Toru Akiyama

Acetabular Diameter Measurement Determines Proper Prosthetic Head Size in Hemiarthroplasty for Femoral Head Osteonecrosis

In hemiarthroplasty for femoral head osteonecrosis, collapse and deformity may make femoral head measurement difficult, thus, precluding the selection of an appropriate prosthetic head. We describe a method for measuring the acetabular diameter using acetabular sizing gauges to estimate the prosthetic head size. We evaluated the precision of this method and found it to be highly accurate and reliable.

Lumbar Intraspinal Cyst

今回われわれは，腰部脊柱管内嚢腫病変（滑膜嚢腫・黄色靭帯内血腫】7例を経験したので報告をする．男性4例，女性3例，年齢は47歳から80歳までであった．臨床症状，画像所見，手術所見そして病理所見などに関して検討を加えた．手術は顕微鏡下による内側椎間関節切除を行い，嚢腫摘出をおこなった．病理組織学的診断では，6例が滑膜嚢腫，1例は黄色靭帯内血腫であった．

Complications of Lumbar Spinal Fusion with Transpedicular Screw Fixation Systems

We retrospectively analyzed the incidence and variety of associated complications in 54 patients who underwent lumber spinal fusion using transpedicular screw fixation systems. The average operative time was 3 hours 28 minutes with an average blood loss of 376 grams for one level fusion. Intraoperatively fracture of the pedicle during screw insertion occurred in 5.6% of cases. The neural infury rate was 3.7%. Post operative complications included 7.7% screw breakage, 1.9% AW-GC spacer breakage, 1.9% nut loosening and 9.6% screw loosening. Final results included 9.6% pseudoarthrosis and 9.6% delayed union. In all of these unsuccessful union cases the graft bone collapsed and the “disc height” became narrow in the post operative period. We believe that the AW-GC spacer offers mechanical advantages compared with iliac bone strut grafts alone.