Watanabe, Koota

写真a

Affiliation

School of Medicine, Department of Orthopaedic Surgery (Shinanomachi)

Position

Associate Professor

External Links
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Career 【 Display / hide 】

  • 1997.04
    -
    Present

    慶應義塾大学, 医学部　整形外科, 研修医

  • 1998.08
    -
    Present

    国立埼玉病院, 整形外科

  • 1999.08
    -
    Present

    栃木県大田原赤十字病院, 整形外科

  • 2001.01
    -
    Present

    群馬県総合太田病院, 整形外科

  • 2002.04
    -
    Present

    慶應義塾大学, 生理学教室（岡野研究室）

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Academic Background 【 Display / hide 】

  • 1997.03

    慶應義塾大学, 医学部

    University, Graduated

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Books 【 Display / hide 】

  • 胸椎側弯症に対する椎弓根スクリュー法（ボールチッププローブ法）. Illustrated Surgery of Spine & Spinal Cord 脊椎脊髄手術　第Ⅱ巻. 戸山芳昭、花北順哉編集.

    渡邉航太, 三輪書店, 2015

    Scope: pp317-20

  • 脊柱側弯症とは. 体と心　保健総合大百科　保健ニュース・心の健康ニュース　縮刷活用版.

    渡邉航太, 少年写真新聞社., 2015

    Scope: pp74

  • 腰部脊柱管狭窄症に対する棘突起縦割式椎弓切除術. OS NEXUS 2 頚椎・腰椎の後方除圧術.

    渡邉航太, メジカルビュー社, 2015

    Scope: pp134-43

  • 腰部脊柱管狭窄症に対する棘突起縦割式椎弓切除術. Illustrated Surgery of Spine & Spinal Cord 脊椎脊髄手術　第Ⅱ巻. 戸山芳昭、花北順哉編集.

    渡邉航太、細谷俊彦、白石　建、松本守雄、千葉一裕, 三輪書店, 2015

    Scope: pp172-6

  • 先天性側弯症に対する半椎切除術. 新脊椎インストゥルメンテーション　テクニカルポイントと合併症対策.　野原裕, 鈴木信正, 中原進之介編集.　

    渡邉航太, メジカルビュー社, 2014

    Scope: pp86-9

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Papers 【 Display / hide 】

  • Can Postoperative Distal Adding-On be Predicted in Lenke Type 1B and 1C Curves with Intraoperative Radiographs?

    Fujii T., Kawabata S., Suzuki S., Tsuji O., Nori S., Okada E., Nagoshi N., Yagi M., Michikawa T., Nakamura M., Matsumoto M., Watanabe K.

    Spine (Spine)  47 ( 6 ) E215 - E221 2022.03

    ISSN  03622436

    　View Summary

    Study Design.A retrospective study of consecutive collected data.Objective.To investigate risk factors for postoperative distal adding-on (DA) in Lenke Type 1B and 1C curves using intraoperative radiographs.Summary of Background Data.In adolescent idiopathic scoliosis (AIS), DA radiographic complication can negatively affect postoperative clinical results. However, few studies have focused on assessing risk factors for DA using intraoperative radiographs.Methods.We retrospectively evaluated 69 AIS patients with Lenke Type 1B or 1C curves who underwent posterior selective thoracic fusion. We divided patients into DA and non-DA groups based on radiograph data at 2-year follow-up using Wang et al (Spine 2011) definition of DA. We compared coronal radiographic parameters, including relative positions of end vertebra (EV), stable vertebra (SV), neutral vertebra (NV), and last touching vertebra (LTV) to lowest instrumented vertebra (LIV), and intraoperative radiographic parameters, between the two groups.Results.DA was present in 13 patients (18.8%) at 2-year follow-up. The mean LIV-EV, LIV-NV, LIV-SV, and LIV-LTV relative positions were significantly smaller in the DA group than in the non-DA group. Multivariate analysis showed that LIV-LTV was significantly associated with DA (DA: -0.2 ± 0.7, non-DA: 0.6 ± 0.7). Intraoperative radiographs showed that the mean angulation of the first disc below the LIV after final adjustment was significantly larger in the DA group (2.3° ± 1.1°) than in the non-DA group (0.9° ± 0.7°). Patients whose angulation of the first disc below the LIV was more than 3° were significantly associated with DA.Conclusion.The LIV selected at more cranial to the LTV may be a risk factor for postoperative DA in Lenke Type 1B and 1C curves. Moreover, it was suggested that LIV extension might be considered when the first disc's angulation below the LIV is >3° in intraoperative radiographs.Level of Evidence: 3.

  • Influence of Intervertebral Level of Stenosis on Neurological Recovery and Reduction of Neck Pain after Posterior Decompression Surgery for Cervical Spondylotic Myelopathy: A Retrospective Multicenter Study with Propensity Scoring

    Nori S., Nagoshi N., Aoyama R., Ishihara S., Fujiyoshi K., Shiono Y., Kitamura K., Ishikawa M., Suzuki S., Takahashi Y., Tsuji O., Yagi M., Nakamura M., Matsumoto M., Watanabe K., Ishii K., Yamane J.

    Spine (Spine)  47 ( 6 ) 476 - 483 2022.03

    ISSN  03622436

    　View Summary

    Study Design.Retrospective multicenter study.Objective.To identify the impact of the intervertebral level of stenosis on surgical outcomes of posterior decompression for cervical spondylotic myelopathy (CSM).Summary of Background Data.As the upper affected cervical levels in elderly patients result from degenerative changes in the lower cervical levels with aging, it is usually difficult to determine the influence of the upper affected cervical levels on surgical outcomes after posterior decompression for CSM in older age.Methods.This study involved 636 patients with CSM who underwent posterior decompression. According to the most stenotic intervertebral level, patients were divided into upper (n = 343, the most stenotic intervertebral level was C2/3, C3/4, or C4/5) and lower (n = 293, the most stenotic intervertebral level was C5/6, C6/7, or C7/T1) cervical stenosis groups. Propensity score matching of the baseline factors (characteristics, comorbidities, and neurological function) was performed to compare surgical outcomes, the Japanese Orthopaedic Association (JOA) scores, and visual analog scale (VAS) for neck pain between the upper (n = 135) and lower (n = 135) cervical stenosis groups.Results.Before propensity score matching, age at surgery was older and pre- and postoperative JOA scores were lower in the upper cervical stenosis group (P < 0.001, P < 0.001, and P < 0.001, respectively). Following matching, baseline factors were comparable between the groups. Postoperative JOA scores, preoperative-to-postoperative changes in the JOA scores, and the JOA score recovery rate were not significantly different between the groups (P = 0.866, P = 0.825, and P = 0.753, respectively). No differences existed in postoperative VAS for neck pain and preoperative-to-postoperative changes in VAS for neck pain between the groups (P = 0.092 and P = 0.242, respectively).Conclusion.The intervertebral level of stenosis did not affect surgical outcomes after posterior decompression for CSM.Level of Evidence: 3.

  • Clinical outcomes and a therapeutic indication of intramedullary spinal cord astrocytoma

    Nagoshi N., Tsuji O., Suzuki S., Nori S., Yagi M., Okada E., Okita H., Fujita N., Ishii K., Matsumoto M., Nakamura M., Watanabe K.

    Spinal Cord (Spinal Cord)  60 ( 3 ) 216 - 222 2022.03

    ISSN  13624393

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    Study design: Retrospective cohort study. Objectives: Although intramedullary astrocytoma is associated with a high mortality rate, the optimal treatment has not reached a consensus. This study aimed at evaluating neurologic function and overall survival rate (OSR) in the treatment of this tumor. Setting: The single institution in Japan. Methods: This study enrolled 67 subjects who underwent surgical treatment for intramedullary astrocytoma. Demographic, imaging, and surgical information were collected from each participant. Tumors were histologically categorized using the World Health Organization classification, and subjects were divided into low-grade (I and II; n = 40) and high-grade (III and IV; n = 27) groups. Neurologic status was evaluated using the modified McCormick scale (MMS). OSR was assessed using Kaplan–Meier methods. Results: The OSR decreased when the pathological grade increased (p < 0.01). Regarding the therapeutic efficacy for low-grade astrocytomas, subjects who underwent gross total resection (GTR) showed a higher OSR than those who did not (p = 0.02). GTR prevented worsening of MMS score, while non-GTR increased the MMS score (p < 0.01). In the high-grade group, 19 and 10 underwent radiation therapy and chemotherapy, respectively. However, both treatments did not improve OSR. Cordotomy was performed for subjects whose lesional area was at the thoracic level, but the OSR did not significantly increase. Conclusions: The most beneficial therapeutic strategy for low-grade astrocytomas was GTR, whereas that for the high-grade tumors was unclear. Further studies with a larger sample size are warranted to validate the effective treatment for malignant astrocytomas.

  • Spontaneous Osseous Fusion after Remodeling Therapy for Chronic Atlantoaxial Rotatory Fixation and Recovery Mechanism of Rotatory Range of Motion of the Cervical Spine

    Kitamura K., Ishii K., Nagoshi N., Chiba K., Matsumoto M., Nakamura M., Watanabe K.

    Journal of Clinical Medicine (Journal of Clinical Medicine)  11 ( 6 )  2022.03

    　View Summary

    We aimed to investigate the risk factors of spontaneous osseous fusion (SOF) of the at-lantoaxial joint after closed reduction under general anesthesia followed by halo fixation (remodeling therapy) for chronic atlantoaxial rotatory fixation, and to elucidate the recovery mechanism of the rotatory range of motion (ROM) after halo removal. Twelve patients who underwent remodeling therapy were retrospectively reviewed. Five patients with SOF were categorized as the fusion group and seven patients without SOF as the non-fusion group. Three dimensional CT was used to detect direct osseous contact (DOC) of facet joints before and during halo fixation, while dynamic CT at neutral and maximally rotated head positions was performed to measure rotatory ROM after halo removal. The duration from onset to initial visit was significantly longer (3.2 vs. 5.7 months, p = 0.04), incidence of DOC during halo fixation was higher (0/7 [0%] vs. 4/5 [80%], p = 0.004), and segmental rotatory ROM of Occiput/C1 (Oc/C1) at final follow-up was larger (9.8 vs. 20.1 degrees, p = 0.003) in the fusion group. Long duration from the onset to the initial visit might induce irreversible damage to the articular surface of the affected facet, which was confirmed as DOC during halo fixation and resulted in SOF. Long duration from the onset to the initial visit and DOC during halo fixation could be used to suggest the risk for SOF. Nonetheless, rotatory ROM of Oc/C1 increased to compensate for SOF.

  • Surgical Predictors for Prevention of Postoperative Shoulder Imbalance in Lenke Type 2A Adolescent Idiopathic Scoliosis

    Sato T., Yonezawa I., Matsumoto H., Otomo N., Suzuki T., Manabe N., Demura S., Watanabe K., Saito T., Nohara A., Kurakawa T., Shimizu T., Uno K., Matsumoto M., Kawakami N.

    Spine (Spine)  47 ( 4 ) E132 - E141 2022.02

    ISSN  03622436

    　View Summary

    Study Design. Multicenter, retrospective cohort study. Objective. The aim of this study was to investigate the occurrence and surgical predictors of postoperative shoulder imbalance (PSI) in Lenke type 2A adolescent idiopathic scoliosis (AIS). Summary of Background Data. Although several studies have investigated the factors influencing PSI in Lenke type 2 curves, no studies have analyzed PSI-related factors considering upper instrumented vertebra (UIV) and lumbar modifier type simultaneously. Methods. Patients with Lenke Type 2A AIS treated by spinal fusion were retrospectively identified and their data were extracted from six spine centers in Japan. Inclusion criteria were age between 10 and 20years at surgery, UIV=T2, major curve 408 to 908, and follow-up for 24 to 30months after surgery. We analyzed patient characteristics, surgical characteristics, and preoperative and immediate-postoperative radiographic parameters. We defined patients with lower instrumented vertebra (LIV) equal or proximal to the last touching vertebra (LTV) as selective thoracic fusion (STF-LTV) and patients with LIV distal to the LTV as non-STF-LTV. t Tests, Mann-Whitney U test, χ2 tests, Fisher exact tests, and multivariate logistic regression were used for statistical analyses. Results. Among the 99 consecutive patients with a mean follow-up of 25.6months, PSI was seen in 27 (27.3%) patients immediately after and in 17 (17.2%) patients at 24 to 30months. The univariate analysis revealed that the significant risk factors of PSI were preoperative radiographical shoulder height, non-STF-LTV, and high main thoracic curve (MTC) correction (immediate-postoperative MTC correction rate: ≥70%), with PSI incidence of 40.0%. The multivariate logistic regression analysis indicated that interaction term of non-STF-LTV and high MTC correction was an independent risk factor for PSI (non-STF-LTV and high MTC correction, odds ratio: 5.167, 95% confidence interval: 1.470-18.159, P=0.010). Conclusion. To prevent PSI in Lenke Type 2A AIS patients, surgeons should avoid the combination of non-STF-LTV and high MTC correction in those surgeries with UIV as T2.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

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Presentations 【 Display / hide 】

  • VEPTRを用いて治療した二分脊椎に伴う著明な後弯症の１例

    藤井 武, 岡田 英次朗, 藤田順之, 八木 満, 中村雅也, 松本守雄, 渡邉航太

    第16回日本乳・幼児側弯症研究会 (東京) , 

    2017.12
    , 

    Oral presentation (general)

  • 小児頚椎疾患と手術.

    渡辺航太

    第28回小児整形外科学会学術集会 (東京) , 

    2017.12
    , 

    Oral presentation (general)

  • 思春期特発性側弯症治療を取り巻く最新テクノロジーと今後の展望.

    渡辺航太

    第28回小児整形外科学会学術集会 (東京) , 

    2017.12
    , 

    Oral presentation (general)

  • Surgical outcome of elderly patients over 80 years with cervical spondylotic myelopathy

    Isogai N, Nagoshi N, Yamane J, Iwanami A, Kono H, Kobayashi Y, Fujita N, Yagi M, Watanabe K, Kitamura K, Shiono Y, Nakamura M, Matsumoto M, Ken I, KSRG members

    45th Cervical Spine Research Society (CSRS) (USA) , 

    2017.11
    , 

    Oral presentation (general)

  • 後方進入で全摘した上位胸髄腹側発生腸管原性囊胞の1例.

    松林紘平, 名越慈人, 辻 収彦, 渡辺航太, 松本守雄, 中村雅也

    第52回 日本脊髄障害医学会 (千葉) , 

    2017.11
    , 

    Oral presentation (general)

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • Pathophysiology of scoliosis using genetics

    2023.04
    -
    2026.03

    基盤研究(B), Principal investigator

  • Research for causative gene of congenital scoliosis

    2020.04
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    2023.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

  • genetic analysis of causative factors for congenital scoliosis

    2017.04
    -
    2020.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

  • Exploration of the pathology of lumbar spinal canal stenosis associated with Diabetes

    2014.04
    -
    2017.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

    　View Summary

    The pathomechanism of the ligamentum flavum (LF) hypertrophy in diabetic patients with lumbar spinal canal stenosis (LSCS) remains unclear. We found that the LF of diabetic patients exhibited significantly higher levels of sorbitol and pro-inflammatory cytokines. The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol, pro-inflammatory factors, and TGF-β1 compared to the low glucose-cultured cells, and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor. Taken together, our data suggests that increased sorbitol levels in the LF of diabetic patients results in increased production of pro-inflammatory and fibrogenic factor, which contribute to LF hypertrophy, and could increase the susceptibility of diabetic patients to LSCS. Furthermore, aldose reductase inhibition effectively reduced the levels of sorbitol and sorbitol-induced pro-inflammatory factor expression in high glucose-cultured fibroblasts.

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Courses Taught 【 Display / hide 】

  • LECTURE SERIES, ORTHOPAEDICS

    2024

  • LECTURE SERIES, ORTHOPAEDICS

    2023

  • LECTURE SERIES, ORTHOPAEDICS

    2022

  • LECTURE SERIES, ORTHOPAEDICS

    2021

  • LECTURE SERIES, ORTHOPAEDICS

    2020

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