Kenji Ohtsuki

A Study of Posterolateral Fusion for Lumbar Degenerative Disease

We reviewed 57 patients who were operated on for degenerative lumbar canal stenosis and evaluated them clinically and radiographically.The surgical method was decompressive wide laminectomy with posterolateral fusion (28 patients) and without posterolateral fusion (29 patients).The mean age of patients at operation was 53 years in the cases with fusion and was 59 years in the cases without fusion. They were followed up for an age of 103 months.The average postoperative JOA score of patients with fusion was 15.5 points and that without fusion was 15.5 points. There was no statistical significance of JOA score between with the groups and without fusion.Acquired spondylolysis was found in 5 patients in the group without fusion, but there were no cases of acquired spondylolysis in patients with fusion.The width of decompression in 5 patients with spondylolysis was greater than that in patients without spondylolysis.We suggest that posterolateral fusion is a useful method for preventing postoperative instability in patients with excessive bony decompression.

Arthrodesis for the Severe Osteoarthritis of the Hip in the Middle Age

From 1976 to 1990, 17 hip arthrodeses have been performed for severe osteoarthritis at the National Misasa Onsen Hospital. The age of the patients ranged from 32 to 55 years at the time of the operation. Follow-up period was 4 months to 13 years (average, 3 years and 6 months).In the follow-up study, operated hips were evaluated using the JOA score. Results showed that preoperative total average score of 53.2 points (range, 32 to 68) was improved to 66.6 points (range, 50 to 76) postoperatively. Especially, pain score changed for the better from 15.3 points to 37.1. Nonunion rate was 17.6 per cent.We come to the conclusion that even recently, hip arthrodesis is one of the useful operation for severe osteoarthritis in the middle age.

A Clinical Report on Diseases of Central Nervous System with Cervical Spondylotic Changes

Between April 1976 and March 1985, 94 patients who have myelopathy and radiculopathy with cervical spondylosis were treated by anterior interbody fusion and laminectomy.Postoperatively, six of these patients were identified as another disorders of central nervous system.These disorders were motor neuron disease, multiple sclerosis, intramedullary tumor, metastatic brain tumor and cerebral vascular accident.

An Experience of Surgical Treatment for Cubital Tunnel Syndrome

The results of eighteen cases of cubital tunnel syndrome in seventeen patients have been investigated after Kings operation, anterior transposition, or neurolysis including release of the aponeurosis.At operation the nerve was constricted by the flexor carpi ulnaris aponeurosis in all cases. Additionally, we found a pseudoneuroma of the proximal of the constricted part in fifteen cases.Recovery was satisfactory when operation was performed within three months of the onset of symptoms, and was most unsatisfactory in the cases caused by osteoarthritis of the elbow.Then, the authors discussed a pathogenesis of cubital tunnel syndrome.

Two Cases of Aseptic Necrosis in the Capitulum Humeri

This report concerns two children with aseptic necrosis of the capitulum humeri.Case 1-A boy aged eight years was brought with slight swelling on the lateral aspect of the right elbow and limitation of range of motion of the elbow. The elbow was immobilized in an apparatus for a few months.Case 2-A boy aged ten years with moderate swelling on the lateral aspect of the right elbow and impairment of elbow movement was treated by bone-peg grafting into the capitulum humeri surgically.The results were compared with clinical features, function of the elbow and roentgenographic views.In conclusion, the latter obtained more excellent results than the former.

Juvenile Rheumatoid Arthritis

We have studied eleven patients of juvenile rheumatoid arthritis. JRA is a diffuse systemic disease and the onset of the disease may be subtle. Often conspicuous evidence of the rheumatoid arthritis is lacking for months. Monoarticular and polyarticular arthritis occurred as the first manifestation and often they had a slight attack of fever.The erythrocyte sedimentation rate is the most useful test. Its elevation is taken to be evidence of active disease. The roentgenographic finding (regional alterations) is helpful for diagnosis.The dangerous complication is rarely and the prognosis for life is good.