that not all patients with postoperative malalignment had poor surgical results. Patients with cervical spondylotic myelopathy (CSM) tended to have better clinical results than those with ossification of the posterior longitudinal ligament (OPLL). Methods. Results in 70 patients who underwent ELAP for cervical myelopathy with postoperative cervical malalignment were investigated. The longitudinal distance index (LDI) was defined as the length of a vertical line between the posteroinferior edges of C2 and C7 divided by the anteroposterior diameter of C4 and was measured on lateral neutral radiographs at final follow-up. Correlation between LDI and surgical results represented by Japanese Orthopedic Association scores and percentage of recovery were analyzed statistically in each patient. Results. Patients with CSM had smaller LDI and better surgical results than those with OPLL. Weak but significant negative correlation was detected between LDI and percentage of recovery, indicating that longitudinal distance of the cervical spine may have some degree of impact on the surgical results of ELAP. Conclusion. A decrease in LDI represents shortening of the cervical spine caused by multiple disc degeneration and may influence surgical results of ELAP by inducing redundancy of the spinal cord in patients with postoperative malalignment.</p>

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整形外科疾患における最近の画像診断―脊椎・脊髄疾患における最近のMRI―

松本守雄，戸山芳昭

関節外科 19 （ 10 ） 108-118 2000年10月

研究論文（学術雑誌）, 共著

von Recklinghausen病に伴う巨大頚髄腫瘍の1治験例

井上浩，千葉一裕，渡辺雅彦，松本守雄，丸岩博文，戸山芳昭，向井万起男

関東整形災害外科学会雑誌 31 （ 5 ） 503-508 2000年10月

研究論文（学術雑誌）, 共著

Anterior dural laceration caused by thoracolumbar and lumbar burst fractures

Carl Allen, Matsumoto Morio, Whalen John

Journal Spinal Disorders 13 （ 5 ） 399-403 2000年10月

研究論文（学術雑誌）, 共著

脊柱側弯症の診断と治療

松本守雄，千葉一裕，戸山芳昭

小児科診療 63 （ 8 ） 1144-1150 2000年08月

研究論文（学術雑誌）, 共著

腰椎椎間板ヘルニアLove法後の再手術例の検討

依光悦郎，千葉一裕，松本守雄，戸山芳昭

脊椎脊髄ジャーナル 13 （ 8 ） 762-767 2000年08月

研究論文（学術雑誌）, 共著

腰椎変性すべり症に対する前方固定術の長期成績

西澤隆，千葉一裕，渡辺雅彦，松本守雄，丸岩博文，藤村祥一，戸山芳昭

脊椎脊髄ジャーナル 13 （ 7 ） 709-714 2000年07月

研究論文（学術雑誌）, 共著

腰椎変性疾患に対する固定術の意義

松本守雄，千葉一裕，戸山芳昭

脊椎脊髄ジャーナル 13 （ 6 ） 652-658 2000年06月

研究論文（学術雑誌）, 共著

In vivo pedicle screw placement: Image-guided virtual vision

Carl Allen, Khanuja Hosper, Gatto Chales, Matsumoto Morio, VomLehn John, Schenck John, Rohling Kenneth, Lorensen Williams, Vosburgh Kirby

Journal Spinal Disorders 13 （ 3 ） 225-229 2000年06月

研究論文（学術雑誌）, 共著

片開き式脊柱管拡大術後の髄節性麻痺の検討

千葉一裕，渡辺雅彦，丸岩博文，松本守雄，藤村祥一，戸山芳昭

臨床整形外科 35 （ 6 ） 607-612 2000年05月

研究論文（学術雑誌）, 共著

乳児脊髄髄膜腫の1例

渡辺雅彦，千葉一裕，松本守雄，丸岩博文，藤村祥一，戸山芳昭

日本パラプレジア医学会誌 13 （ 4 ） 144-145 2000年04月

研究論文（学術雑誌）, 共著

頚椎症性脊髄症に対する前方除圧固定術の長期成績―術後10年以上における成績不良例の検討―

高石官成，松本守雄，渡辺雅彦，丸岩博文，千葉一裕，藤村祥一，平林洌，戸山芳昭

臨床整形外科 35 （ 5 ） 401-407 2000年04月

研究論文（学術雑誌）, 共著

胸腰椎部硬膜外くも膜嚢腫の治療経験―Flexible fiber scopeにより交通孔を確認した2例―

丸岩博文，千葉一裕，渡辺雅彦，松本守雄，藤村祥一，戸山芳昭

日本パラプレジア医学会雑誌 13 （ 1 ） 262-263 2000年04月

研究論文（学術雑誌）, 共著

頚椎症性脊髄症に対する片開き式脊柱管拡大術の長期成績―術後10年以上―

丸岩博文，千葉一裕，渡辺雅彦，松本守雄，藤村祥一，平林洌，戸山芳昭

臨床整形外科 35 （ 5 ） 411-416 2000年04月

研究論文（学術雑誌）, 共著

Increased signal intensity of the spinal cord on magnetic resonance images in cervical compressive myelopathy

Matsumoto Morio, Toyama Yoshiaki, Ishikawa Masayuki, Chiba Kazuhiro, Suzuki Nobumasa, Fujimura Yoshikazu

Spine 25 （ 6 ） 677 - 682 2000年03月

ISSN  0362-2436

　概要を見る

<p>Study Design. Correlation between a lesion of the spinal cord that elicits increased signal intensity (ISI) on magnetic resonance images (MRIs) and the outcome of conservative treatment for cervical compressive myelopathy was retrospectively investigated. Objective. To investigate whether ISI could predict the outcome of conservative treatment for cervical compressive myelopathy. Summary of Background Data. It is unknown whether ISI is related to the outcome of conservative treatment for cervical compressive myelopathy. Methods. Fifty-two patients with mild cervical myelopathy underwent conservative treatment with a cervical brace. The compressive lesions were spondylosis in 29 patients, disc herniation in 12, and an ossification of the longitudinal ligament in 11. They also underwent MRI (1.5 T), and ISI was evaluated on T2-weighted sagittal and axial images. The ISI areas were classified as focal or multisegmental. Thirty-nine patients underwent follow- up MRI after a mean interval of 2 years, 4 months. The transverse area of the spinal cord was also measured on T2-weighted axial images. The outcome of conservative treatment was assessed using the Japanese Orthopedic Association Score (JOA score). Patients showing either an improvement in the JOA score or with a JOA score of 15 or more were considered to have a satisfactory outcome. Results. The average JOA score was 14.0 ± 1.4 (range, 10-16) before conservative treatment and 14.4 ± 1.9 (range, 10-17) at follow-up. The average gain in the JOA score was 0.4 points ± 1.9 (range, -5 to +6). The outcome was satisfactory in 36 patients (69%). An area of ISI was observed in 34 patients (65%) before treatment (24 focal and 10 multisegmental). A satisfactory outcome was obtained in 78% of the patients without ISI, in 63% of those with focal ISI, and in 70% of those with multisegmental ISI. No statistically significant difference was seen among these three groups in the percentages of patients with satisfactory outcome, JOA scores before and after treatment or transverse spinal cord area. Of the 39 patients who were re-examined by MRI, 28 showed an area of ISI. The ISI regressed in five patients (18%). Satisfactory outcome was obtained in all 5 patients with regression of ISI, in 16 (70%) of the 23 patients without regression of ISI, and in 10 (91%) of the 11 patients without ISI apparent on the the first images (difference, not significant). Conclusions. Increased signal intensity was not related to a poor outcome of conservative treatment or severity of myelopathy in the patients with mild cervical myelopathy.</p>

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Increased signal intensity of the spinal cord on magnetic resonance images in cervical compressive myelopathy does it predict the outcome of conservative treatment?

Matsumoto Morio, Toyama Yoshiaki, Ishikawa Masayuki, Chiba Kazuhiro, Suzuki Nobumasa, Fujimura Yoshikazu

Spine 25 （ 6 ） 677-682 2000年03月

研究論文（学術雑誌）, 共著