Publications by authors named "Masafumi Kashii"
Purpose: To investigate the impact of baseline total N-terminal propeptide of procollagen (PINP) levels on increases in bone mineral density (BMD) after treatment with romosozumab (ROMO), teriparatide (TPTD), and denosumab (DMAb) in patients with treatment naïve primary osteoporosis.
Methods: This multicenter, retrospective cohort study included 462 treatment-naïve patients (88.7 % female; mean age, 75.
Intradural lumbar disc herniation (ILDH) is a very rare condition, with cerebrospinal fluid (CSF) leakage as a postoperative complication. The central canal of the conus medullaris was reported to communicate with the subarachnoid space through a caudal aperture; however, this aperture has never been observed in vivo. Herein, we report a case of L1/2 ILDH with postoperative spinal adhesive arachnoiditis and syringomyelia in which the communication considered to be a caudal aperture was detected.
View Article and Find Full Text PDFSurgery is often the treatment of choice for lumbar disc herniation (LDH) with severe leg pain. This study aimed to investigate the efficacy of Condoliase chemonucleolysis (CC) in patients who were nonambulatory because of severe leg pain. A total of 58 patients who underwent CC for conservative treatment-resistant LDH were included in this study.
View Article and Find Full Text PDFPurpose: To evaluate the impact of prior teriparatide (TPTD) treatment on the effectiveness of romosozumab (ROMO) in postmenopausal osteoporosis.
Methods: In this retrospective, case-controlled, multicenter study, 323 postmenopausal patients were initiated ROMO. Of these, 275 were treatment-naïve, and 48 were switched from TPTD, with uninterrupted ROMO treatment for 12 months.
Article Synopsis
- - The study investigated the effectiveness of condoliase chemonucleolysis (CC) for patients with lumbar disc herniation (LDH), focusing on identifying factors that predict early pain relief after treatment.
- - Out of 52 patients, 75% experienced significant leg pain relief just one day post-treatment, while those with a smaller baseline straight leg raising (SLR) angle were more likely to be early responders.
- - The findings suggest that patients with lower pretreatment SLR angles are more likely to achieve early and sustained relief from leg pain following CC, regardless of the characteristics of their disc herniation.
Unlabelled: The impact of ROMO on the width of anabolic windows and the increase in BMD was reduced in the RA group compared to the non-RA group, and this reduction was associated with correlations to RA-related factors.
Purpose: To investigate the effects of romosozumab (ROMO) in postmenopausal osteoporosis, with and without comorbid rheumatoid arthritis (RA).
Methods: In this retrospective, case-controlled, multicenter study, 171 postmenopausal patients who did not receive oral glucocorticoid, comprising 59 in the RA group and 121 in the non-RA group, received uninterrupted ROMO treatment for 12 months.
Article Synopsis
- Ossification of the posterior longitudinal ligament of the spine (OPLL) is a disease that can cause serious neurological issues, and its causes are not fully understood, particularly in relation to type 2 diabetes and high body mass index (BMI).
- A comprehensive meta-analysis involving 22,016 Japanese individuals identified 14 significant genetic markers linked to OPLL, with 8 being newly discovered, and further analyses pointed to specific genes associated with the disease.
- The research revealed that increased BMI and high bone mineral density could have a causal relationship with OPLL, and different subtypes of the disease were identified, particularly highlighting a strong correlation between BMI and thoracic OPLL.
Article Synopsis
- Baseline serum PINP levels were found to be a significant predictor for improved bone mineral density (BMD) in the hip and femoral neck after 12 months of romosozumab (ROMO) treatment in postmenopausal women with osteoporosis.
- The study observed 63 patients, revealing significant improvements in lumbar spine BMD, but noted that more than half did not achieve the desired increase in hip and femoral neck BMD.
- The identified optimal baseline PINP cut-off value for predicting significant BMD increase was 53.7 µg/L, with high specificity and moderate sensitivity, indicating its potential usefulness in assessing treatment outcomes.
Development of Atypical Ulnar Fracture is Associated with Bisphosphonate Therapy and Severe Spinal Deformity: A Case Report.
J Hand Surg Asian Pac Vol
June 2022
Article Synopsis
- - Atypical ulna fractures (AUF) are uncommon and linked to long-term use of bisphosphonates, with unclear development mechanisms.
- - An 85-year-old woman on oral alendronate for 8 years, without vitamin D, experienced an atraumatic ulna fracture while doing kitchen work, along with severe spinal deformities.
- - The study suggests that sustained local stress on the ulna, compounded by the effects of bisphosphonates and vitamin D deficiency, may contribute to the development of AUF.
Assessment of bone health in patients with prostate cancer using cancer staging computed tomography.
J Bone Miner Metab
July 2022
Purpose: To evaluate the utility of vertebral Hounsfield unit (HU) values from computed tomography (CT) in cancer staging as a supplementary screening tool for bone health among prostate cancer (PCa) patients.
Methods: T-scores of bone mineral density (BMD) in each lumbar vertebra (L1-L4) and hip for newly diagnosed PCa patients (N = 139) were measured using dual-energy X-ray absorptiometry (DXA). The degenerative changes in each lumbar vertebra were assessed, and the HU values of trabecular bone in axial CT images of each vertebral body (vertebral CT-HU value) were measured using staging CT.
Article Synopsis
- The study focuses on exploring the link between vitamin D deficiency and the severity of distal radius fractures (DRFs) in women over 45 years old.
- It found that patients with severe fractures (articular comminuted) had significantly lower levels of serum 25-hydroxyvitamin-D compared to those with less severe fractures.
- The researchers concluded that vitamin D supplementation could potentially help prevent more severe types of fractures due to its association with lower vitamin D levels.
Preoperative Risk Factors Affecting Outcome in Surgically Treated Pyogenic Spondylodiscitis.
Global Spine J
October 2023
Study Design: Retrospective study.
Objective: The primary aim of this study was to investigate the predictors of severe complications in patients following surgery for pyogenic spondylodiscitis (PS) using a surgeon-maintained database. The secondary aim was to investigate the predictors of early recovery.
Article Synopsis
- The study evaluated the tolerability of a once-yearly infusion of zoledronic acid (ZA) 5 mg for preventing fractures after hip surgery, focusing on side effects like acute-phase reactions (APRs) and calcium levels.
- Researchers analyzed 84 patients (average age 83) and found APRs in 11.9% of cases, primarily showing symptoms like fever; hypocalcemia occurred in 6% of patients a week after the infusion.
- Results indicated that increased inflammatory markers post-surgery and higher bone turnover may raise the risks of APRs and low calcium levels, but overall, the infusion was deemed well tolerated with supportive care.
Objectives: To investigate the effects of prior treatment and determine the predictors of a 12-month treatment response of romosozumab (ROMO) in 148 patients with postmenopausal osteoporosis.
Methods: In this prospective, observational, and multicenter study, treatment naïve patients (Naïve; n=50) or patients previously treated with bisphosphonates (BP; n=37) or denosumab (DMAb; n=45) or teriparatide (TPTD; n=16) (mean age, 75.0 years; T-scores of the lumbar spine [LS] -3.
Article Synopsis
- The study analyzed data from 5,015 patients who underwent primary cervical spine surgery to identify risk factors for surgery-related complications.
- Major risk factors for complications included the presence of ossification of the posterior longitudinal ligament (OPLL), older age, and specific surgical procedures like foraminotomy and anterior spinal fusion.
- The findings emphasize the need for clinicians to be aware of these risks, particularly in patients with OPLL, to better manage and inform them about potential complications post-surgery.
Article Synopsis
- A study aimed to analyze the impact of concomitant foraminotomy on the incidence of upper limb palsy (ULP) following cervical laminoplasty, highlighting the uncertainty around this relationship.
- Among 4080 patients reviewed, the study found that those who underwent laminoplasty with foraminotomy had a significantly higher ULP incidence (15.1%) compared to those who had laminoplasty alone (3.1%).
- The findings also revealed that the location of foraminotomy often matched where ULP occurred and suggested that factors like preoperative muscle weakness and potential thermal nerve damage contribute to this higher incidence of ULP in patients undergoing the combined procedure.*
Article Synopsis
- The study investigates how different prior treatments affect the early response to romosozumab (ROMO) in postmenopausal osteoporosis patients.
- It includes 130 patients categorized by previous treatments (treatment-naïve, bisphosphonates, denosumab, or teriparatide) and measures changes in bone mineral density (BMD) and bone turnover markers over six months.
- Results show significant variations in lumbar spine BMD increases among groups, with earlier changes in specific bone markers predicting these responses.
Objective: The purpose of this study was to examine the effect of single or combination therapy of teriparatide (TPTD) and a monoclonal antibody against the murine receptor activator of nuclear factor κB ligand (anti-RANKL Ab) on cancellous and cortical bone regeneration in a mouse model of glucocorticoid-induced osteoporosis (GIOP).
Methods: C57BL/6 J mice (24 weeks of age) were divided into five groups: (1) the SHAM group: sham operation + saline; (2) the prednisolone (PSL) group: PSL + saline; (3) the TPTD group: PSL + TPTD; (4) the Ab group: PSL + anti-RANKL Ab; and (5) the COMB group: PSL + TPTD + anti-RANKL Ab (n = 8 per group). With the exception of the SHAM group, 7.
Article Synopsis
- - Discontinuing denosumab leads to increased bone turnover and significant bone loss, with reports of multiple spontaneous vertebral fractures (MSCVFs) occurring after the treatment ends.
- - A case study is presented about a 60-year-old woman who developed MSCVFs after being treated with romosozumab following the discontinuation of denosumab, despite initially having no symptoms.
- - The findings indicate that romosozumab does not effectively prevent vertebral fractures that can occur after stopping denosumab, suggesting a need for more effective management strategies for these patients.
Article Synopsis
- The study investigated the effects of follow-on therapies for postmenopausal osteoporosis patients after they discontinued denosumab (DMAb), comparing different treatments like raloxifene (RAL), bisphosphonates (BP), and zoledronate (ZOL).
- Over 1.5 years post-DMAb, bone mineral density (BMD) changes were observed, with raloxifene showing significant declines in both lumbar spine and femoral neck BMD, while ZOL notably reduced fracture incidence.
- Findings suggest that the choice of follow-on therapy after DMAb discontinuation is critical, particularly highlighting ZOL's effectiveness, but further research is needed to fully understand these outcomes.
Background: Osteoporotic fragility fractures frequently occur at the distal part of the radius. This suggests that initial osteoporosis evaluation at this site may inform screening and treatment to prevent additional fractures. The purpose of this study was to investigate the utility of distal forearm dual x-ray absorptiometry (DXA) as a screening tool to assess the risk of fragility fractures at the distal part of the radius.
View Article and Find Full Text PDFArticle Synopsis
- The study aims to identify factors that contribute to in-hospital mortality rates following spine surgery by analyzing data from a large multicenter database of patients who underwent the procedure between 2012 and 2018.
- Researchers conducted a matched case-control study, comparing 25 patients who died in the hospital after surgery with 100 matched controls, focusing on preoperative and intraoperative factors, along with complications.
- Findings indicated a very low mortality rate (0.09%), with higher mortality associated with specific conditions like dialysis-related spondyloarthropathy and massive intraoperative hemorrhage being a significant risk factor (OR 28.2).
Objective: The purpose of this study was to investigate the combined effects of teriparatide (TPTD) and anti-murine receptor activator of nuclear factor-κB ligand monoclonal antibody (anti-RANKL Ab) on both cancellous and cortical bone healing in ovariectomized mice.
Methods: Thirteen-week-old mice were divided into the sham-operated group (n=11) or the ovariectomized group (n=44). At 1 month post-operation, all mice underwent bone defect surgery on the left femoral metaphysis (cancellous bone healing model) and right femoral mid-diaphysis (cortical bone healing model).
Aims: The aim of this study was to explore risk factors for complications associated with dural tear (DT), including the types of DT, and the intra- and postoperative management of DT.
Patients And Methods: Between 2012 and 2017, 12 171 patients with degenerative lumbar diseases underwent primary lumbar spine surgery. We investigated five categories of potential predictors: patient factors (sex, age, body mass index, and primary disease), surgical factors (surgical procedures, operative time, and estimated blood loss), types of DT (inaccessible for suturing/clipping and the presence of cauda equina/nerve root herniation), repair techniques (suturing, clipping, fibrin glue, polyethylene glycol (PEG) hydrogel, and polyglycolic acid sheet), and postoperative management (drainage duration).