Details of a Researcher - Matsumoto, Morio

Papers - Matsumoto, Morio

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Transoral anterior approach using median mandibular splitting in upper spinal tumor extirpation

Hiromasa Kawana, Shin Kato, Seiji Asoda, Akihiko Koike, Ryotaro Iwasaki, Morio Matsumoto, Kota Watanebe, Yorihisa Imanishi, Kaoru Ogawa, Taneaki Nakagawa

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 114 ( 5 ) 2012.11

ISSN 2212-4403

Objective: Transoral approach from the anterior direction is necessary if an upper spinal tumor is too big to extirpate via the posterior approach alone. To obtain a good anterior view of the surgical field, the mandible, tongue, and soft palate have to be split, and we developed a criterion to select the surgical strategy. Study Design: We indicated a decision-making process of splitting techniques and indications with actual cases and review of literatures. Result: Tumors were located from the level of C1 to the lower part of C3. Computerized tomography and magnetic resonance imaging were important to decide approaches. The orthopedic surgical team invited oral and maxillofacial surgeons team to assist in all transoral anterior approach cases. Conclusions: Vertical splitting of the mandible, incising the skin of the mental region, and splitting the middle of the tongue were combined according to the position of the spinal tumor. © 2012 Elsevier Inc. All rights reserved.

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A method for quantifying intervertebral disc signal intensity on T2-weighted imaging

Nagashima Masaki, Abe Hitoshi, Amaya Kenji, Matsumoto Hideo, Yanaihara Hisashi, Nishiwaki Yuji, Toyama Yoshiaki, Matsumoto Morio

Acta Radiologica 53 ( 9 ) 1059 - 1065 2012.11

ISSN 0284-1851

Background: Quantification of intervertebral disc degeneration based on intensity of the nucleus pulposus in magnetic resonance imaging (MRI) often uses the mean intensity of the region of interest (ROI) within the nucleus pulposus. However, the location and size of ROI have varied in different reports, and none of the reported methods can be considered fully objective. Purpose: To develop a more objective method of establishing ROIs for quantitative evaluation of signal intensity in the nucleus pulposus using T2-weighted MRI. Material and Methods: A 1.5-T scanner was used to obtain T2-weighted mid-sagittal images. A total of 288 intervertebral discs from 48 patients (25 men, 23 women) were analyzed. Mean age was 47.4 years (range, 17-69 years). All discs were classified into five grades according to Pfirrmann et al. Discs in grades I and II were defined as bright discs, and discs in grades IV and V were defined as dark discs. Eight candidate methods of ROI determination were devised. The method offering the highest degree of discrimination between bright and dark discs was investigated among these eight methods. Results: The method with the greatest degree of discrimination was as follows. The quadrangle formed by anterior and posterior edges of the upper and lower end plates in contact with the intervertebral disc to be measured was defined as the intervertebral area. A shape similar to the intervertebral area but with one-quarter the area was drawn. The geometrical center of the shape was matched to the center of intensity, and this shape was then used as the ROI. Satisfactory validity and reproducibility were obtained using this method. Conclusion: The present method offers adequate discrimination and could be useful for longitudinal tracking of intervertebral disc degeneration with sufficient reproducibility.

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Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis

Funao Haruki, Tsuji Takashi, Hosogane Naobumi, Watanabe Kota, Ishii Ken, Nakamura Masaya, Chiba Kazuhiro, Toyama Yoshiaki, Matsumoto Morio

European Spine Journal 21 ( 11 ) 2181 - 2187 2012.11

ISSN 0940-6719

Abstract Introduction To date, few studies have focused on spinopelvic sagittal alignment as a predisposing factor for the development of degenerative spondylolisthesis (DS). The objectives of this study were to compare differences in spinopelvic sagittal alignment between patients with or without DS and to elucidate factors related to spinopelvic sagittal alignment. Materials and methods A total of 100 patients with or without DS who underwent surgery for lumbar spinal canal stenosis were assessed in this study. Fifty patients with DS (DS group) and 50 age- and gender-matched patients without DS (non-DS group) were enrolled. Spinopelvic parameters including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L4 slope, L5 slope, thoracic kyphosis (TK), lumbar lordosis (LL) and sagittal balance were compared between the two groups. In the DS group, the percentage of vertebral slip (% slip) was also measured. Results Several spinopelvic parameters, PI, SS, L4 slope, L5 slope, TK and LL, in the DS group were significantly greater than those in the non-DS group, and PI had positive correlation with % slip (r = 0.35, p0.05). Degrees of correlations among spinopelvic parameters differed between the two groups. In the DS group, PI was more strongly correlated with SS (r = 0.82, p0.001) than with PT (r = 0.41, p0.01). In the non-DS group, PI was more strongly correlated with PT (r = 0.73, p0.001) than with SS (r = 0.38, p0.01). Conclusions Greater PI may lead to the development and the progression of vertebral slip. Different compensatory mechanisms may contribute to the maintenance of spinopelvic sagittal alignment in DS and non-DS patients. © 2012 Springer-Verlag.

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Increase in spinal longitudinal length by correction surgery for adolescent idiopathic scoliosis

Watanabe Kota, Hosogane Naobumi, Kawakami Noriaki, Tsuji Taichi, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

European Spine Journal 21 ( 10 ) 1920 - 1925 2012.10

ISSN 0940-6719

Purpose One of the downsides of spinal correction surgery for adolescent idiopathic scoliosis (AIS) is the cessation of spinal longitudinal growth within the fused levels in growing children. However, the surgery itself has the potential to increase spinal longitudinal length by correcting the curvature. The purpose of this study was to evaluate the correlation between curve correction and increased spinal longitudinal length by corrective surgery for AIS. Methods This study included 208 consecutive patients (14 male, 194 female) with AIS who underwent posterior or anterior correction and fusion surgeries. Mean age at the time of surgery was 15.7 ± 3.3 years (range 10-20 years). Patients with hyperkyphosis of more than 40° were excluded. All patients had main curves in the thoracic spine (Lenke type 1 or 2). Forty-three patients underwent anterior spinal correction and fusion (ASF) and 164 underwent posterior spinal correction and fusion (PSF). The mean preoperative height was 154.7 ± 6.9 cm (range 133-173 cm). Pre and postoperative PA standing X-ray films were used to measure the Cobb angle and spinal length between the end vertebrae of the main thoracic curve, and between T1 and L5. The patients were divided into ASF and PSF groups, within which correlations between the Cobb angle correction and spinal length increase were evaluated. Results In the ASF group, the mean preoperative Cobb angle of the main thoracic curve was 54.9 ± 8.3° (range 41-83°) and it was corrected to 19.7 ± 9.5° (range 0-47°) with a mean correction of 35.2 ± 11.1° (range 10-74°) after surgery. The mean increase in the length of the main thoracic curve was 1.5 ± 4.6 mm (range -8 to 13 mm), and the mean increase in T1-L5 length was 16.6 ± 7.7 mm (range -3 to 51 mm). Significant correlation between the correction of the Cobb angle and increase in T1-L5 length was observed, with a correlation coefficient of 0.44. In the PSF group, the mean preoperative Cobb angle of the main thoracic curve was 58.8 ± 11.6° (range 36-107°) and it was corrected to 17.1 ± 7.6° (range 10-49°), with a mean correction of 41.7 ± 10.2° (range 21-73°) after surgery. The mean increase in the length of the main thoracic curve was 14.0 ± 5.2 mm (range 0-42 mm), and the mean increase in T1-L5 length was 32.4 ± 10.8 mm (10-61 mm). Correlation between the correction of the Cobb angle and increase in T1-L5 length was high, with a correlation coefficient of 0.64. The increase in T1-L5 length could be calculated by the following formula based on linear regression analysis: increase in T1-L5 length (mm) = correction of the Cobb angle (8) 9 0.77. Conclusion Spinal longitudinal length was significantly increased after surgery in both the ASF and PSF groups. Correction of the Cobb angle and increase in T1-L5 length were highly correlated with each other, especially in the PSF group. © Springer-Verlag 2012.

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An essential role for STAT6-STAT1 protein signaling in promoting macrophage cell-cell fusion

Miyamoto Hiroya, Katsuyama Eri, Miyauchi Yoshiteru, Hoshi Hiroko, Miyamoto Kana, Sato Yuiko, Kobayashi Tami, Iwasaki Ryotaro, Yoshida Shigeyuki, Mori Tomoaki, Kanagawa Hiroya, Fujie Atsuhiro, Hao Wu, Morioka Hideo, Matsumoto Morio, Toyama Yoshiaki, Miyamoto Takeshi

Journal of Biological Chemistry 287 ( 39 ) 32479 - 32484 2012.09

ISSN 0021-9258

Macrophage lineage cells such as osteoclasts and foreign body giant cells (FBGCs) form multinuclear cells by cell-cell fusion of mononuclear cells. Recently, we reported that two seven-transmembrane molecules, osteoclast stimulatory transmembrane protein (OC-STAMP) and dendritic cell-specific transmembrane protein (DC-STAMP), were essential for osteoclast and FBGC cell-cell fusion in vivo and in vitro. However, signaling required to regulate FBGC fusion remained largely unknown. Here, we show that signal transducer and activator of transcription 1 (STAT1) deficiency in macrophages enhanced cell-cell fusion and elevated DC-STAMP expression in FBGCs. By contrast, lack of STAT6 increased STAT1 activation, significantly inhibiting cell-cell fusion and decreasing OC-STAMP and DC-STAMP expression in IL-4-induced FBGCs. Furthermore, either STAT1 loss or co-expression of OC-STAMP/DC-STAMP was sufficient to induce cell-cell fusion of FBGCs without IL-4. We conclude that the STAT6-STAT1 axis regulates OC-STAMP and DC-STAMP expression and governs fusogenic mechanisms in FBGCs. © 2012 by The American Society for Biochemistry and Molecular Biology, Inc.

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Aldehyde-stress resulting from Aldh2 mutation promotes osteoporosis due to impaired osteoblastogenesis

Hoshi Hiroko, Hao Wu, Fujita Yoshinari, Funayama Atsushi, Miyauchi Yoshiteru, Hashimoto Kazuaki, Miyamoto Kana, Iwasaki Ryotaro, Sato Yuiko, Kobayashi Tami, Miyamoto Hiroya, Yoshida Shigeyuki, Mori Tomoaki, Kanagawa Hiroya, Katsuyama Eri, Fujie Atsuhiro, Kitagawa Kyoko, Nakayama Keiichi I., Kawamoto Toshihiro, Sano Motoaki, Fukuda Keiichi, Ohsawa Ikuroh, Ohta Shigeo, Morioka Hideo, Matsumoto Morio, Chiba Kazuhiro, Toyama Yoshiaki, Miyamoto Takeshi

Journal of Bone and Mineral Research 27 ( 9 ) 2015 - 2023 2012.09

ISSN 0884-0431

Osteoporosis is a complex disease with various causes, such as estrogen loss, genetics, and aging. Here we show that a dominant-negative form of aldehyde dehydrogenase 2 (ALDH2) protein, ALDH2*2, which is produced by a single nucleotide polymorphism (rs671), promotes osteoporosis due to impaired osteoblastogenesis. Aldh2 plays a role in alcohol-detoxification by acetaldehyde-detoxification; however, transgenic mice expressing Aldh2*2 (Aldh2*2 Tg) exhibited severe osteoporosis with increased levels of blood acetaldehyde without alcohol consumption, indicating that Aldh2 regulates physiological bone homeostasis. Wild-type osteoblast differentiation was severely inhibited by exogenous acetaldehyde, and osteoblastic markers such as osteocalcin, runx2, and osterix expression, or phosphorylation of Smad1,5,8 induced by bone morphogenetic protein 2 (BMP2) was strongly altered by acetaldehyde. Acetaldehyde treatment also inhibits proliferation and induces apoptosis in osteoblasts. The Aldh2*2 transgene or acetaldehyde treatment induced accumulation of the lipid-oxidant 4-hydroxy-2-nonenal (4HNE) and expression of peroxisome proliferator-activated receptor gamma (PPARγ), a transcription factor that promotes adipogenesis and inhibits osteoblastogenesis. Antioxidant treatment inhibited acetaldehyde-induced proliferation-loss, apoptosis, and PPARγ expression and restored osteoblastogenesis inhibited by acetaldehyde. Treatment with a PPARγ inhibitor also restored acetaldehyde-mediated osteoblastogenesis inhibition. These results provide new insight into regulation of osteoporosis in a subset of individuals with ALDH2*2 and in alcoholic patients and suggest a novel strategy to promote bone formation in such osteopenic diseases. © 2012 American Society for Bone and Mineral Research.

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Conditional inactivation of Blimp1 in adult mice promotes increased bone mass

Miyauchi Yoshiteru, Miyamoto Hiroya, Yoshidas Shigeyuki, Mori Tomoaki, Kanagawa Hiroya, Katsuyama Eri, Fujie Atsuhiro, Hao Wu, Hoshi Hiroko, Miyamoto Kana, Sato Yuiko, Kobayashi Tami, Akiyama Haruhiko, Morioka Hideo, Matsumoto Morio, Toyama Yoshiaki, Miyamoto Takeshi

Journal of Biological Chemistry 287 ( 34 ) 28508 - 28517 2012.08

ISSN 0021-9258

Bone resorption, which is regulated by osteoclasts, is excessively activated in bone destructive diseases such as osteoporosis. Thus, controlling osteoclasts would be an effective strategy to prevent pathological bone loss. Although several transcription factors that regulate osteoclast differentiation and function could serve as molecular targets to inhibit osteoclast formation, those factors have not yet been characterized using a loss of function approach in adults. Here we report such a study showing that inactivation of B-lymphocyte induced maturation protein 1 (Blimp1) in adult mice increases bone mass by suppressing osteoclast formation. Using an ex vivo assay, we show that osteoclast differentiation is significantly inhibited by Blimp1 inactivation at an early stage of osteoclastogenesis. Conditional inactivation of Blimp1 inhibited osteoclast formation and increased bone mass in both male and female adult mice. Bone resorption parameters were significantly reduced by Blimp1 inactivation in vivo. Blimp1 reportedly regulates immune cell differentiation and function, but we detected no immune cell failure following Blimp1 inactivation. These data suggest that Blimp1 is a potential target to promote increased bone mass and prevent osteoclastogenesis. © 2012 by The American Society for Biochemistry and Molecular Biology, Inc.

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Serum cartilage metabolites as biomarkers of degenerative lumbar scoliosis

Hosogane Naobumi, Watanabe Kota, Tsuji Takashi, Miyamoto Takeshi, Ishii Ken, Niki Yasuo, Nakamura Masaya, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

Journal of Orthopaedic Research 30 ( 8 ) 1249 - 1253 2012.08

ISSN 0736-0266

Several biomarkers have been used to evaluate osteoarthritis of the limb joints. Here we evaluated the use of serum cartilage metabolites as biomarkers for degenerative lumbar scoliosis (DLS). Fifty-two DLS patients with Cobb angle>10° were compared with 19 control patients. Serum levels of hyaluronic acid (HA), keratan sulfate (KS), cartilage oligomeric matrix protein (COMP), collagen type II cleavage (C2C), and procollagen type II C-propeptide (CPII) were measured. Serum levels of KS (DLS 1.20±0.44μg/ml vs. control 0.98±0.33μg/ml), CPII (DLS 1905.1±948.2ng/ml vs. control 1223.6±884.4ng/ml), and C2C (DLS 219.1±59.2ng/ml vs. control 177.7±71.7ng/ml) were significantly higher in DLS. There were no significant differences in the levels of HA or COMP. There was a significant positive correlation between the Cobb angle and CPII in DLS. This is the first study to evaluate the cartilage biomarkers in DLS. The results suggest DLS patients have higher levels of type II collagen synthesis and degradation, indicated by elevated serum CPII and C2C, respectively. As type II collagen is a major component of collagens in the nucleus pulposus and facet joint cartilages, its enhanced turnover may be related to the development and progression of DLS. Copyright © 2012 Orthopaedic Research Society.

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Surgical treatment of spinal extradural arachnoid cysts in the thoracolumbar spine

Funao Haruki, Nakamura Masaya, Hosogane Naobumi, Watanabe Kota, Tsuji Takashi, Ishii Ken, Kamata Michihiro, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

Neurosurgery 71 ( 2 ) 278 - 284 2012.08

ISSN 0148-396X

BACKGROUND: Because an idiopathic spinal extradural arachnoid cyst (SEAC) is rare, its optimal surgical treatment remains controversial. OBJECTIVE: To evaluate the results of surgical treatments for SEACs and to clarify features of the disease associated with poor outcomes. METHODS: Twelve patients with SEACs who underwent surgery at our hospital between 1988 and 2008 were examined retrospectively. The mean follow-up period was 4.7 years. Total resection of the cyst was performed in 7 patients and closure of the dural defect without cyst resection in 5 patients. Surgical outcomes were evaluated with regard to the duration of symptoms, the size of the cyst, and the surgical procedure used. RESULTS: Neurological recovery was observed in all patients, and there was no recurrence. Poor outcomes were observed in patients with a long duration of symptoms (>1 year, P < .01) and large cyst size (>5 vertebrae, P < .05). The surgical procedure had no significant association with the postoperative neurological recovery. However, there was a significant difference in the degree of the mean postoperative kyphotic angle between the patients treated by total resection of the cyst (9.7 degrees) and those treated by closure of the dural defect without cyst resection through selective laminectomy (2.2 degrees) (P < .01). CONCLUSION: There was no significant difference in postoperative neurological recovery between the 2 surgical procedures. However, closure of the dural defect without cyst resection was less invasive, preventing postoperative kyphotic deformity of the thoracolumbar spine. Copyright © 2012 by the Congress of Neurological Surgeons.

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Clinical significance of diffusion tensor tractography as a predictor of functional recovery after laminoplasty in patients with cervical compressive myelopathy

Nakamura Masaya, Fujiyoshi Kanehiro, Tsuji Osahiko, Konomi Tsunehiko, Hosogane Naobumi, Watanabe Kota, Tsuji Takashi, Ishii Ken, Momoshima Suketaka, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

Journal of Neurosurgery: Spine 17 ( 2 ) 147 - 152 2012.08

ISSN 1547-5654

Object. This study was conducted to determine whether postoperative changes in the fractional anisotropy (FA) value and diffusion tensor imaging of the cervical spinal cord can predict functional outcome for patients with cervical compressive myelopathy (CCM). Methods. Twenty patients with CCM were treated by laminoplasty from 2008 to 2009. Both T2-weighted MRI and diffusion tensor imaging were performed before and after surgery. The FA values were analyzed and fiber tracking was performed. The fiber tract (FT) ratio was calculated according to the following formula: (number of fibers at the compressed level)/(number of fibers at the C-2 level) x 100%. The Japanese Orthopaedic Association scoring system for cervical myelopathy was used to determine pre- and postoperative neurological status of the patients, and the Hirabayashi method was used to calculate the recovery rate. Results. There was no significant difference in recovery rates between patients with and those without intramedullary high signal intensity on preoperative T2-weighted images. Substantial differences in FA value among spinal cord, bone, and CSF made it difficult to obtain a precise FA value for the compressed spinal cord. There was a significant correlation between the preoperative FT ratio and the recovery rate (p = 0.0006). A poor outcome (recovery rate < 40%) could be anticipated for CCM patients with preoperative FT ratios below 60%. Conclusions. The preoperative FT ratio correlated significantly with the recovery rates in CCM patients. Preoperative diffusion tensor tractography can be a new prognostic predictor for neurological recovery in CCM patients after laminoplasty.

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Impact of lamina closure on long-term outcomes of open-door laminoplasty in patients with cervical myelopathy

Matsumoto Morio, Watanabe Kota, Hosogane Naobumi, Tsuji Takashi, Ishii Ken, Nakamura Masaya, Chiba Kazuhiro, Toyama Yoshiaki

Spine 37 ( 15 ) 1288 - 1291 2012.07

ISSN 0362-2436

Study Design: A prospective follow-up study. Objective: To elucidate the impact of lamina closure on long-term outcomes after open-door laminoplasty. Summary of Background Data: In a previous study, we did not find significant associations between lamina closure and short-term outcomes. Methods: Of the original cohort of 82 patients who underwent open-door laminoplasty, 69 were included in this study (52 men, 17 women; mean age, 60.9 yr; mean follow-up, 6.2 yr; 56 with spondylosis or disc herniation, 13 with ossification of posterior longitudinal ligament). Lamina closure was previously observed in 23 of these patients (closure group) but not in 46 (nonclosure group). The Japanese Orthopaedic Association (JOA) scores and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire were recorded. Results: The JOA score was 9.9 ± 3.2 in the closure group and 11.2 ± 2.3 in the nonclosure group before surgery (P = 0.1), 13.8 ± 2.3 and 13.8 ± 2.2 at 1.8 years (P = 0.99), and 13.6 ± 2.2 and 14.2 ± 2.7 at final follow-up (P = 0.29). The recovery rate of the JOA scores was 56.7 ± 30.0% and 46.7 ± 29.2% at 1.8 years (P = 0.22) and 51.0 ± 32.5 and 57.6 ± 31.1 at the final follow-up (P = 0.42). The subdomains assessed by the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire at follow-up were cervical spine function, 68.7 ± 27.5 in the closure group and 67.7 ± 30.0 in the nonclosure group (P = 0.93); upper extremity function, 78.6 ± 24.3 and 87.6 ± 15.4 (P = 0.40); lower extremity function, 69.9 ± 26.0 and 73.9 ± 22.5 (P = 0.68); bladder function, 74.6 ± 22.6 and 84.9 ± 29.2 (P = 0.18); and quality of life, 53.9 ± 25.3 and 56.2 ± 18.1 (P = 0.96). Conclusion: Lamina closure did not significantly impact the long-term surgical outcomes of laminoplasty for cervical myelopathy. Although not statistically significant, the recovery rate tended to decline in the closure group compared with the nonclosure group during the long-term follow-up period, and the utilization of a laminar retention device to prevent the laminar closure should be considered. Copyright © 2012 Lippincott Williams & Wilkins.

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Central neuropathic pain after surgical resection in patients with spinal intramedullary tumor

Nakamura Masaya, Tsuji Osahiko, Iwanami Akio, Tsuji Takashi, Ishii Ken, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

Journal of Orthopaedic Science 17 ( 4 ) 352 - 357 2012.07

ISSN 0949-2658

Study design Retrospective case series. Objective To examine central neuropathic pain after surgical resection of intramedullary spinal cord tumor (IMSCT). Summary of background data Because of the rarity of IMSCT, there is little information about postoperative neuropathic pain after surgical resection. Methods Eighty-five of 105 patients treated surgically for IMSCT at our hospital between 2000 and 2008 completed the Neuropathic Pain Symptom Inventory (NPSI) and the short form (SF)-36 health inventory. The NPSI score was analyzed against the tumor type and the postoperative Japanese Orthopaedic Association (JOA) score for neurological symptoms. Results The mean NPSI score of the patients was 13.5. The subscore for paresthesia/dysesthesia was significantly higher than the other subscores. Analysis of the NPSI scores by tumor type revealed no significant differences among patients with ependymoma, astrocytoma, and vascular tumors. The postoperative JOA score showed a weak negative correlation with the NPSI score in patients with thoracic spinal cord tumor, and no correlation in those with cervical tumor. In the 11 patients with hemangioblastoma, intense pain was reported at the level of the tumor, although postoperative paralysis was mild. All the postoperative SF-36 subscores of our study patients were significantly lower than the national average, and a significant negative correlation was observed between the SF-36 and the NPSI subscores. Conclusion Neuropathic pain after surgical resection reduces the QOL of patients with IMSCTs, and pain severity varies with the tumor's location and histological features, the severity of paralysis, and the location of pain relative to the tumor. © The Japanese Orthopaedic Association 2012.

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Osteoclast stimulatory transmembrane protein and dendritic cell-specific transmembrane protein cooperatively modulate cell-cell fusion to form osteoclasts and foreign body giant cells

Miyamoto Hiroya, Suzuki Takayuki, Miyauchi Yoshiteru, Iwasaki Ryotaro, Kobayashi Tami, Sato Yuiko, Miyamoto Kana, Hoshi Hiroko, Hashimoto Kazuaki, Yoshida Shigeyuki, Hao Wu, Mori Tomoaki, Kanagawa Hiroya, Katsuyama Eri, Fujie Atsuhiro, Morioka Hideo, Matsumoto Morio, Chiba Kazuhiro, Takeya Motohiro, Toyama Yoshiaki, Miyamoto Takeshi

Journal of Bone and Mineral Research 27 ( 6 ) 1289 - 1297 2012.06

ISSN 0884-0431

Cell-cell fusion is a dynamic phenomenon promoting cytoskeletal reorganization and phenotypic changes. To characterize factors essential for fusion of macrophage lineage cells, we identified the multitransmembrane protein, osteoclast stimulatory transmembrane protein (OC-STAMP), and analyzed its function. OC-STAMP-deficient mice exhibited a complete lack of cell-cell fusion of osteoclasts and foreign body giant cells (FBGCs), both of which are macrophage-lineage multinuclear cells, although expression of dendritic cell specific transmembrane protein (DC-STAMP), which is also essential for osteoclast/FBGC fusion, was normal. Crossing OC-STAMP-overexpressing transgenic mice with OC-STAMP-deficient mice restored inhibited osteoclast and FBGC cell-cell fusion seen in OC-STAMP-deficient mice. Thus, fusogenic mechanisms in macrophage-lineage cells are regulated via OC-STAMP and DC-STAMP. Copyright © 2012 American Society for Bone and Mineral Research.

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Cross-sectional area of the posterior extensor muscles of the cervical spine in whiplash injury patients versus healthy volunteers - 10 year follow-up MR study

Matsumoto Morio, Ichihara Daisuke, Okada Eijiro, Chiba Kazuhiro, Toyama Yoshiaki, Fujiwara Hirokazu, Momoshima Suketaka, Nishiwaki Yuji, Takahata Takeshi

Injury 43 ( 6 ) 912 - 916 2012.06

ISSN 0020-1383

Introduction: Long-term follow-up studies focusing on the posterior extensor muscles in patients suffering from whiplash injury are scarce. The purpose of this study was to elucidate the changes in the posterior extensor muscles 10 years after whiplash injury. Methods: Twenty-three patients who had suffered from whiplash injury in 1994-1996 and had undergone MRI using a 1.5-T superconductive imager participated in this follow-up study (13 males, 10 females, mean age 51.8 years, mean follow-up 11.5 years). In addition, 60 healthy volunteers who had undergone MRI in the same period were included as controls (36 males, 24 females, mean age 47.8 years, mean follow-up 11.1 years). All participants underwent follow-up MRI. The cross-sectional areas of the deep posterior muscles (CSA) including the multifidus, semispinalis cervicis, semispinalis capitis, and splenius capitis were digitally measured at C3-4, C4-5, and C5-6 using NIH image. The long-term changes in the CSA were compared between the two groups. In addition, correlations between the CSA and cervical spine-related symptoms were evaluated. Results: The mean total CSA per patient (the sum of the area from C3-4 to C5-6) was 4811.6 ± 878.4 mm ² in the whiplash patients and 4494.9 ± 1032.7 mm ² in the controls at the initial investigation (p = 0.20), and 5173.4 ± 946.1 mm ² and 4713.0 ± 1065.3 mm ² at the follow-up (p = 0.07). The mean change in CSA over time was 361.8 ± 804.9 mm ² in the whiplash patients and 218.1 ± 520.7 mm ² in the controls (p = 0.34). Ten whiplash patients (43.5%) had neck pain and 11 (47.8%) had shoulder stiffness. However, there was no difference in the change in CSA over time between the symptomatic and asymptomatic patients. Conclusions: There was no significant difference in the change in CSA between whiplash patients and healthy volunteers after a 10-year follow-up period. In both groups, the cross-sectional area slightly increased at follow-up. In addition, there was no association between the change in CSA and clinical symptoms such as neck and shoulder pain. These results suggest that whiplash injury is not associated with symptomatic atrophy of the posterior cervical muscles over the long term. © 2012 Elsevier Ltd. All rights reserved.

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Loss of apical vertebral derotation in adolescent idiopathic scoliosis

Cui Guanyu, Watanabe Kota, Nishiwaki Yuji, Hosogane Naobumi, Tsuji Takashi, Ishii Ken, Nakamura Masaya, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

European Spine Journal 21 ( 6 ) 1111 - 1120 2012.06

ISSN 0940-6719

Purpose: The objective of this study was to evaluate 2 years post-surgical loss of three-dimensional correction in adolescent idiopathic scoliosis (AIS) patients using multi-planar reconstruction computed tomography (CT). Methods: Twenty-seven AIS patients treated by segmental pedicle screw (PS) constructs were included in this study. Correction in the axial plane was evaluated using the "relative apical vertebral rotation angle" (rAVR), defined as the difference between the axial rotation angles of the upper instrumented vertebra and the apical vertebra on reconstructed axial CT images. The Cobb angle of the main curve and apical vertebral translation was measured to evaluate the coronal correction. Thoracic kyphosis was also measured for the evaluation of sagittal profile. Measurements were performed before surgery, and 1 week and 2 years after surgery. The relationships between the correction losses and skeletal maturity, and variety of spinal constructs were also evaluated. Results: The mean preoperative Cobb angle of the major curve was 59.1° ± 11.2° before and 13.0° ± 7.2° immediately after surgery. Two years later, the mean Cobb angle had increased significantly, to 15.5° ± 7.8°, with a mean correction loss of 2.5° ± 1.5° (p<0.001). The mean preoperative rAVR of 28.5° ± 8.4° was corrected to 15.8° ± 7.8° after surgery. It had increased significantly to 18.5 ± 8.4 by 2 years after surgery, with a mean correction loss of 2.7° ± 1.0° (p<0.001). The mean correction losses for both the Cobb angle and rAVR were significantly greater in the skeletally immature patients. The significant correlations were recognized between the correction losses and the proportion of multi-axial screws, and the materials of constructs. Conclusions: Statistically significant loss of correction in the Cobb angle and apical vertebral axial rotation angle (AVR) were recognized 2 years after surgery using PS constructs. The correction losses, especially AVR, were more evident in the skeletally immature patients, and in patients treated with more multi-axial screws and with titanium constructs rather than with stainless constructs. © Springer-Verlag 2012.

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Radiographic analysis of the progression of congenital scoliosis with rib anomalies during the growth period

Kawakami Noriaki, Tsuji T., Yanagida H., Uno K., Matsumoto M., Watanabe K., Yamamoto T., Hirano T., Taneichi H., Yamazaki K., Fujiwara K.

ArgoSpine News and Journal 24 ( 1-2 ) 56 - 61 2012.06

ISSN 1957-7729

Study design: Retrospective study. Objectives: To evaluate progression of various types of congenital scoliosis (CS) with rib anomalies (RA) during the various stages of the growth period, and to assess severity of progression in order to make a strategic planning of expansion thoracoplasty. Summary of background data: VEPTR is approved for the treatment of patients with TIS in more than 30 countries. However, there is no consensus on the surgical indications, or the age or time when VEPTR surgery should be performed. Furthermore, there is no study related to natural history of congenital scoliosis with rib anomalies except two reports that are not sufficient to indicate risk factors of progression during the growth period. Methods: Based on a survey of CS and RA via questionnaires, 70 patients (32 males and 38 females with an average age of 2. 6 years at the first visit.) matched the inclusion criteria: CS with RA, no procedures that could influence natural history during follow-up periods, repeated plain X-ray check-ups with at least two years interval during growth periods. Average follow-up (F/U) time was 5. 4 years (2-14). Plain X-ray images of 70 patients were divided into three age groups: infantile (0-5,6), juvenile (5-10,11), and adolescent (11,12-). Each X-ray image was evaluated in terms of laterality, range and type of RA, severity of scoliosis, type of CS, thoracic height ratio, SAL, and associated anomalies. Results: 54 of the 70 patients had unilateral rib anomalies. Rib anomalies included rib fusion in 52, mixed type (fusion and defect) in 8, rib proximity in 6, and rib defect in 4. Vertebral anomalies included formation failure in 1, segmentation failure in 16 and mixed type in 53. The magnitude of scoliosis was 46. 9° at the first visit and 65. 7° at the final F/U. Scoliosis progressed at the rate of 4. 6°/year in 70, 3. 6°/year in bilateral RA involvement and 4. 9°/year in unilateral. Scoliosis progressed with the rate of 4. 6°/year in 70, 3. 6°/year in bilateral RA involvement and 4. 9°/year in unilateral. Scoliosis progressed most severely during infantile period with the rate of 5. 0°/year, followed by adolescent of 3. 8°/year and juvenile of 2. 3°/year. Patients with rib defect or unilateral unsegmented bar showed higher progression rates (10. 7°/year and 7. 0°/year) during infantile period. According to the relationship between SAL and scoliosis, four grades in severity of progression (most severe, severe, moderate, mild) were set up with the cut-off value of 70%, 85% of SAL and 45°, 85° of scoliosis for making the strategic planning of ET. Those grades were significantly related with types and location of RA and types of vertebral anomalies. Conclusions: Progression of scoliosis was analysed in 70 patients with CS & RA. Congenital scoliosis with rib anomalies progressed most rapidly during the early infantile period (7. 8°/year), followed by the late infantile period (5. 0°/year), and the adolescent period (3. 8°/year). Progression of scoliosis in patients with CS and RA occurred in early phase of growth periods and significantly related with types and location of RA as well as type of vertebral anomalies. The results of this study surely suggest the timing of ET for the patients with CS and RA. © 2012 ARGOS and Springer-Verlag France.

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PDGFBB promotes PDGFRα-positive cell migration into artificial bone in vivo

Yoshida Shigeyuki, Iwasaki Ryotaro, Kawana Hiromasa, Miyauchi Yoshiteru, Hoshi Hiroko, Miyamoto Hiroya, Mori Tomoaki, Kanagawa Hiroya, Katsuyama Eri, Fujie Atsuhiro, Hao Wu, Kobayashi Tami, Sato Yuiko, Miyamoto Kana, Morioka Hideo, Matsumoto Morio, Chiba Kazuhiro, Toyama Yoshiaki, Nakagawa Taneaki, Miyamoto Takeshi

Biochemical and Biophysical Research Communications 421 ( 4 ) 785 - 789 2012.05

ISSN 0006-291X

Bone defects caused by traumatic bone loss or tumor dissection are now treated with auto- or allo-bone graft, and also occasionally by artificial bone transplantation, particularly in the case of large bone defects. However, artificial bones often exhibit poor affinity to host bones followed by bony union failure. Thus therapies combining artificial bones with growth factors have been sought. Here we report that platelet derived growth factor bb (PDGFBB) promotes a significant increase in migration of PDGF receptor α (PDGFRα)-positive mesenchymal stem cells/pre-osteoblastic cells into artificial bone . in vivo. Growth factors such as transforming growth factor beta (TGFβ) and hepatocyte growth factor (HGF) reportedly inhibit osteoblast differentiation; however, PDGFBB did not exhibit such inhibitory effects and in fact stimulated osteoblast differentiation . in vitro, suggesting that combining artificial bones with PDGFBB treatment could promote host cell migration into artificial bones without inhibiting osteoblastogenesis. © 2012 Elsevier Inc.

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Long-term surgical outcomes of spinal meningiomas

Nakamura Masaya, Tsuji Osahiko, Fujiyoshi Kanehiro, Hosogane Naobumi, Watanabe Kota, Tsuji Takashi, Ishii Ken, Toyama Yoshiaki, Chiba Kazuhiro, Matsumoto Morio

Spine 37 ( 10 ) 2012.05

ISSN 0362-2436

STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7%, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29%) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47%) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10% for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30% of patients who underwent grade II resection. Copyright © 2012 Lippincott Williams &Wilkins.

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A case of spontaneous spinal epidural hematoma that mimicked acute cerebral ischemic stroke and was treated by a recombinant tissue-type plasminogen activator

Okada Eijiro, Matsumoto Morio, Watanabe Kota, Yagi Mituru, Ninomiya Ken, Horiuchi Yukio, Toyama Yoshiaki

Neurosurgery Quarterly 22 ( 2 ) 99 - 101 2012.05

ISSN 1050-6438

Summary: A healthy 49-year-old female complaining of progressive hemiplegia of the left side consulted the Emergency Department. Neurological examinations and non-contrast computed tomography of the brain showed no evidence of hemorrhage. Acute ischemic stroke was diagnosed, and intravenous recombinant tissue-type plasminogen activator was administered under the guidelines of the National Institute of Neurological Disorders. After starting the treatment, the patient developed progressive quadriplegia and pain in the back of her neck. Cervical magnetic resonance imaging showed a vast epidural hematoma. The patient underwent emergency decompression surgery and removal of the hematoma by spine surgeons. Intraoperative epidural bleeding was observed on the left side at the C3-C4 level. Postoperatively, the patient showed significant improvement, becoming neurologically intact and functional by the 14-month follow-up. Importantly, this case illustrates that a cervical epidural hematoma can present as hemiplegia, which can be misdiagnosed as a cerebrovascular accident in neurology emergency rooms. Copyright © 2012 by Lippincott Williams & Wilkins.

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Modic changes in the cervical spine

Matsumoto M., Okada E., Ichihara D., Chiba K., Toyama Y., Fujiwara H., Momoshima S., Nishiwaki Y., Takahata T.

Journal of Bone and Joint Surgery - Series B 94 B ( 5 ) 678 - 683 2012.05

ISSN 0301-620X

We conducted a prospective follow-up MRI study of originally asymptomatic healthy subjects to clarify the development of Modic changes in the cervical spine over a ten-year period and to identify related factors. Previously, 497 asymptomatic healthy volunteers with no history of cervical trauma or surgery underwent MRI. Of these, 223 underwent a second MRI at a mean follow-up of 11.6 years (10 to 12.7). These 223 subjects comprised 133 men and 100 women with a mean age at second MRI of 50.5 years (23 to 83). Modic changes were classified as not present and types 1 to 3. Changes in Modic types over time and relationships between Modic changes and progression of degeneration of the disc or clinical symptoms were evaluated. A total of 31 subjects (13.9%) showed Modic changes at followup: type 1 in nine, type 2 in 18, type 3 in two, and types 1 and 2 in two. Modic changes at follow-up were significantly associated with numbness or pain in the arm, but not with neck pain or shoulder stiffness. Age (≥ 40 years), gender (male), and pre-existing disc degeneration were significantly associated with newly developed Modic changes. In the cervical spine over a ten-year period, type 2 Modic changes developed most frequently. Newly developed Modic changes were significantly associated with age, gender, and pre-existing disc degeneration. © 2012 British Editorial Society.

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