Watanabe, Koota

写真a

Affiliation

School of Medicine, Department of Orthopaedic Surgery (Shinanomachi)

Position

Associate Professor

E-mail Address

E-mail address

External Links

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

  • 1992.03

    慶應義塾高等学校

    Graduated

  • 1992.04
    -
    1997.03

    慶應義塾大学, 医学部

    University, Graduated

 
 

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

  • Spinal fractures in patients with diffuse idiopathic skeletal hyperostosis: Clinical characteristics by fracture level

    Okada E., Shimizu K., Kato M., Fukuda K., Kaneko S., Ogawa J., Yagi M., Fujita N., Tsuji O., Suzuki S., Nagoshi N., Tsuji T., Nakamura M., Matsumoto M., Watanabe K.

    Journal of Orthopaedic Science (Journal of Orthopaedic Science)  24 ( 3 ) 393 - 399 2019.05

    ISSN  09492658

     View Summary

    © 2018 The Japanese Orthopaedic Association Background: Diffuse idiopathic skeletal hyperostosis (DISH) makes the spine prone to unstable fractures with neurological deterioration. This study was conducted to assess clinical and radiographic features of spinal fractures in DISH by the level of spinal injury, and to evaluate the optimal treatment for each level. Methods: A multicenter retrospective study over a 5-year period, including 46 patients (35 males; 11 females) with a mean age of 77.2 ± 9.7 years at the time of injury. By fracture level, there were 7 cervical (15.2%), 25 thoracic (54.3%), and 14 lumbar (30.4%) fractures. We recorded the cause of injury, whether diagnosis was delayed, and neurological status by Frankel grade. Ossification and fracture patterns were assessed by CT-multi-planar reconstruction (MPR). Results: Neurological status immediately after the cervical-spine injury was C (28.6%) or E (71.4%); after thoracic injury, C (12.0%) or E (88.0%); and after lumbar injury, D (21.4%) or E (78.6%). Inability to walk at admission was more frequent in patients with a spinal-cord injury above the lumbar level (P = .033). Vertebral-body fractures were observed in 14.3% of the cervical injuries, 80.0% of the thoracic injuries, and 50.0% of the lumbar injuries (P = .004). Most patients with a cervical fracture had a disc-level fracture (85.7%). Posterior-column ankylosis was observed in 14.3% of the cervical-fracture group, 72.0% of the thoracic-fracture group, and 78.6% of the lumbar-fracture group (P = .008). Conclusion: Ossification and fracture patterns in patients with DISH varied distinctly by the level of spinal injury. Intervertebral-disc fractures were frequently observed in the cervical spine. Delayed diagnosis, vertebral-body fracture, and posterior-column ankylosis were observed in the thoracolumbar spine. This study recommends 3 above and 3 below fusion, to avoid instrumentation failure in the fixation of spinal fracture in patients with DISH.

  • Surgical risk stratification based on preoperative risk factors in adult spinal deformity

    Yagi M., Hosogane N., Fujita N., Okada E., Suzuki S., Tsuji O., Nagoshi N., Asazuma T., Tsuji T., Nakamura M., Matsumoto M., Watanabe K.

    Spine Journal (Spine Journal)  19 ( 5 ) 816 - 826 2019.05

    ISSN  15299430

     View Summary

    © 2018 Elsevier Inc. BACKGROUND CONTEXT: Corrective surgery for adult spinal deformity (ASD) improves health-related quality of life but has high complication rates. Predicting a patient's risk of perioperative and late postoperative complications is difficult, although several potential risk factors have been reported. PURPOSE: To establish an accurate, ASD-specific model for predicting the risk of postoperative complications, based on baseline demographic, radiographic, and surgical invasiveness data in a retrospective case series. STUDY DESIGN/SETTING: Multicentered retrospective review and the surgical risk stratification. PATIENT SAMPLE: One hundred fifty-one surgically treated ASD at our hospital for risk analysis and model building and 89 surgically treated ASD at 2 other our hospitals for model validation. OUTCOME MEASURES: HRQoL measures and surgical complications. METHODS: We analyzed demographic and medical data, including complications, for 151 adults with ASD who underwent surgery at our hospital and were followed for at least 2years. Each surgical risk factor identified by univariate analyses was assigned a value based on its odds ratio, and the values of all risk factors were summed to obtain a surgical risk score (range 0–20). We stratified risk scores into grades (A–D) and analyzed their correlations with complications. We validated the model using data from 89 patients who underwent ASD surgery at two other hospitals. RESULTS: Complications developed in 48% of the patients in the model-building cohort. Univariate analyses identified 10 demographic, physical, and surgical risk indicators, with odds ratios from 5.4 to 1.4, for complications. Our risk-grading system showed good calibration and discrimination in the validation cohort. The complication rate increased with and correlated well with the risk grade using receiver operating characteristic curves. CONCLUSIONS: This simple, ASD-specific model uses readily accessible indicators to predict a patient's risk of perioperative and postoperative complications and can help surgeons adjust treatment strategies for best outcomes in high-risk patients.

  • Surgical Outcomes for Drop Body Syndrome in Adult Spinal Deformity

    Yagi M., Fujita N., Okada E., Tsuji O., Nagoshi N., Yato Y., Asazuma T., Nakamura M., Matsumoto M., Watanabe K.

    Spine (Spine)  44 ( 8 ) 571 - 578 2019.04

     View Summary

    STUDY DESIGN: A multicenter retrospective case series of patients treated surgically for adult spinal deformity (ASD). OBJECTIVE: The aim of this study was to compare clinical outcomes between propensity score matched ASD patients with or without drop body syndrome (DBS). SUMMARY OF BACKGROUND DATA: DBS is an extreme primary sagittal-plane deformity often seen in Asian countries. Although the importance of sagittal alignment is widely recognized, surgical outcomes for deformities purely in the sagittal plane are poorly understood. METHODS: This study included 243 consecutive patients (age 66 ± 17 years; range 22-78) who were treated surgically for ASD and were followed at least 2 years (mean follow-up 3.7 ± 2.3 years). DBS was defined as a primary lumbar kyphosis with PI-LL >40°, Cobb angle <30°, and multifidus cross-sectional area <300 mm. DBS patients were matched with non-DBS patients by propensity scores for age, gender, lowest instrumented vertebra (LIV) level, and number of levels fused. Demographics, radiographic findings, and clinical outcomes were compared between DBS and non-DBS patients. RESULTS: Of 243 patients with ASD, 34 had DBS (14%); 28 of these were propensity-matched with ASD patients without DBS. Baseline bone mineral density (BMD), body mass index (BMI), and frailty were similar in DBS and non-DBS patients. Baseline sagittal alignment was worse in DBS than in non-DBS patients [C7SVA 14 ± 5 vs. 8 ± 5 cm; pelvic incidence (PI) - lumbar lordosis (LL) 60 ± 14 vs. 36 ± 20°], and scoliosis research society (SRS)22 scores were also worse for DBS patients (2.5 ± 0.6 vs. 2.9 ± 0.8). Although DBS patients had more complications (20 DBS vs. 16 non-DBS), the clinical outcomes were similarly improved in both groups after surgery. At the 2-year follow-up, the spinopelvic malalignment was worse in DBS than non-DBS patients (PI-LL 17 ± 16° vs. 8 ± 13°, P < 0.05). CONCLUSION: DBS affected 14% of 234 ASD patients. Although DBS patients had inferior baseline SRS22 scores than non-DBS patients, ASD surgery resulted in similar clinical improvement in both groups. Future studies should examine the influence of lifestyle and genetics on clinical outcomes after surgery for DBS.3.

  • Potential involvement of semaphorin 3A in maintaining intervertebral disc tissue homeostasis

    Mima Y., Suzuki S., Fujii T., Morikawa T., Tamaki S., Takubo K., Shimoda M., Miyamoto T., Watanabe K., Matsumoto M., Nakamura M., Fujita N.

    Journal of Orthopaedic Research (Journal of Orthopaedic Research)  37 ( 4 ) 972 - 980 2019.04

    ISSN  07360266

     View Summary

    © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. Intervertebral discs (IVDs) are avascular; however, ingrowth of blood vessels into their outer regions has been noted during the progression of degeneration. The mechanisms underlying vascularization in IVD degeneration are not completely understood. Semaphorin 3A (Sema3A), originally characterized as a chemorepulsive factor for growing axons in the developing nervous system, inhibits angiogenesis. This study aimed to elucidate the potential involvement of Sema3A in maintaining tissue homeostasis within the avascular IVD. We demonstrated that the mRNA expression of Sema3A was higher in rat annulus fibrosus (AF) than in nucleus pulposus (NP) and that its expression level decreased with age. Both mRNA and protein expression level of Sema3A was also markedly suppressed in AF tissues of a rat IVD degeneration model. Both real-time RT-PCR and Western blot clearly indicated that Sema3A expression significantly reduced by treating inflammatory cytokines in rat AF cells. In a gain- and loss-of-function study, we observed that Sema3A reduced the catabolic shift in rat AF cells. In addition, our results indicated that Sema3A potentially inhibited the IL-6/JAK/STAT pathway. Finally, BrdU assay and tube formation assay revealed that treatment of recombinant Sema3A significantly blocks both proliferation and tube formation of HUVEC. Our results indicate that Sema3A may help maintain IVD tissue homeostasis. Thus, although further studies are needed, Sema3A may be a potential molecular target for suppressing IVD degeneration. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  • Spinal correction surgery improves asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis with thoracic major curve

    Nishida M., Nagura T., Fujita N., Nakamura M., Matsumoto M., Watanabe K.

    European Spine Journal (European Spine Journal)  28 ( 3 ) 619 - 626 2019.03

    ISSN  09406719

     View Summary

    © 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: To clarify the effect of posterior correction and fusion surgery on the trunk–pelvic kinematics during gait in adolescent idiopathic scoliosis (AIS) patients with single thoracic major curve. Methods: Among preoperative AIS patients who planned correction surgery, 18 patients with Lenke type 1A or B were selected for this study. All patients were female. The patients’ trunk and pelvic kinematics during gait were measured three-dimensionally and dynamically using reflective markers, optoelectronic motion capture system. The gait analysis was performed before and 1–2 years after surgery. The trunk and pelvic symmetry during gait was evaluated at coronal, sagittal, and transverse planes between concave and convex sides. Results: The trunk and pelvic angles in sagittal and coronal planes were equivalent between concave and convex sides before and after surgery. Preoperatively, transverse trunk rotation angles were significantly deviated toward the concave (left) side during both static standing (4.3 ± 2.0°) and gait (8.8 ± 0.6°, p < 0.01). Preoperative transverse pelvic rotation angles were significantly deviated toward the convex side during static standing (4.0 ± 3.8°). However, pelvis displayed with symmetric rotational kinematics during gait. Postoperatively, the deviated transverse trunk rotation angle significantly decreased (1.6 ± 0.3°), and the transverse rotational kinematics of both trunk and pelvis improved to symmetric. Conclusions: Posterior correction and fusion surgery have improved preoperative asymmetric global rotational kinematics of trunk and pelvis in transverse plane to symmetric postoperatively in AIS patients with thoracic single major curve. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

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

Reviews, Commentaries, etc. 【 Display / hide

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

  • genetic analysis of causative factors for congenital scoliosis

    2017.04
    -
    2020.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, 渡邉 航太, 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, 渡邉 航太, 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.

 

Courses Taught 【 Display / hide

  • LECTURE SERIES, ORTHOPAEDICS

    2019