Masahiko Nishiguchi

Multi‐Detector Row CT Imaging of Vertebral Microstructure for Evaluation of Fracture Risk

We applied MDCT for in vivo evaluation of the microarchitecture of human vertebrae. Microstructure parameters, such as structure model index, Eulers number, and bone volume fraction, revealed higher relative risk for prevalent vertebral fracture than did BMD obtained by DXA. Thus, microstructure analysis by MDCT, together with simultaneously obtained volumetric BMD values, is useful for clinical assessment of fracture risk.

Clinical Results of Surgical Treatment for Rotator Cuff Tear in Tsushima

We treated rotator cuff tears surgically by the McLaughlin method on 14 cases from 1994 to 1997. They were followed up for an average of 26 months (range, 6 to 52). There were 11 were men and 5 were women. The average age of the patients was 58.1 years (range, 48 to 68). The clinical results were evaluated using the JOA score system and questionnaires on the patients satisfaction and problems and self score system (10 point method). The average JOA score was 96.1 points. The average 10 points score was 8.9 points.

Treatment of Rotator Interval Lesion

We surgically treated 6 patients with rotator interval lesions. Our diagnosis required (1) existence of shoulder pain, (and night pain), (2) existence of motion pain or limitation of range of motion, (3) tenderness of the rotator interval, (4) rotator cuff (supra spinatus tendon and subscapular tendon) are not torn, (5) arthrographic findings suggest a rotator interval lesion. Surgical procedure; coraco-acromial ligament is resected and coraco-humeral ligament is retracted, rotator interval is sutured side to side. Patients were evaluated acording to their JOA score. Mean preoperative JOA score was 65.5 and postoperative JOA score was 96.3.

A Study of Meniscus Injury to Knees in the Elderly

Injuries to meniscus were studied in 31 knees of 30 patients, of which 11 knees were male and 21 were Female Their ages ranged from 65 to 78 years old with an average being 68.9. The following observation were noted:1) Of the 31 knees, 27 were surgically treated under arthroscopy only, and the remaining 4 were with additional intraarticular incision.2) Medial meniscus injury was seen in 24 knees, lateral in 4 knees, and both in 3 knees. Total meniscectomy was carried out in 3 knees, extensive in 13 and partial in 18.3) No obvious correlation between the meniscus injury and the degeneration of articular cartilage was shown.4) Certain correlation between the X-ray findings of Injured Meniscus and the degeneration was noted.5) No correlation between the injury and the difference in body weight or the medial deformity of knee joints was noted.

The Post-Operative Evaluation of Spondylolysis, Degenerative Spondylolisthesis and Spondylolytic Spondylolisthesis in Adults -A Long-Term Follow-up-

Thirty-two patients (24 male, 8 female) had clinical and radiographic evaluation with an average follow-up of ten years and one month. (range 6-15 years)The material consisted of 12 cases of spondylolysis, 10 cases of degenerative spondylolisthesis and 10 cases of spondylolytic spondylolisthesis. Ten cases of spondylolysis were treated with P. L. F. J 2 cases with P. L. F. and laminectomy, and all cases of deg. spondylolisthesis with P. L. F. and laminectomy. Seven cases of lytic-listhesis were treated with P. L. F. or P. L. F. and laminectomy, 2 cases with A. F. and laminectomy, and one case with laminectomy. An increase in the slip was recorded in 5/7 cases in deg. spondylolisthesis and 4/9 cases in liytic-listhesis.Clinically, 28 cases (87.5%) were evaluated as excellent or good, one case as fair, and 3 cases as poor. The spondylolytic group was evaluated as worse than the other two groups.

Postoperatice Evaluation of Cervical Myelopathy due to Ossification of Posterior Longitudinal Ligament

Postoperative clinical results were evaluated in 42 patients (33 males and 9 females) with O. P. L. L. in cervical spine. The mean follow-up period was 5 years and 5 months. The mean age of the patients at operation was 56 (36-73) years. Twenty-six (61.9%) patients were treated by the method of enlargement of spinal canal (reported by Hirabayashi and Miyazaki), 9 patients by extirpation of ossification area by anterior approach, and 7 patients by laminectomy. Thus, 34 (92.8%) of the 42 patients obtained good and excellent results. This clinical outcome correlated with trauma and severity of the preoperative symptoms.