Kiyotsugu Maekawa

Operative Results for Ligamentous Ossification in the Thoracic Spine

We surgically treated 20 cases of thoracic myelopathy caused by ossification of the yellow ligament (OYL) and combined OPLL. Subjects included 10 males and 10 females. The duration between the occurrence of symptoms and time of surgery ranged from 1 month to 2 years (average 8.3 months).The average age at surgery was 58 years. All patients had had laminectomy. We found difficulty in some cases in performing decompression of the ossified spinal lesions.

A Follow-up Study of Postoperative Cervical Laminoplasty

We studied 69 patients with cervical spondylotic myelopathy, and 33 patients with cervical ossification of the posterior longitudinal ligament with a mean age of 65.5 years and an average follow-up period of 4 years and 5 months. Clinical results were evaluated using the JOA score for cervical myelopathy and recovery rates using Hirabayashis method. The overall mean recovery rate was 58%. There was no significant difference between recovery rate and age, duration of symptoms or preoperative JOA score.Moreover, we radiographically investigated changes in cervical alignment and rate of enlargement, antero-posterior movement, and instability in 50 cases.

Surgical Treatment for Paraparesis after Vertebral Fracture with Osteoporosis using Luque Instrumentation

The number of high aged patients with osteoporosis are increasing. We treated surgically two patients with paraparesis after fracture of vertebral body with osteoporosis using Luque instrumentation. These cases showed good neurological recovery after operation. Up to now, surgical treatment for osteoporosis was aboided, but we proved that surgical treatment was useful for improvement of neurological deficit.

Therapy and Problems to C. S. M. Patients over 65 Years Old

Since 1979 we have operated 53 patients over 65 years old. They were evaluated as to postoperative results. Satisfactory results were achieved in 27 (55%).Patients under 64 years of age appeared to do better. Postoperative complications were found considerably among them.To avoid postoperative complications, we make efforts to improve technical devices for anterior and posterior decompression surgery.

Posterolateral Decompression for OPLL with OYL in Thoracic Spine

Recently we have experimented witn the treatment of three cases associated with OPLL and OYL in the thoracic spine. For three cases with myelopathy we carried out resection of the OPLL and OYL using the posterior and lateral approach. Results of them were good, but one case needed Halo-pelvic apparatus for post-operative instability.

Luque Instrumentation after Posterior Decompression for Lumbar Degeneration of High Aged Patients

Eighteen cases of Luque instrumentation with spinous process wiring after posterior decompression for lumbar degeneration of high aged patients were discussed.The operative time and intraoperative bleeding of them were not so different from those of the cases without Luque instrumentation. The mean duration until ambulation was 10 days. The improvement rate of JOA score was 72%.Comfortable stabilization for decompressed segment was obtained. The decrease in total lumbar motion was about 10 degree, and it did not disturb the ADL so much.This method is easy, and has good application when high aged patients need early ambulation, and when the instability of multiple segments exists or will occur by decompression.

Surgical Treatment with Instrument and Ceramic Spacer for Spinal Lesion

Reconstructive surgical treatment with the spinal instrument or the ceramic spacer were performed on 8 patients and good results were achieved. Six patients were suffering from the pain of the spinal metastatic tumor and 2 patients had the slight senile dementia from old age.

Two Cases of Foreign Bodies in the Knee. (Arthroscopic removal)

Arthroscopic surgery was performed in two cases of knee joints containing foreign bodies.Case 1: 46-year-old female. Broken glass penetrated into her right knee joint and 6 years later, her right knee suffered from septic arthritis, so we performed arthroscopic removal of the glass.Case 2: 6-year-old male. A needle penetrated into his left knee joint, so we performed arthroscopic removal of the needle.Arthroscopic removal of foreign bodies in the knee joint is more useful than large incision removal.