Research activity information

• Clinical Outcomes of Patients Who Underwent Palliative Surgery for Spinal Metastases With and Without a History of Radiation: A Multicenter Registry Study.

  Ichiro Kawamura, Hiroyuki Tominaga, Hirofumi Shimada, Hiromi Sasaki, Noboru Taniguchi, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  Study DesignA multicenter retrospective cohort study using prospectively collected data.ObjectivesRadiotherapy (RT) is the standard treatment for spinal metastases; however, the optimal timing of RT in patients requiring surgery remains unclear. This study compared the clinical outcomes of palliative surgery according to RT timing.MethodsAmong 413 patients screened across 35 centers, 146 patients with spinal metastases limited to the spine who underwent palliative surgery were included. Patients were classified into three groups based on RT timing: preoperative RT, postoperative RT, and no RT. Short-term outcomes were compared among the three groups.ResultsOf the 146 patients (preoperative RT: n = 42; postoperative RT: n = 59; no RT: n = 45), baseline characteristics and postoperative functional outcomes were comparable between the postoperative RT and no RT groups. Preoperative opioid use was significantly more frequent in the preoperative RT group. Postoperative complications were more common in the preoperative RT group. Functional outcomes improved in all groups; however, greater improvements in pain and numbness were observed in the nonpreoperative RT group than in the preoperative RT group, with a significant difference noted in numbness improvement.ConclusionsPostoperative recovery after palliative surgery was largely comparable among the three groups. Although greater improvements in pain and numbness were observed in patients who did not receive preoperative RT, the clinical impact of preoperative RT in patients with mechanical instability remains uncertain. Postoperative wound complications were more frequent in the preoperative RT group, but these findings should be interpreted with cautiously given the limited number of events.

  Feb. 2026, Global spine journal, 21925682261426935 - 21925682261426935, English, International magazine

  Scientific journal


• Changes in performance status and predictive factors for poor improvement following surgery for spinal metastasis: a nationwide multicenter prospective cohort study

  Akinobu Suzuki, Koji Tamai, Shinji Takahashi, Masayoshi Iwamae, Hiroshi Taniwaki, Yuki Shiratani, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  Elsevier BV, Feb. 2026, The Spine Journal, 26(2) (2), 386 - 399

  Scientific journal


• Machine Learning-Based Prognostic Scoring for Spinal Metastases: A JASA Multicenter Prospective Study Integrating Modern Oncologic Advances.

  Sadayuki Ito, Hiroaki Nakashima, Naoki Segi, Jun Ouchida, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Narihito Nagoshi, Satoshi Kato, Kota Watanabe, Shiro Imagama, Gen Inoue, Takeo Furuya

  STUDY DESIGN: Large multicenter prospective study. OBJECTIVE: We aimed to develop and validate a novel machine learning-based prognostic scoring system for spinal metastases. SUMMARY OF BACKGROUND DATA: Spinal metastases, common complications in patients with advanced cancer, significantly affect neurological function, pain, and quality of life. Although surgery plays a crucial role in selected cases, the accurate prediction of patient prognosis remains challenging. Traditional scoring systems, developed for older treatment paradigms, do not fully reflect the impact of modern oncologic therapies. METHODS: This multicenter prospective study, conducted by the Japan Association of Spine Surgeons with Ambition, included 401 patients who underwent surgery for spinal metastases at 35 medical centers between 2018 and 2021. Patient demographics, tumor burden, performance status, and treatment history data were collected. Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression was used to identify significant predictors of one-year survival, followed by stepwise variable selection. The model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and calibration plots. RESULTS: Among the 401 patients, 67.1% survived for one year, whereas 32.9% did not. Survivors had better performance status, lower tumor burden, and lower opioid use than non-survivors. LASSO regression identified five key predictors of one-year survival: age ≥75 years, poor performance status (≥3), presence of other bone metastases, preoperative opioid use, and lower preoperative Vitality Index. The final model demonstrated a strong predictive performance (AUROC=0.762). Based on the key prognostic factors, a simplified risk stratification system was developed to classify patients into low- (one-year survival 82.2%), intermediate- (67.2%), and high-risk (34.2%) groups. CONCLUSION: We developed a clinically applicable prognostic scoring system for patients with spinal metastases using machine learning techniques to enhance predictive accuracy. This model provides a practical risk assessment tool to aid surgical decision-making and optimize postoperative management. LEVEL OF EVIDENCE: 2.

  Jan. 2026, Spine, English, International magazine

  Scientific journal


• Prognostic scoring systems reflect the prognosis of patients with metastatic spinal tumors who underwent spinal surgery in recent cases: JASA multicenter prospective study

  Masahiro Iinuma, Takeo Furuya, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kosei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takagami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Seiji Ohtori, Hisateru Niki

  Elsevier BV, Jan. 2026, Journal of Orthopaedic Science

  Scientific journal


• Machine Learning-Based Prediction of Quality of Life Improvement After Surgery for Spinal Metastases: A Prospective Multicenter Study.

  Kyota Kitagawa, Satoshi Maki, Yuki Shiratani, Akinobu Suzuki, Koji Tamai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Koichi Sairyo, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Kenji Kato, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Seiji Ohtori, Gen Inoue, Takeo Furuya

  STUDY DESIGN: A prospective multicenter cohort study. OBJECTIVE: To develop and validate machine learning models for predicting health-related quality of life (HRQoL) improvements in patients after one month and six months of surgery for spinal metastases. SUMMARY OF BACKGROUND DATA: The prediction of postoperative HRQoL of spinal metastases surgery remains understudied compared with studies of survival outcomes. METHODS: We analyzed data from 413 patients who underwent surgery for spinal metastases at 40 participating institutions in Japan. The primary outcome was HRQoL improvement, defined as an increase in the EuroQol 5-Dimension 5-Level (EQ-5D) utility value of ≥0.32 from baseline. We developed two models for 1-month (n=360) and 6-month (n=189) outcomes using various machine learning algorithms. Missing values were imputed, and feature selection was performed using recursive feature elimination with cross-validation. We split the data into training (80%) and test (20%) sets for each model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, precision, and F1-score. SHapley Additive exPlanations (SHAP) analysis was used to interpret feature importance. RESULTS: The 6-month model outperformed the 1-month model across all metrics. For 1-month predictions, Logistic Regression achieved an AUC of 0.8136 and an accuracy of 0.7639 on the test set. For 6-month predictions, Naive Bayes demonstrated an AUC of 0.8928 and an accuracy of 0.8684. The 1-month model used 12 features, while the 6-month model required seven. SHAP analysis revealed that EQ-5D Mobility was the most influential feature in both models. CONCLUSIONS: Our models demonstrate high predictive accuracy for HRQoL improvements following spinal metastases surgery, with superior performance of the 6-month model. These models could enhance clinical decision-making and patient counseling by providing personalized predictions of postoperative QoL. Future research should focus on external validation and integration of these models into clinical practice.

  Oct. 2025, Spine, 50(20) (20), 1410 - 1419, English, International magazine

  Scientific journal


• Relationships between frailty and surgical outcomes of palliative surgery for spinal metastases : a prospective cohort study.

  Takeru Tsujimoto, Tomoya Matsuo, Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Ryosuke Kuroda, Kenichiro Kakutani

  AIMS: Frailty has recently been associated with postoperative complications and clinical outcomes in various fields. This study aimed to assess the relationships between frailty and surgical outcomes of palliative surgery for spinal metastases and assess the usefulness of the modified five-item frailty index (mFI-5) in this population. METHODS: We prospectively evaluated 273 patients who underwent spinal metastasis surgery from June 2015 to December 2021. The mFI-5 was used to assess frailty, with a score of 0 defined as non-frailty, 1 as pre-frailty, and 2 or more as frailty. The following variables were assessed: background characteristics, complications (Clavien-Dindo grade 2 or higher), postoperative clinical outcomes, and life expectancy. The clinical outcomes compared between the three groups were the performance status (PS), Barthel index, and EuroQoL five-dimension questionnaire (EQ-5D) at six months postoperatively. A multivariate stepwise logistic regression analysis was performed of variables with values of p < 0.1 on the univariate analysis. RESULTS: The overall complication rate was 19% (52/273). The complication rate was significantly higher in the frailty group (p = 0.005), and patients with a greater mFI-5 score tended to have a higher incidence of postoperative complications. The Kaplan-Meier curve showed that the non-frailty group had a significantly longer survival time than the pre-frailty and frailty groups (p < 0.001). Multivariate logistic regression analysis suggested that mFI-5 is not predictive of postoperative complications and improvement of the EQ-5D, while is predictive of improvement of the PS (odds ratio (OR) 4.22) and Barthel index (OR 4.49). CONCLUSION: The current study suggested that mFI-5 is not predictive of postoperative complications and improvement of the EQ-5D, while is predictive of improvement of the PS and Barthel index. Furthermore, palliative surgery for spinal metastases improved the PS, Barthel index, and EQ-5D, even in patients with frailty.

  Oct. 2025, Bone & joint open, 6(10) (10), 1199 - 1207, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Effect of Preoperative Nutritional Status on Postoperative Clinical Outcomes of Patients with Metastatic Spinal Tumors: Japan Association of Spine Surgeons with Ambition Multicenter Study.

  Masafumi Kawai, Satoshi Kato, Noriaki Yokogawa, Takaki Shimizu, Satoru Demura, Yuki Shiratani, Akinobu Suzuki, Koji Tamai, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Koji Akeda, Norihiko Takegami, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Haruki Funao, Koji Uotani, Shinji Tanishima, Koichi Sairyo, Ko Hashimoto, Chizuo Iwai, Shoji Seki, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  STUDY DESIGN: A multicenter prospective study. OBJECTIVE: To evaluate the effect of preoperative nutritional status, assessed using the Prognostic Nutritional Index (PNI), on clinical outcomes, including survival prognosis, postoperative complications, hospitalization duration, and functional prognosis, in patients with metastatic spinal tumors undergoing surgery. SUMMARY OF BACKGROUND DATA: Malnutrition is common in patients with cancer and is associated with poor clinical outcomes. However, data on the role of nutritional status in metastatic spinal tumors are limited. METHODS: We included 309 patients who underwent surgery for metastatic spinal tumors between October 2018 and March 2021. Patients were divided into two groups: normal nutrition (PNI ≥40) and malnutrition (PNI <40). Clinical outcomes, including 1-year mortality, postoperative complications, and functional improvements (performance status, Frankel grade, Barthel Index, Vitality Index, and EuroQol 5-Dimension 5-level), were compared using propensity score matching to adjust for confounding factors, such as age, sex, preoperative chemotherapy, performance status, primary tumor type, and visceral metastases. RESULTS: Thirty-six percent of patients were malnourished. After propensity score matching, the malnutrition group had a significantly higher mortality rate within 1 year than the normal nutrition group (55% vs. 31%, P<0.001) and showed limited physical improvement, including neurological recovery, 1 month postoperatively. However, improvements in motivation and quality of life (QOL) were comparable between the groups, and physical function recovery at 6 months was similar. No significant differences in postoperative complications or length of hospital stay were observed between the groups. CONCLUSION: Preoperative malnutrition was observed in 36% of patients with metastatic spinal tumors who underwent surgery and was associated with a poor postoperative survival prognosis and delayed physical recovery. However, surgical treatment improved motivation, QOL, and physical function 6 months after surgery. These findings highlight the importance of assessing the nutritional status preoperatively and considering both survival and functional prognoses when selecting surgical treatment for patients with malnutrition.

  Sep. 2025, Spine, English, International magazine

  Scientific journal


• The significance of adding posterior decompression to spine stabilization in metastatic spinal surgery: a multicenter prospective study.

  Hiroyuki Tominaga, Ichiro Kawamura, Hirofumi Shimada, Hiromi Sasaki, Noboru Taniguchi, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  The usefulness of spine stabilization for treating metastatic spinal tumors with tumor-induced instability has been reported. However, no reports have prospectively evaluated the effectiveness of adding posterior decompression to stabilization surgery for improving symptoms. This multicenter prospective study aimed to determine whether adding posterior decompression to spine stabilization surgery for metastatic spinal tumors affects postoperative outcomes and complications. A total of 263 patients who underwent spine stabilization with (n = 189) or without (n = 74) decompression were analyzed. Patient demographics, the Spinal Instability Neoplastic Score (SINS), and the Epidural Spinal Cord Compression (ESCC) score were recorded. The outcomes were assessed preoperatively and at 1 and 6 months postoperatively in terms of neurological status, the Barthel Index, the EQ-5D-5 L, and the visual analog scale (VAS). Decompression was primarily performed in patients with severe neurological deficits and high-grade ESCC. Both groups showed postoperative improvement. Propensity score matching was applied to adjust for baseline differences. After matching, there were no significant differences in functional improvement between the decompression and nondecompression groups, and the complication rates were comparable. In matched patients presenting primarily with spinal instability and pain, the addition of decompression did not appear to confer a significant functional benefit within 6 months postoperatively.

  Jul. 2025, Scientific reports, 15(1) (1), 27684 - 27684, English, International magazine

  Scientific journal


• Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis.

  Yutaro Kanda, Fumiaki Makiyama, Ryota Mio, Kozaburo Mizutani, Masashi Kumon, Saori Soeda, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo

  In adult isthmic spondylolysis/spondylolisthesis, a fibrocartilaginous mass, ragged edge, and decrease in disk height cause radiculopathy with intervertebral foraminal stenosis. There are few reports on the outcomes of full-endoscopic spine surgery for isthmic spondylolisthesis because of difficulty in the ragged edge resection. This study evaluated the short-term outcomes of our original full-endoscopic spine surgery technique in patients with isthmic spondylolisthesis with a focus on the "pars crisscross." An important landmark, the pars crisscross consist of the superior articular process at S1, floating lamina, inferior articular process at L4, and pars ragged edge. The exiting nerve root can only be decompressed by complete resection of the ragged edge after confirmation of the pars crisscross. This case series includes 6 patients (mean age 63.2 ± 14.3 years) who underwent full-endoscopic spine surgery under local anesthesia for radiculopathy. The leg pain improved immediately after surgery in all patients and the mean visual analog scale score improved from 8.2 ± 1.3 preoperatively to 1.2 ± 1.1 at 2 weeks postoperatively. The neuroforaminal area at the inlet and center expanded dramatically from 184 ± 41 mm2 and 192 ± 45 mm2, respectively, before surgery to 340 ± 55 mm2 and 338 ± 80 mm2 postoperatively. No patient experienced a recurrence of leg pain, aggravation of low back pain, or spinal instability during the 3 months after surgery. full-endoscopic spine surgery pars crisscross decompression had excellent short-term clinical and radiographic outcomes. Patients who are unsuitable for general anesthesia and instrumentation surgery could be candidates for this procedure.

  Jun. 2025, Neurologia medico-chirurgica, 65(6) (6), 271 - 277, English, Domestic magazine

  Scientific journal


• Risk Factors for Wound Dehiscence After Spinal Metastasis Surgery and a New Approach to Prevention-Curved Skin Incision.

  Kunihiko Miyazaki, Yutaro Kanda, Takashi Yurube, Yoshiki Takeoka, Takeru Tsujimoto, Tomoya Matsuo, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Ryosuke Kuroda, Kenichiro Kakutani

  Background: Postoperative wound dehiscence is a major complication following spinal metastasis surgery, particularly in patients who receive preoperative radiotherapy or molecular-targeted therapy; however, preventive strategies remain limited. Objective: In this study, we aimed to identify the risk factors for postoperative wound dehiscence and evaluate the clinical utility of a novel curved skin incision (CSI) technique, designed to avoid irradiated areas, in comparison with the conventional midline incision (MI) technique. Methods: Logistic regression analysis was conducted on 107 patients who underwent MI between 2013 and 2018. Based on the results, we developed the CSI technique. Propensity score matching was performed to compare postoperative wound dehiscence in 29 matched pairs of patients treated with either CSI or MI from 2019 to 2021. Results: Preoperative radiotherapy and molecular-targeted therapy were found to be significant risk factors for wound dehiscence. CSI, which circumvents irradiated skin, was associated with a substantially lower rate of wound dehiscence than MI. Conclusions: The CSI technique offers a simple, reproducible, and effective surgical approach to reduce postoperative wound complications in high-risk patients. Its clinical benefit, especially for those with prior radiotherapy, suggests that it may serve as a valuable addition to standard spinal metastasis surgery.

  Jun. 2025, Cancers, 17(12) (12), English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Impact of surgical treatment on patient reported outcome in patients with spinal metastases from prostate cancer.

  Ryosuke Hirota, Tsutomu Oshigiri, Noriyuki Iesato, Makoto Emori, Atsushi Teramoto, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  OBJECTIVE: This study aimed to elucidate postoperative outcomes in patients with spinal metastases of prostate cancer, with a focus on patient-oriented assessments. METHODS: This was a prospective multicenter registry study involving 35 centers. A total of 413 patients enrolled in the Japanese Association for Spine Surgery and Oncology Multicenter Prospective Study of Surgery for Metastatic Spinal Tumors were evaluated for inclusion. The eligible patients were followed for at least 1 year after surgery. The Frankel Classification, Eastern Cooperative Oncology Group Performance Status, visual analog scale for pain, face scale, Barthel Index, vitality index, indications for oral pain medication, and the EQ-5D-5L questionnaire were used for evaluating functional status, activities of daily living, and patient motivation. RESULTS: Of the 413 eligible patients, 41 with primary prostate cancer were included in the study. The patient-oriented assessments indicated that the patients experienced postoperative improvements in quality of life and motivation in most items, with the improvements extending for up to 6 months. More than half of the patients with Frankel classifications B or C showed improved neurological function at 1 month after surgery, and most patients presented maintained or improved their classification at 6 months. CONCLUSION: Surgical intervention for spinal metastases of prostate cancer significantly improved neurological function, quality of life, and motivation of the patients. Consequently, our results support the validity of surgical intervention for improving the neurological function and overall well-being of patients with spinal metastases of prostate cancer.

  May 2025, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 30(3) (3), 423 - 432, English, Domestic magazine

  Scientific journal


• Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient's Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study.

  Naoki Segi, Hiroaki Nakashima, Sadayuki Ito, Jun Ouchida, Yuki Shiratani, Takaki Shimizu, Akinobu Suzuki, Hidetomi Terai, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Masahiro Funaba, Toru Funayama, Hideaki Nakajima, Koji Akeda, Takashi Hirai, Hirokazu Inoue, Kazuo Nakanishi, Haruki Funao, Tsutomu Oshigiri, Bungo Otsuki, Kazu Kobayakawa, Shinji Tanishima, Ko Hashimoto, Takuya Iimura, Hirokatsu Sawada, Koji Uotani, Hiroaki Manabe, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Narihito Nagoshi, Satoshi Kato, Kota Watanabe, Shiro Imagama, Gen Inoue, Takeo Furuya

  Study DesignProspective multicenter study.ObjectivesPalliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.MethodsWe prospectively compared the data of 203 patients with spinal metastases at 2-3 consecutive segments who were divided into the following three groups: cervical, patients with cervical spine lesions; thoracic, patients with upper-middle thoracic spine lesions; and TL/L/S, patients with lesions at the thoracolumbar junction and lumbar and sacral regions. Preoperative and postoperative EuroQol 5-dimension (EQ5D) 5-level were compared.ResultsAll groups exhibited improvement in the Frankel grade, performance status, pain, Barthel index, EQ5D health state utility value (HSUV), and EQ5D visual analog scale (VAS) postoperatively. Although preoperative EQ5D HSUVs did not significantly differ between the groups (cervical, 0.461 ± 0.291; thoracic, 0.321 ± 0.292; and TL/L/S, 0.376 ± 0.272), the thoracic group exhibited significantly lower postoperative EQ5D HSUVs than the other two groups (cervical, 0.653 ± 0.233; thoracic, 0.513 ± 0.252; and TL/L/S, 0.624 ± 0.232). However, postoperative EQ5D VAS was not significantly different between the groups (cervical, 63.4 ± 25.8; thoracic, 54.7 ± 24.5; and TL/L/S, 61.7 ± 21.9).ConclusionsPalliative surgery for metastatic spinal tumors provided comparable QOL improvement, irrespective of the spinal segment involved. Patients with upper and middle thoracic spinal metastases had poorer QOL outcomes than those with metastases in other segments; however, sufficient QOL improvement was achieved.

  May 2025, Global spine journal, 15(4) (4), 2286 - 2299, English, International magazine

  Scientific journal


• Risk Factors for Early 3-Month Postoperative Mortality in Metastatic Spinal Tumor Surgery: A JASA Multicenter Prospective Study.

  Takaaki Uto, Satoshi Kato, Noriaki Yokogawa, Takaki Shimizu, Satoru Demura, Yuki Shiratani, Akinobu Suzuki, Koji Tamai, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Hideaki Nakajima, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Haruki Funao, Koji Uotani, Shinji Tanishima, Koichi Sairyo, Ko Hashimoto, Chizuo Iwai, Shoji Seki, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  STUDY DESIGN: Prospective multicenter study. OBJECTIVE: To investigate risk factors for 3-month postoperative mortality in metastatic spinal tumor surgery, focusing on nutritional biomarkers and prognostic scores alongside clinical indicators. SUMMARY OF BACKGROUND DATA: Metastatic spinal tumors affect patient morbidity and mortality. Although prognostic tools exist, they have limitations, particularly in emergency situations requiring rapid assessment. Nutritional biomarkers and prognostic scores may influence outcomes, but their role in predicting early postoperative mortality after spinal tumor surgery, particularly in prospective, multicenter studies, warrants investigation. METHODS: Data from 336 patients undergoing palliative surgery for metastatic spinal tumors were collected from 35 centers. The primary outcome was 3-month postoperative mortality. Univariate and multivariate logistic regression analyses with bootstrapping were performed to identify predictors of early mortality, including demographics, prognostic scores (revised Tokuhashi, Tomita, modified Glasgow Prognostic Score [mGPS], and the New England Spinal Metastasis Score [NESMS]), and nutritional biomarkers. The discriminative ability of these factors was evaluated using the receiver operating characteristic curve analysis. RESULTS: Results: The 3-month postoperative mortality rate was 15.5%, with primary cancer progression accounting for 54% of the deaths. Multivariate analysis revealed that high mGPS (OR=1.989, P=0.008) and low preoperative performance status (PS) (OR=1.412, P=0.034) were significant independent predictors of early mortality, the Tomita score showed a trend towards significance (OR=1.234, P=0.050). The mGPS demonstrated a high discriminative ability, with an area under the curve of 0.716. CONCLUSION: High mGPS and low preoperative PS are significant predictors of 3-month postoperative mortality in patients undergoing surgery for metastatic spinal tumors. Incorporating the mGPS, which reflects nutritional and inflammatory status, into preoperative risk stratification is crucial for optimizing surgical decision-making. LEVEL OF EVIDENCE: 2.

  Apr. 2025, Spine, English, International magazine

  Scientific journal


• Predicting Postoperative Neurological Outcomes in Metastatic Spinal Tumor Surgery Using Machine Learning.

  Satoshi Maki, Yuki Shiratani, Sumihisa Orita, Akinobu Suzuki, Koji Tamai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Kenji Kato, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Gen Inoue, Shiro Imagama, Kota Watanabe, Satoshi Kato, Seiji Ohtori, Takeo Furuya

  STUDY DESIGN: Retrospective analysis of data collected across multiple centers. OBJECTIVE: To develop machine learning models for predicting neurological outcomes one month postoperatively in patients with metastatic spinal tumors undergoing surgery, and to identify key factors influencing neurological recovery. SUMMARY OF BACKGROUND DATA: The increasing prevalence of spinal metastases has led to a growing need for surgical intervention to address mechanical instability and neurological deficits. Predicting postoperative neurological status, as assessed by the Frankel classification, can provide valuable insights for surgical planning and patient counseling. Traditional prognostic models have shown limitations in capturing the complexity of neurological recovery patterns. METHODS: We analyzed data from 244 patients who underwent spinal surgery for metastatic disease across 38 institutions. The primary outcome was functional ambulation, defined as Frankel grades D or E at one month postoperatively. Four machine learning algorithms (Random Forest, XGBoost, LightGBM, and CatBoost) were used to build predictive models. Feature selection employed the Boruta algorithm and Variance Inflation Factor analysis to reduce multicollinearity. RESULTS: Among the 244 patients, the proportion of ambulatory patients (Frankel grades D or E) increased from 36.8% preoperatively to 63.1% at one month postoperatively. The Random Forest model achieved the highest area under the receiver operating characteristic curve (AUC-ROC) of 0.8516, followed by XGBoost (0.8351), CatBoost (0.8331), and LightGBM (0.8098). SHapley Additive exPlanations analysis identified preoperative Frankel classification, transfer ability, inflammatory markers (C-reactive protein, white blood cell-lymphocyte), and surgical timing as the most important predictors of postoperative outcomes. CONCLUSIONS: Machine learning models showed strong predictive performance in assessing postoperative neurological status for patients with metastatic spinal tumors. Key factors including preoperative neurological function, functional ability, and inflammation markers significantly influenced outcomes. These findings could inform surgical decision-making and help set realistic postoperative expectations while potentially improving patient care through more accurate outcome prediction.

  Mar. 2025, Spine, English, International magazine

  Scientific journal


• Transient Receptor Potential Vanilloid 4 Knockdown Decreases Extracellular Matrix Synthesis via Autophagy Suppression in the Rat Intervertebral Disc.

  Tomoya Matsuo, Yoshiki Takeoka, Takashi Yurube, Takeru Tsujimoto, Yutaro Kanda, Kunihiko Miyazaki, Hiroki Ohnishi, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Ryosuke Kuroda, Kenichiro Kakutani

  BACKGROUND: Transient receptor potential vanilloid 4 (TRPV4) has been identified as a Ca2+-permeable channel and is activated under physiological mechanical stimulation in disc nucleus pulposus (NP) cells. Meanwhile, the Ca2+-dependent AMP-activated protein kinase (AMPK)/mTOR pathway activates autophagy in notochordal cells. We hypothesized that TRPV4 is involved in the maintenance of intradiscal homeostasis via autophagy. Our objective was to elucidate the role of TRPV4 in extracellular matrix (ECM) metabolism and autophagy in the rat intervertebral disc through a loss-of-function study with the RNA interference (RNAi) technique. METHODS: In vitro study: Small interfering RNA (siRNA) was applied to knockdown TRPV4 by the reverse transfection method in rat disc NP cells. Expression of TRPV4, AMPK/mTOR pathway-related markers, and autophagy markers were measured by Western blotting (WB). Next, ECM metabolism was assessed under serum starvation and/or proinflammatory interleukin-1 beta (IL-1β) stimulation. In vivo study: TRPV4 and control siRNAs were injected into rat discs. To confirm in vivo transfection, WB for TRPV4 was conducted in rat disc NP-tissue protein extracts 2, 28, and 56 days after injection. Furthermore, 24-h temporary static compression-induced disruption of TRPV4 siRNA-injected discs was observed by radiography, histomorphology, and immunofluorescence. RESULTS: In vitro study: In disc cells, three different TRPV4 siRNAs consistently suppressed autophagy with TRPV4 protein knockdown (mean 33.2% [95% CI: -50.8, -15.5], 44.1% [-61.7, -26.4], 58.3% [-76.0, -40.7]). ECM metabolism was significantly suppressed by TRPV4 RNAi under proinflammatory IL-1β stimulation. In vivo study: The WB displayed sustained decreases in TRPV4 protein expression 2, 28, and 56 days after injection. Under the loaded condition, TRPV4 siRNA-injected discs presented radiographic height loss ([-31.7, -7.75]), histomorphological damage ([0.300, 4.70]), and immunofluorescent suppression of autophagy ([1.61, 20.5]) and ECM metabolism ([-25.2, -6.41]) compared to control siRNA-injected discs at 56 days. CONCLUSIONS: The TRPV4 could be a therapeutic target for intervertebral disc diseases via modulating autophagy.

  Mar. 2025, JOR spine, 8(1) (1), e70046, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• A Commentary on "Impact of Paraspinal Muscle Degeneration on Surgical Outcomes and Radiographical Sagittal Alignment in Adult Spinal Deformity: A Multicenter Study".

  Yutaro Kanda

  Mar. 2025, Neurospine, 22(1) (1), 38 - 39, English, International magazine

  Scientific journal


• 当院Cancer Boardレジストリにおける脊椎転移手術後合併症とそのリスク因子の検討

  松尾 智哉, 神田 裕太郎, 酒井 良忠, 由留部 崇, 辻本 武尊, 武岡 由樹, 劉 正夫, 熊谷 直利, 黒島 康平, 黒田 良祐, 角谷 賢一朗

  (一社)日本脊椎脊髄病学会, Feb. 2025, Journal of Spine Research, 16(3) (3), 102 - 102, Japanese


• Surgical strategy for metastatic spinal tumors based on Spine Instability Neoplastic Score and patient-reported outcomes: JASA multicenter prospective study.

  Hideaki Nakajima, Shuji Watanabe, Kazuya Honjoh, Arisa Kubota, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  OBJECTIVE: Instrumentation surgery in combination with radiotherapy (RT) is one of the key management strategies for patients with spinal metastases. However, the use of materials can affect the RT dose delivered to the tumor site and surrounding tissues, as well as hinder optimal postoperative tumor evaluation. The association of the preoperative Spine Instability Neoplastic Score (SINS) with the need for spinal stabilization and life expectancy are unclear. This multicenter prospective study aimed to investigate the current situation and make recommendations regarding the choice of surgical procedure based on the preoperative SINS and prospectively collected postoperative patient-reported outcomes (PROs). METHODS: The study prospectively included 317 patients with spinal metastases who underwent palliative surgery and had a minimum follow-up period of 6 months. The survey items included SINS, patient background, and clinical data including surgical procedure, history of RT, prognosis, and PROs (i.e., the visual analog scale score, Faces Scale, Barthel Index, Vitality Index, and 5-level EQ-5D health survey) at baseline, and at 1 and 6 months after surgery. The association of preoperative SINS with life expectancy, PROs, and surgical procedures was examined using statistical analysis. RESULTS: Preoperative SINS (three categories) had no association with life expectancy. All PROs evaluated in the study improved up to 6 months after surgery. Pain categories (visual analog scale score and/or Faces Scale) at baseline were correlated with preoperative SINS. As many as 90.9% of enrolled patients underwent fusion surgery, and even in SINS 0-6 cases, implants were used in 64.3% of patients. Postoperative RT was performed in 42.9% of the patients. However, prospective assessments of PROs showed no significant difference between surgical procedures (with and without fusion) in patients with SINS 0-9. In addition, no cases required conversion from noninstrumentation surgery to fusion surgery. CONCLUSIONS: Although the choice of surgical procedure should be made on a case-by-case basis on the NOMS (neurological, oncological, mechanical, and systemic) framework, careful consideration is required to determine whether spinal stabilization is needed in patients with SINS ≤ 9, considering the patient's background and the plan for postoperative adjuvant therapy.

  Feb. 2025, Journal of neurosurgery. Spine, 42(2) (2), 203 - 214, English, International magazine

  Scientific journal


• Pitfalls in the Diagnosis and Treatment of Low Back Pain in an Elite Para-athlete Successfully Treated by Transforaminal Full-endoscopic Discectomy with Thermal Annuloplasty: A Case Reports.

  Yutaro Kanda, Kozaburo Mizutani, Masashi Kumon, Saori Soeda, Kosuke Sugiura, Masatoshi Morimoto, Fumitake Tezuka, Kazuta Yamashita, Koichi Sairyo

  We report a rare case of an elite para-athlete with lumbar disk herniation whose pain generator was difficult to diagnose and treat. A 28-year-old woman with paraplegia below the T10 level felt pain in her low back and left leg during a match. Magnetic resonance imaging revealed a lateral lumbar disk herniation and a high-intensity zone on the left side at the L5-L6 level. Because the pain disappeared following L5 selective nerve block, we performed transforaminal full-endoscopic discectomy alone. Despite the disappearance of leg pain after surgery, her low back pain persisted. We performed thermal annuloplasty because reproducible pain and subsequent temporary pain relief by discography and discoblock after the initial surgery indicated discogenic pain. Her suffering from back pain gradually reduced. She returned to competition 2 months after the second surgery without intensive rehabilitation due to difficulty in performing core exercises for abdominal muscles. During the return match, she experienced a relapse of pain in the low back and left leg, which was caused by a recurrence of disk herniation. We performed a full-endoscopic discectomy with thermal annuloplasty again. Her clinical symptoms were immediately relieved. We enhanced her thoracic spine flexibility to prevent subsequent recurrence. Finally, she returned to international competition 2 months after the third surgery. Close attention to para-athletes is required to achieve an accurate diagnosis of pain generators and prevent recurrence due to their distinctive disorders. Thermal annuloplasty and rehabilitating thoracic movement can be an excellent option for para-athletes with discogenic low back pain.

  2025, NMC case report journal, 12, 7 - 13, English, Domestic magazine

  Scientific journal


• Gene-Silencing Therapeutic Approaches Targeting PI3K/Akt/mTOR Signaling in Degenerative Intervertebral Disk Cells: An In Vitro Comparative Study Between RNA Interference and CRISPR-Cas9.

  Masao Ryu, Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Takeru Tsujimoto, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Ryosuke Kuroda, Kenichiro Kakutani

  The mammalian target of rapamycin (mTOR), a serine/threonine kinase, promotes cell growth and inhibits autophagy. The following two complexes contain mTOR: mTORC1 with the regulatory associated protein of mTOR (RAPTOR) and mTORC2 with the rapamycin-insensitive companion of mTOR (RICTOR). The phosphatidylinositol 3-kinase (PI3K)/Akt/mTOR signaling pathway is important in the intervertebral disk, which is the largest avascular, hypoxic, low-nutrient organ in the body. To examine gene-silencing therapeutic approaches targeting PI3K/Akt/mTOR signaling in degenerative disk cells, an in vitro comparative study was designed between small interfering RNA (siRNA)-mediated RNA interference (RNAi) and clustered regularly interspaced short palindromic repeat (CRISPR)-CRISPR-associated protein 9 (Cas9) gene editing. Surgically obtained human disk nucleus pulposus cells were transfected with a siRNA or CRISPR-Cas9 plasmid targeting mTOR, RAPTOR, or RICTOR. Both of the approaches specifically suppressed target protein expression; however, the 24-h transfection efficiency differed by 53.8-60.3% for RNAi and 88.1-89.3% for CRISPR-Cas9 (p < 0.0001). Targeting mTOR, RAPTOR, and RICTOR all induced autophagy and inhibited apoptosis, senescence, pyroptosis, and matrix catabolism, with the most prominent effects observed with RAPTOR CRISPR-Cas9. In the time-course analysis, the 168-h suppression ratio of RAPTOR protein expression was 83.2% by CRISPR-Cas9 but only 8.8% by RNAi. While RNAi facilitates transient gene knockdown, CRISPR-Cas9 provides extensive gene knockout. Our findings suggest that RAPTOR/mTORC1 is a potential therapeutic target for degenerative disk disease.

  Dec. 2024, Cells, 13(23) (23), English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Modified Frailty Index as a novel predictor for the incidence and severity of postoperative complications after spinal metastases surgery.

  Tomoya Matsuo, Yutaro Kanda, Yoshitada Sakai, Takashi Yurube, Yoshiki Takeoka, Kunihiko Miyazaki, Ryosuke Kuroda, Kenichiro Kakutani

  AIMS: Frailty has been gathering attention as a factor to predict surgical outcomes. However, the association of frailty with postoperative complications remains controversial in spinal metastases surgery. We therefore designed a prospective study to elucidate risk factors for postoperative complications with a focus on frailty. METHODS: We prospectively analyzed 241 patients with spinal metastasis who underwent palliative surgery from June 2015 to December 2021. Postoperative complications were assessed by the Clavien-Dindo classification; scores of ≥ Grade II were defined as complications. Data were collected regarding demographics (age, sex, BMI, and primary cancer) and preoperative clinical factors (new Katagiri score, Frankel grade, performance status, radiotherapy, chemotherapy, spinal instability neoplastic score, modified Frailty Index-11 (mFI), diabetes, and serum albumin levels). Univariate and multivariate analyses were developed to identify risk factors for postoperative complications (p < 0.05). RESULTS: Overall, 57 postoperative complications occurred in 47 of 241 (19.5%) patients. The most common complications were wound infection/dehiscence, urinary tract infection, and pneumonia. Univariate analysis identified preoperative radiotherapy (p = 0.028), mFI (p < 0.001), blood loss ≥ 500 ml (p = 0.016), and preoperative molecular targeted drugs (p = 0.030) as potential risk factors. From the receiver operating characteristic curve, the clinically optimal cut-off value of mFI was 0.27 (sensitivity, 46.8%; specificity, 79.9%). Multivariate analysis identified mFI ≥ 0.27 (odds ratio (OR) 2.94 (95% CI 1.44 to 5.98); p = 0.003) and preoperative radiotherapy (OR 2.11 (95% CI 1.00 to 4.46); p = 0.049) as significant risk factors. In particular, urinary tract infection (p = 0.012) and pneumonia (p = 0.037) were associated with mFI ≥ 0.27. Furthermore, the severity of postoperative complications was positively correlated with mFI (p < 0.001). CONCLUSION: The mFI is a useful tool to predict the incidence and the severity of postoperative complications in spinal metastases surgery.

  Dec. 2024, The bone & joint journal, 106-B(12) (12), 1469 - 1476, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Factors Associated With the Absence of Cervical Spine Instability in Rheumatoid Arthritis: A >10-Year Prospective Multicenter Cohort Study.

  Takashi Yurube, Yutaro Kanda, Hiroaki Hirata, Masatoshi Sumi

  OBJECTIVE: To identify factors associated with the absence of cervical spine instability in patients with rheumatoid arthritis (RA). METHODS: Cervical spine instability was defined as the presence of at least one of the following: atlantoaxial subluxation, vertical subluxation of the axis, or subaxial subluxation. In 2001-2002, 634 enrolled outpatients with "classical" or "definite" RA underwent a radiographic cervical spine checkup. In 2012-2013, 233 (36.8%) prospectively underwent routine clinical follow-ups with a >10-year radiographic evaluation. The prevalence and independent predictive factors for no instability were analyzed by multivariable logistic regression. Next, 85 of 292 outpatients (29.1%) without baseline cervical spine instability completed consecutive >5-year and >10-year radiographic examinations. The incidence and predictors for no new development of instability were assessed similarly. RESULTS: Among 233 patients, those without cervical spine instability decreased from 114 (48.9%) to 47 (20.2%) during >10 years. Steinbrocker peripheral joint destruction stages I-II (odds ratio [OR], 3.797; p=0.001), no corticosteroid administration (OR, 2.700; p=0.007), and no previous joint surgery (OR, 2.480; p=0.020) were predictors for no instability. Then, 33 of 85 (38.8%) consecutively followed patients without baseline cervical spine lesions did not develop instability throughout. Steinbrocker stages I-II (OR, 5.355; p=0.005) and no corticosteroid therapy (OR, 3.868; p=0.010) were predictors for no new onset of instability. C-reactive protein (CRP) level≤1.0 mg/dL was marginal in both models (n=233 [OR, 2.013; p=0.057], n=85 [OR, 2.453; p=0.075]). CONCLUSION: Steinbrocker stages I-II, no corticosteroids, no previous joint surgery, and possibly CRP ≤1.0 mg/dL are factors associated with >10-year absence of cervical spine instability in RA.

  Dec. 2024, Neurospine, 21(4) (4), 1230 - 1240, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Prospective Registration Study for Establishing Minimal Clinically Important Differences in Patients Undergoing Surgery for Spinal Metastases.

  Ryosuke Hirota, Tsutomu Oshigiri, Noriyuki Iesato, Makoto Emori, Atsushi Teramoto, Yuki Shiratani, Akinobu Suzuki, Hidetomi Terai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Yuta Goto, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Satoshi Kato, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya

  STUDY DESIGN: Multicenter, prospective registry study. OBJECTIVE: To clarify minimal clinically important differences (MCIDs) for surgical interventions for spinal metastases, thereby enhancing patient care by integrating quality of life assessments with clinical outcomes. BACKGROUND: Despite its proven usefulness in degenerative spinal diseases and deformities, the MCID remains unexplored regarding surgery for spinal metastases. PATIENTS AND METHODS: This study included 171 (out of 413) patients from the multicenter "Prospective Registration Study on Surgery for Metastatic Spinal Tumors" by the Japan Association of Spine Surgeons. These were evaluated preoperatively and at 6 months postoperatively using the Face Scale, EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), including the Visual Analog Scale, and performance status. The MCIDs were calculated using an anchor-based method, classifying participants into the improved, unchanged, and deteriorated groups based on the Face Scale scores. Focusing on the improved and unchanged groups, the change in the EQ-5D-5L values from before to after treatment was analyzed, and the cutoff value with the highest sensitivity and specificity was determined as the MCID through receiver operating characteristic curve analysis. The validity of the MCIDs was evaluated using a distribution-based calculation method for patient-reported outcomes. RESULTS: The improved, unchanged, and deteriorated groups comprised 121, 28, and 22 participants, respectively. The anchor-based MCIDs for the EQ-5D-5L index, EQ-Visual Analog Scale, and domains of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were 0.21, 15.50, 1.50, 0.50, 0.50, 0.50, and 0.50, respectively; the corresponding distribution-based MCIDs were 0.17, 15,99, 0.77, 0.80, 0.78, 0.60, and 0.70, respectively. CONCLUSION: We identified MCIDs for surgical treatment of spinal metastases, providing benchmarks for future clinical research. By retrospectively examining whether the MCIDs are achieved, factors favoring their achievement and risks affecting them can be explored. This could aid in decisions on surgical candidacy and patient counseling. LEVEL OF EVIDENCE: II.

  Nov. 2024, Spine, 49(22) (22), 1539 - 1547, English, International magazine

  Scientific journal


• Prevalence and aggravation of cervical spine instabilities in rheumatoid arthritis during over 10 years: a prospective multicenter cohort study.

  Yutaro Kanda, Takashi Yurube, Hiroaki Hirata, Masatoshi Sumi

  We designed a prospective multicenter cohort study to clarify a long-term, > 10-year prevalence and aggravation of cervical spine instabilities in rheumatoid arthritis (RA). In 2001-2002, 634 outpatients were enrolled, and 233 (36.8%) were followed for > 10 years. Cervical spine instability was defined as atlantoaxial subluxation (AAS, > 3-mm atlantodental interval), vertical subluxation (VS, < 13-mm Ranawat value), and subaxial subluxation (SAS, ≥ 2-mm irreducible vertebral translation). The aggravation was determined as ≥ 2 mm decrease of the Ranawat value in VS, ≥ 2-mm increase of slippage in SAS, and these new developments. The prevalence of VS and SAS increased during both the initial and last > 5 years (all, p ≤ 0.049). While VS aggravation was associated with pre-existing AAS (p = 0.007) and VS (p = 0.002), SAS aggravation correlated with pre-existing VS (p = 0.002). Multivariable analysis found hand mutilating changes (odds ratio [OR] = 4.048, p = 0.008), RA duration ≥ 5 years (OR = 3.711, p = 0.013), C-reactive protein (CRP) level ≥ 3.8 mg/dL (OR = 2.187, p = 0.044), and previous joint surgery (OR = 2.147, p = 0.021) as predictors for VS aggravation. Pre-existing VS (OR = 2.252, p = 0.024) and CRP ≥ 1.0 mg/dL (OR = 2.139, p = 0.013) were disclosed as predictors for SAS aggravation. Low disease activity and clinical remission before the development of VS and advanced peripheral joint destruction are essential to prevent progressive cervical spine instability in RA.

  Nov. 2024, Scientific reports, 14(1) (1), 26821 - 26821, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• The Utility and Feasibility of Smart Glasses in Spine Surgery: Minimizing Radiation Exposure During Percutaneous Pedicle Screw Insertion.

  Yoshiaki Hiranaka, Yoshiki Takeoka, Takashi Yurube, Takeru Tsujimoto, Yutaro Kanda, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Ryosuke Kuroda, Kenichiro Kakutani

  OBJECTIVE: Spine surgeons are often at risk of radiation exposure due to intraoperative fluoroscopy, leading to health concerns such as carcinogenesis. This is due to the increasing use of percutaneous pedicle screw (PPS) in spinal surgeries, resulting from the widespread adoption of minimally invasive spine stabilization. This study aimed to elucidate the effectiveness of smart glasses (SG) in PPS insertion under fluoroscopy. METHODS: SG were used as an alternative screen for fluoroscopic images. Operators A (2-year experience in spine surgery) and B (9-year experience) inserted the PPS into the bilateral L1-5 pedicles of the lumbar model bone under fluoroscopic guidance, repeating this procedure twice with and without SG (groups SG and N-SG, respectively). Each vertebral body's insertion time, radiation dose, and radiation exposure time were measured, and the deviation in screw trajectories was evaluated. RESULTS: The groups SG and N-SG showed no significant difference in insertion time for the overall procedure and each operator. However, group SG had a significantly shorter radiation exposure time than group N-SG for the overall procedure (109.1 ± 43.5 seconds vs. 150.9 ± 38.7 seconds; p = 0.003) and operator A (100.0 ± 29.0 seconds vs. 157.9 ± 42.8 seconds; p = 0.003). The radiation dose was also significantly lower in group SG than in group N-SG for the overall procedure (1.3 ± 0.6 mGy vs. 1.7 ± 0.5 mGy; p = 0.023) and operator A (1.2 ± 0.4 mGy vs. 1.8 ± 0.5 mGy; p = 0.013). The 2 groups showed no significant difference in screw deviation. CONCLUSION: The application of SG in fluoroscopic imaging for PPS insertion holds potential as a useful method for reducing radiation exposure.

  Jun. 2024, Neurospine, 21(2) (2), 432 - 439, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Clinical Characteristics, Surgical Outcomes, and Risk Factors for Emergency Surgery in Patients With Spinal Metastases: A Prospective Cohort Study.

  Yutaro Kanda, Kenichiro Kakutani, Yoshitada Sakai, Takashi Yurube, Yoshiki Takeoka, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Ryosuke Kuroda

  OBJECTIVE: To elucidate the patient characteristics and outcomes of emergency surgery for spinal metastases and identify risk factors for emergency surgery. METHODS: We prospectively analyzed 216 patients with spinal metastases who underwent palliative surgery from 2015 to 2020. The Eastern Cooperative Oncology Group performance status, Barthel index, EuroQol-5 dimension (EQ5D), and neurological function were assessed at surgery and at 1, 3, and 6 months postoperatively. Multivariate analysis was performed to identify risk factors for emergency surgery. RESULTS: In total, 146 patients underwent nonemergency surgery and 70 patients underwent emergency surgery within 48 hours of diagnosis of a surgical indication. After propensity score matching, we compared 61 patients each who underwent nonemergency and emergency surgery. Regardless of matching, the median performance status and the mean Barthel index and EQ5D score showed a tendency toward worse outcomes in the emergency than nonemergency group both preoperatively and 1 month postoperatively, although the surgery greatly improved these values in both groups. The median survival time tended to be shorter in the emergency than nonemergency group. The multivariate analysis showed that lesions located at T3-10 (p = 0.002; odds ratio [OR], 2.92; 95% confidence interval [CI], 1.48-5.75) and Frankel grades A-C (p < 0.001; OR, 4.91; 95% CI, 2.45-9.86) were independent risk factors for emergency surgery. CONCLUSION: Among patients with spinal metastases, preoperative and postoperative subjective health values and postoperative survival are poorer in emergency than nonemergency surgery. Close attention to patients with T3-10 metastases is required to avoid poor outcomes after emergency surgery.

  Mar. 2024, Neurospine, 21(1) (1), 314 - 327, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• 脊椎転移に対する緊急手術成績と緊急手術に至るリスク因子の前向き検討

  神田 裕太郎, 角谷 賢一朗, 酒井 良忠, 由留部 崇, 辻本 武尊, 武岡 由樹, 宮崎 邦彦, 大西 洋輝, 松尾 智哉, 劉 正夫, 熊谷 直利, 黒島 康平, 平中 良明, 黒田 良祐

  (一社)日本脊椎脊髄病学会, Feb. 2024, Journal of Spine Research, 15(3) (3), 330 - 330, Japanese


• 脊椎転移手術における悪性度別手術成績比較

  大西 洋輝, 神田 裕太郎, 由留部 崇, 武岡 由樹, 辻本 武尊, 宮崎 邦彦, 松尾 智哉, 劉 正夫, 熊谷 直利, 黒島 康平, 平中 良明, 酒井 良忠, 秋末 敏弘, 黒田 良祐, 角谷 賢一朗

  (一社)日本脊椎脊髄病学会, Feb. 2024, Journal of Spine Research, 15(3) (3), 650 - 650, Japanese


• Transforaminal full-endoscopic decompression under local anesthesia for foraminal stenosis due to stable L5 isthmic spondylolisthesis, a technical note and review:Pars crisscross decompression.

  Koichi Sairyo, Yutaro Kanda, Kozaburo Mizutani, Masashi Kumon, Saori Soeda, Fumiaki Makiyama, Ryota Mio, Masatoshi Morimoto, Shunsuke Tamaki, Keisuke Nishidono, Kosuke Sugiura, Makoto Takeuchi, Hiroaki Manabe, Fumitake Tezuka, Kazuta Yamashita, Hiroshi Kageyama, Junzo Fujitani

  Foraminal stenosis is one of the types of lumbar spinal stenosis. The pathology can be treated minimally invasively by full-endoscopic spine surgery (FESS). The final challenge in transforaminal FESS is foraminal stenosis in patients with stable isthmic spondylolisthesis at L5. This article provides a step-by-step explanation of how to achieve complete decompression. A cannula of 8 mm in diameter is docked at the base of the superior articular process of the sacrum. The pars crisscross that consists of the superior articular process at S1, the floating lamina, the inferior articular process at L4, and the pars ragged edge is then clearly seen endoscopically. Visualization of the pars crisscross is key to successful decompression. Starting with the superior articular process at S1, followed by partial removal of the floating lamina. Next, the tip of the inferior articular process at L4 is removed. The pars ragged edge is then carefully shaved. Finally, decompression of the exiting nerve root at L5 is confirmed. This report provides the first step-by step description of full-endoscopic decompression of foraminal stenosis under local anesthesia in patients with stable L5 isthmic spondylolisthesis, which we have named "full-endoscopic pars crisscross decompression". J. Med. Invest. 71 : 191-196, August, 2024.

  2024, The journal of medical investigation : JMI, 71(3.4) (3.4), 191 - 196, English, Domestic magazine

  Scientific journal


• Effect of Bone Metastasis Cancer Board on Spinal Surgery Outcomes: A Retrospective Study.

  Kunihiko Miyazaki, Yutaro Kanda, Yoshitada Sakai, Ryo Yoshikawa, Takashi Yurube, Yoshiki Takeoka, Hitomi Hara, Toshihiro Akisue, Ryosuke Kuroda, Kenichiro Kakutani

  Background and Objectives: Bone metastasis cancer boards (BMCBs) focusing on the management of bone metastases have been gathering much attention. However, the association of BMCBs with spinal surgery in patients with spinal metastases remains unclear. In this retrospective single-center observational study, we aimed to clarify the effect of a BMCB on spinal metastasis treatment. Materials and Methods: We reviewed consecutive cases of posterior decompression and/or instrumentation surgery for metastatic spinal tumors from 2008 to 2019. The BMCB involved a team of specialists in orthopedics, rehabilitation medicine, radiation oncology, radiology, palliative supportive care, oncology, and hematology. We compared demographics, eastern cooperative oncology group performance status (ECOGPS), Barthel index (BI), number of overall versus emergency surgeries, and primary tumors between patients before (2008-2012) and after (2013-2019) BMCB establishment. Results: A total of 226 patients including 33 patients before BMCB started were enrolled; lung cancer was the most common primary tumor. After BMCB establishment, the mean patient age was 5 years older (p = 0.028), the mean operating time was 34 min shorter (p = 0.025), the mean hospital stay was 34.5 days shorter (p < 0.001), and the mean BI before surgery was 12 points higher (p = 0.049) than before. Moreover, the mean number of surgeries per year increased more than fourfold to 27.6 per year (p < 0.01) and emergency surgery rates decreased from 48.5% to 29.0% (p = 0.041). Patients with an unknown primary tumor before surgery decreased from 24.2% to 9.3% (p = 0.033). Postoperative deterioration rates from 1 to 6 months after surgery of ECOGPS and BI after BMCB started were lower than before (p = 0.045 and p = 0.027, respectively). Conclusion: The BMCB decreased the emergency surgery and unknown primary tumor rate despite an increase in the overall number of spinal surgeries. The BMCB also contributed to shorter operation times, shorter hospital stays, and lower postoperative deterioration rates of ECOGPS and BI.

  Nov. 2023, Medicina (Kaunas, Lithuania), 59(12) (12), English, International magazine

  Scientific journal


• Clinical Characteristics and Surgical Outcomes of Metastatic Spine Tumors in the Very Elderly: A Prospective Cohort Study in a Super-Aged Society.

  Yutaro Kanda, Kenichiro Kakutani, Yoshitada Sakai, Kunihiko Miyazaki, Tomoya Matsuo, Takashi Yurube, Yoshiki Takeoka, Hiroki Ohnishi, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Teruya Kawamoto, Hitomi Hara, Yuichi Hoshino, Shinya Hayashi, Toshihiro Akisue, Ryosuke Kuroda

  The number of advanced-age patients with spinal metastases is rising. This study was performed to clarify the characteristics and surgical outcomes of spinal metastases in advanced-age patients. We prospectively analyzed 216 patients with spinal metastases from 2015 to 2020 and divided them into three age groups: <70 years (n = 119), 70-79 years (n = 73), and ≥80 years (n = 24). Although there were no significant intergroup differences in preoperative characteristics and surgery-related factors except for age, patients aged ≥80 years tended to have a worse performance status (PS), Barthel index, and EuroQol-5 dimension (EQ-5D) before and after surgery than the other two groups. Although the median PS, mean Barthel index and mean EQ-5D greatly improved postoperatively in each group, the median PS and mean Barthel index at 6 months and the mean EQ-5D at 1 month postoperatively were significantly poorer in the ≥80-year group than the 70-79-year group. The rates of postoperative complications and re-deterioration of the EQ-5D were significantly higher in the oldest group than in the other two groups. Although surgery for spinal metastases improved the PS, Barthel index, and EQ-5D regardless of age, clinicians should be aware of the poorer outcomes and higher complication rates in advanced-age patients.

  Jul. 2023, Journal of clinical medicine, 12(14) (14), English, International magazine

  Scientific journal


• Intervertebral disc cell fate during aging and degeneration: apoptosis, senescence, and autophagy.

  Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Ryosuke Kuroda, Kenichiro Kakutani

  BACKGROUND: Degenerative disc disease, a major cause of low back pain and associated neurological symptoms, is a global health problem with the high morbidity, workforce loss, and socioeconomic burden. The present surgical strategy of disc resection and/or spinal fusion results in the functional loss of load, shock absorption, and movement; therefore, the development of new biological therapies is demanded. This achievement requires the understanding of intervertebral disc cell fate during aging and degeneration. METHODS: Literature review was performed to clarify the current concepts and future perspectives of disc cell fate, focused on apoptosis, senescence, and autophagy. RESULTS: The intervertebral disc has a complex structure with the nucleus pulposus (NP), annulus fibrosus (AF), and cartilage endplates. While the AF arises from the mesenchyme, the NP originates from the notochord. Human disc NP notochordal phenotype disappears in adolescence, accompanied with cell death induction and chondrocyte proliferation. Discs morphologically and biochemically degenerate from early childhood as well, thereby suggesting a possible involvement of cell fate including age-related phenotypic changes in the disease process. As the disc is the largest avascular organ in the body, nutrient deprivation is a suspected contributor to degeneration. During aging and degeneration, disc cells undergo senescence, irreversible growth arrest, producing proinflammatory cytokines and matrix-degradative enzymes. Excessive stress ultimately leads to programmed cell death including apoptosis, necroptosis, pyroptosis, and ferroptosis. Autophagy, the intracellular degradation and recycling system, plays a role in maintaining cell homeostasis. While the incidence of apoptosis and senescence increases with age and degeneration severity, autophagy can be activated earlier, in response to limited nutrition and inflammation, but impaired in aged, degenerated discs. The phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) is a signal integrator to determine disc cell fate. CONCLUSIONS: Cell fate and microenvironmental regulation by modulating PI3K/Akt/mTOR signaling is a potential biological treatment for degenerative disc disease.

  Jun. 2023, North American Spine Society journal, 14, 100210 - 100210, English, International magazine

  Scientific journal

  Link to Kobe Univ. Repository (Kernel)


• Preoperative Base Excess as a Predictor of Perioperative Complications in Patients with Nonidiopathic Scoliosis who Have High Risk Associated with General Anesthesia.

  Yutaro Kanda, Kenichiro Kakutani, Moritoki Egi, Zhongying Zhang, Takashi Yurube, Yoshiki Takeoka, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Yuichi Hoshino, Ryosuke Kuroda

  INTRODUCTION: Patients with nonidiopathic scoliosis often have a high risk associated with general anesthesia because of cardiac or pulmonary dysfunction secondary to underlying diseases. Base excess has been reported as a predictor in the management of trauma and cancer, although not yet in scoliosis. This study was performed to clarify the surgical outcomes and the association of perioperative complications with base excess in patients with nonidiopathic scoliosis who have a high risk associated with general anesthesia. METHODS: Patients with nonidiopathic scoliosis who were referred to our institution from 2009 to 2020 because of their high risk associated with general anesthesia were retrospectively enrolled. High-risk factors for anesthesia were determined by a senior anesthesiologist and categorized into circulatory or pulmonary dysfunction. Perioperative complications were analyzed using the Clavien-Dindo classification; severe complications were defined as grade ≥III. We investigated high-risk factors for anesthesia, underlying diseases, preoperative and postoperative Cobb angle, surgery-related factors, base excess, and postoperative management. These variables were statistically compared between patients with and without complications. RESULTS: Thirty-six patients (mean age, 17.9 years old; range, 11-40 years old) were enrolled (two patients declined surgery). High-risk factors were circulatory dysfunction in 16 patients and pulmonary dysfunction in 20 patients. The mean Cobb angle improved from 85.1° (36°-128°) preoperatively to 43.6° (9°-83°) postoperatively. Three intraoperative complications and 23 postoperative complications occurred in 20 (55.6%) patients. Severe complications occurred in 10 (27.8%) patients. All patients underwent postoperative intensive care unit management after posterior all-screw construction. A large preoperative Cobb angle (p=0.021) and base excess outliers (>3 or <-3 mEq/L) (p=0.005) were significant risk factors for complications. CONCLUSIONS: Patients with nonidiopathic scoliosis who have a high risk associated with general anesthesia have a higher complication rate. Preoperative large deformity and base excess (>3 or <-3 mEq/L) could be predictors of complications.

  May 2023, Spine surgery and related research, 7(3) (3), 268 - 275, English, Domestic magazine

  Scientific journal


• Regenerative Capability of Human Nucleus Pulposus Cells in Degenerated Disc Under Hydrostatic Pressure Mimicking Physiologically Relevant Intradiscal Pressure In Vitro.

  Yoshiki Takeoka, Yutaro Kanda, James D Kang, Shuichi Mizuno

  STUDY DESIGN: Isolated human nucleus pulposus (hNP) cells from the degenerated intervertebral disc (IVD) were incubated under hydrostatic pressure (HP) and evaluated for regenerative potential. OBJECTIVES: To characterize metabolic turnover in hNP cells isolated from degenerated IVDs classified by Pfirrmann grade under physiologically relevant HP at high osmolality in vitro. SUMMARY OF BACKGROUND DATA: We demonstrated that bovine caudal nucleus pulposus cells isolated from healthy cows produced more extracellular matrix under cyclic HP followed by constant pressure (mimicking physiological intradiscal pressure in humans) than under no pressure in vitro. We assessed the effects of pressure on human degenerated cells isolated under the same regimen of pressure used for bovine cells. MATERIALS AND METHODS: hNP cells isolated from discarded tissue classified as Pfirrmann grade 2 to 3 (n = 13: age, 46.7 ± 14.0) and grade 4 (n = 13: age, 53.0 ± 11.5) were incubated under cyclic HP at 0.2 to 0.7 MPa, 0.5 Hz for 2 days followed by constant pressure at 0.3 MPa for 1 day, repeated twice over 6 days. The gene expression and immunohistology of matrix molecules and catabolic and anticatabolic proteins were evaluated. RESULTS: Aggrecan and collagen type II expression were significantly more upregulated under HP in grades 2 to 3 than in grade 4 tissues (both, P < 0.01). Linear regression analysis showed a positive correlation between matrix metalloproteinase 13 and tissue inhibitor for metalloproteinase 2 expression in grades 2 to 3, whereas a negative correlation was found in grade 4 ( P < 0.05). Immunohistological staining revealed the activation of a mechanoreceptor, transient receptor potential vanilloid 4, under HP. CONCLUSIONS: Resident cells in mild-moderate degenerated discs classified as Pfirrmann grade 2 to 3 have the potential to promote extracellular matrix production and maintain adequate cell viability under physiological spinal loading. RELEVANCE: This study explored the potential of degenerated remnant nucleus pulposus cells under a physiological environment, possibly leading to establishing strategies for IVD regeneration.

  May 2023, Spine, 48(10) (10), 728 - 736, English, International magazine

  Scientific journal


• Anti-Inflammatory Effects of Adiponectin Receptor Agonist AdipoRon against Intervertebral Disc Degeneration.

  Hiroki Ohnishi, Zhongying Zhang, Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Ryu Tsujimoto, Kunihiko Miyazaki, Tomoya Matsuo, Masao Ryu, Naotoshi Kumagai, Kohei Kuroshima, Yoshiaki Hiranaka, Ryosuke Kuroda, Kenichiro Kakutani

  Adiponectin, a hormone secreted by adipocytes, has anti-inflammatory effects and is involved in various physiological and pathological processes such as obesity, inflammatory diseases, and cartilage diseases. However, the function of adiponectin in intervertebral disc (IVD) degeneration is not well understood. This study aimed to elucidate the effects of AdipoRon, an agonist of adiponectin receptor, on human IVD nucleus pulposus (NP) cells, using a three-dimensional in vitro culturing system. This study also aimed to elucidate the effects of AdipoRon on rat tail IVD tissues using an in vivo puncture-induced IVD degeneration model. Analysis using quantitative polymerase chain reaction demonstrated the downregulation of gene expression of proinflammatory and catabolic factors by interleukin (IL)-1β (10 ng/mL) in human IVD NP cells treated with AdipoRon (2 μM). Furthermore, western blotting showed AdipoRon-induced suppression of p65 phosphorylation (p < 0.01) under IL-1β stimulation in the adenosine monophosphate-activated protein kinase (AMPK) pathway. Intradiscal administration of AdipoRon was effective in alleviating the radiologic height loss induced by annular puncture of rat tail IVD, histomorphological degeneration, production of extracellular matrix catabolic factors, and expression of proinflammatory cytokines. Therefore, AdipoRon could be a new therapeutic candidate for alleviating the early stage of IVD degeneration.

  May 2023, International journal of molecular sciences, 24(10) (10), English, International magazine

  Scientific journal


• Separation Surgery and Postoperative Intensity-Modulated Radiation Therapy for a High-Grade Myxofibrosarcoma Involving the Spine: A Case Report.

  Yutaro Kanda, Takashi Yurube, Ryosuke Kuroda, Kenichiro Kakutani

  BACKGROUND Myxofibrosarcoma involving the spine is a rare and intractable disease. Although wide surgical resection is the mainstay of treatment, it is often difficult to complete marginal en-bloc resection due to adjacent neurovascular components in the spine. Separation surgery, a partial resection to achieve circumferential separation and high-dose irradiation such as postoperative intensity-modulated radiation therapy, has received much attention as a new therapy for spinal tumors. However, little evidence regarding separation surgery with intensity-modulated radiation therapy for a spinal myxofibrosarcoma exists. CASE REPORT We present a case of a 75-year-old man with progressive myelopathy. Radiological examination revealed severe spinal cord compression due to an unknown widespread multiple tumor in the cervical and thoracic spine. Computed tomography-guided biopsy showed high-grade sarcoma. Positron emission tomography detected no other tumors in the body. Separation surgery was therefore performed with posterior stabilization. Hematoxylin and eosin staining showed storiform cellular infiltrates and pleomorphic cell nuclei. Histopathology identified high-grade myxofibrosarcoma. Postoperative intensity-modulated radiation therapy of 60 Gy in 25 fractions was completed without any adverse effects. The patient had greatly improved neurological function, was capable of walking with a cane, and had no recurrence for at least 1 year after surgery. CONCLUSIONS We reported a case of an unresectable high-grade myxofibrosarcoma of the spine successfully treated with the combination of separation surgery and postoperative intensity-modulated radiation therapy. This combination therapy is a relatively safe and effective treatment option in patients with impending neurological damage by unresectable sarcomas when total en-bloc resection is challenging due to the size, location, or adhesion.

  Mar. 2023, The American journal of case reports, 24, e939368, English, International magazine

  Scientific journal


• The Identification of Risk Factors for Symptomatic Spinal Metastasis Onset: A Prospective Cohort Study of 128 Asymptomatic Spinal Metastasis Patients.

  Kenichiro Kakutani, Yutaro Kanda, Takashi Yurube, Yoshiki Takeoka, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Kohei Kuroshima, Naotoshi Kumagai, Yoshiaki Hiranaka, Shinya Hayashi, Yuichi Hoshino, Hitomi Hara, Yoshitada Sakai, Ryosuke Kuroda

  Background: Symptomatic spinal metastasis (SSM) decreases the activities of daily living (ADL) and quality of life of cancer patients. However, the risk factors for SSM onset remain unclear. This prospective cohort study aimed to statistically analyze the significant risk factors. Methods: From 2016 to 2018, 210 consecutive patients with spinal metastases were prospectively registered. Patients with SSM at the first consultation and those who were unable to be followed-up owing to poor general condition were excluded. The demographic factors (age, sex, primary cancer, performance status, and ADL), clinical factors (radiation therapy, chemotherapy, molecularly targeted drugs, and bone-modifying agents (BMAs)), and Spinal Neoplastic Instability Score (SINS) were evaluated. Multivariate analysis was performed to identify the risk factors for SSM onset. Furthermore, the threshold was calculated from the receiver operating characteristic curve using the Youden index. Results: Thirty-nine patients who presented with SSM at the first consultation and 43 patients who were unable to be followed-up owing to poor general condition were excluded. Finally, 128 asymptomatic patients were included. Thirty-seven patients (28.9%) developed SSM during the follow-up period. The total SINS (OR: 1.739; 95% CI: 1.345-2.250) was identified as the most significant factor. The cut-off value of the SINS was 9.5 (sensitivity: 67.6%; specificity: 83.5%). Twenty-five (62.5%) of the forty patients with a SINS ≥ 10 developed SSM within a mean of 5.5 months (95% CI: 1.17-9.83). Furthermore, all patients with a SINS ≥ 13 developed SSM (n = 5) within a mean of 1.37 months (95% CI: 0.0-3.01). Conclusions: This study identified the significant risk factors for SSM onset and the threshold of the SINS. If long-term survival is expected, patients with a SINS ≥ 10 should be considered for intervention to prevent SSM.

  Feb. 2023, Cancers, 15(4) (4), English, International magazine

  Scientific journal


• The Combination of Separation Surgery and Intensity Modulated Radiation Therapy (IMRT) for a Primary Osteosarcoma of the Spine: A Case Report and Literature Review.

  Yutaro Kanda, Yuji Kakiuchi, Takashi Yurube, Yoshiki Takeoka, Kunihiko Miyazaki, Ryosuke Kuroda, Kenichiro Kakutani

  BACKGROUND: Primary spinal osteosarcoma is a rare and intractable disease. Although en bloc resection is favorable for longer survival, it is not always achievable. Separation surgery, a partial resection with circumferential separation to safely deliver high-dose irradiation including intensity-modulated radiation therapy (IMRT), has been recently indicated for patients with spinal cord compression secondary to solid tumor metastases. However, little evidence regarding this combination approach to spinal osteosarcoma exists. CASE PRESENTATION: We report a 55-year-old male patient with a T1 tumor who underwent urgent decompression surgery for epidural spinal cord compression. Pathological findings revealed primary osteosarcoma. Separation surgery, IMRT, and adjuvant chemotherapy were applied to reduce the symptoms of epidural spinal cord compression. The patient was alive without local recurrence at the 5-year follow-up. CONCLUSIONS: Separation surgery with IMRT can be a relatively safe and effective treatment option in patients with osteosarcoma adjacent to spinal cord when en-bloc resection is challenging.

  2023, Clinical medicine insights. Case reports, 16, 11795476231171891 - 11795476231171891, English, International magazine

  Scientific journal


• Survival Rate after Palliative Surgery Alone for Symptomatic Spinal Metastases: A Prospective Cohort Study.

  Kenichiro Kakutani, Yoshitada Sakai, Zhongying Zhang, Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Kunihiko Miyazaki, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Kohei Kuroshima, Naotoshi Kumagai, Yoshiaki Hiranaka, Shinya Hayashi, Yuichi Hoshino, Hitomi Hara, Ryosuke Kuroda

  The effect of spine surgery for symptomatic spinal metastases (SSM) on patient prognosis remains unclear. This study aimed to reveal the prognosis of patients with SSM after spine surgery. One hundred twenty-two patients with SSM were enrolled in this prospective cohort study. The patients who received chemotherapy after enrollment were excluded. The decision of surgery depended on patient's willingness; the final cohort comprised 31 and 24 patients in the surgery and non-surgery groups, respectively. The patients were evaluated by their performance status (PS), activities of daily living (ADL) and ambulatory status. Survival was evaluated by the Kaplan-Meier method. The PS, ADL and ambulation were significantly improved in the surgery group compared to non-surgery group. The median survival was significantly longer in the surgery group (5.17 months, 95% confidence interval (CI) 3.27 to 7.07) than in the non-surgery group (2.23 months, 95% CI 2.03 to 2.43; p = 0.003). Furthermore, the patients with a better PS, ADL and ambulatory status had a significantly longer survival. Surgery improved the PS, ADL, ambulation and survival of patients with SSM. In the management of SSM, spine surgery is not only palliative but may also prolong survival.

  Oct. 2022, Journal of clinical medicine, 11(21) (21), English, International magazine

  Scientific journal


• Protective Effects of Growth Differentiation Factor-6 on the Intervertebral Disc: An In Vitro and In Vivo Study.

  Kunihiko Miyazaki, Shingo Miyazaki, Takashi Yurube, Yoshiki Takeoka, Yutaro Kanda, Zhongying Zhang, Yuji Kakiuchi, Ryu Tsujimoto, Hiroki Ohnishi, Tomoya Matsuo, Masao Ryu, Ryosuke Kuroda, Kenichiro Kakutani

  Growth differentiation factors (GDFs) regulate homeostasis by amplifying extracellular matrix anabolism and inhibiting pro-inflammatory cytokine production in the intervertebral disc (IVD). The aim of this study was to elucidate the effects of GDF-6 on human IVD nucleus pulposus (NP) cells using a three-dimensional culturing system in vitro and on rat tail IVD tissues using a puncture model in vivo. In vitro, Western blotting showed decreased GDF-6 expression with age and degeneration severity in surgically collected human IVD tissues (n = 12). Then, in moderately degenerated human IVD NP cells treated with GDF-6 (100 ng/mL), immunofluorescence demonstrated an increased expression of matrix components including aggrecan and type II collagen. Quantitative polymerase chain reaction analysis also presented GDF-6-induced downregulation of pro-inflammatory tumor necrosis factor (TNF)-α (p = 0.014) and interleukin (IL)-6 (p = 0.016) gene expression stimulated by IL-1β (10 ng/mL). Furthermore, in the mitogen-activated protein kinase pathway, Western blotting displayed GDF-6-induced suppression of p38 phosphorylation (p = 0.041) under IL-1β stimulation. In vivo, intradiscal co-administration of GDF-6 and atelocollagen was effective in alleviating rat tail IVD annular puncture-induced radiologic height loss (p = 0.005), histomorphological degeneration (p < 0.001), matrix metabolism (aggrecan, p < 0.001; type II collagen, p = 0.001), and pro-inflammatory cytokine production (TNF-α, p < 0.001; IL-6, p < 0.001). Consequently, GDF-6 could be a therapeutic growth factor for degenerative IVD disease.

  Mar. 2022, Cells, 11(7) (7), English, International magazine

  Scientific journal


• Involvement of autophagy in the maintenance of rat intervertebral disc homeostasis: an in-vitro and in-vivo RNA interference study of Atg5.

  R Tsujimoto, T Yurube, Y Takeoka, Y Kanda, K Miyazaki, H Ohnishi, Y Kakiuchi, S Miyazaki, Z Zhang, T Takada, R Kuroda, K Kakutani

  OBJECTIVE: In the largest avascular low-nutrient intervertebral disc, resident cells would utilize autophagy, a stress-response survival mechanism by self-digestion and recycling wastes. Our goal was to elucidate the involvement of autophagy in disc homeostasis through RNA interference of autophagy-related gene 5 (Atg5). DESIGN: In vitro, small interfering RNAs (siRNAs) targeting autophagy-essential Atg5 were transfected into rat disc cells. Cell viability with levels of autophagy including Atg5 expression, apoptosis, and senescence was assessed under serum starvation and/or pro-inflammatory interleukin-1 beta (IL-1β) stimulation. In vivo, time-course autophagic flux was monitored following Alexa Fluor® 555-labeled Atg5-siRNA injection into rat tail discs. Furthermore, 24-h temporary static compression-induced disruption of Atg5 siRNA-injected discs was observed by radiography, histomorphology, and immunofluorescence. RESULTS: In disc cells, three different Atg5 siRNAs consistently suppressed autophagy with Atg5 protein knockdown (mean 44.4% [95% confidence interval: -51.7, -37.1], 51.5% [-80.5, -22.5], 62.3% [-96.6, -28.2]). Then, Atg5 knockdown reduced cell viability through apoptosis and senescence not in serum-supplemented medium (93.6% [-0.8, 21.4]) but in serum-deprived medium (66.4% [-29.8, -8.6]) further with IL-1β (44.5% [-36.9, -23.5]). In disc tissues, immunofluorescence detected intradiscal signals for the labeled siRNA even at 56-d post-injection. Immunoblotting found 56-d autophagy suppression with prolonged Atg5 knockdown (33.2% [-52.8, -5.3]). With compression, Atg5 siRNA-injected discs presented radiographic height loss ([-43.9, -0.8]), histological damage ([-5.5, -0.2]), and immunofluorescent apoptosis ([2.2, 22.2]) and senescence ([4.1, 19.9]) induction compared to control siRNA-injected discs at 56 d. CONCLUSIONS: This loss-of-function study suggests Atg5-dependent autophagy-mediated anti-apoptosis and anti-senescence. Autophagy could be a molecular therapeutic target for degenerative disc disease.

  Mar. 2022, Osteoarthritis and cartilage, 30(3) (3), 481 - 493, English, International magazine

  Scientific journal


• Improved Accuracy and Safety of Pedicle Screw Placement by Using a Probe with an Electrical Conductivity-Measuring Device during Severe Syndromic and Neuromuscular Scoliosis Spine Surgery.

  Takashi Yurube, Yutaro Kanda, Masaaki Ito, Yoshiki Takeoka, Teppei Suzuki, Koki Uno, Ryosuke Kuroda, Kenichiro Kakutani

  An electrical conductivity-measuring device (ECD) has recently been developed to support pedicle screw placement. However, no evidence exists regarding its efficacy for syndromic/neuromuscular scoliosis with extremely difficult screwing. We retrospectively reviewed 2010-2016 medical records of 21 consecutive syndromic/neuromuscular scoliosis patients undergoing free-hand segmental fixation surgery at our institution and compared the pedicle screw insertion accuracy and safety between 10 with a conventional non-ECD probe (2010-2013) and 11 with an ECD probe (2014-2016). We analyzed preoperative pedicle shape and postoperative screw placement in computed tomography. There were no significant differences between ECD and non-ECD groups in demographic, clinical, and treatment characteristics including scoliosis severity and pedicle diameter. The abandonment rate due to liquorrhea or perforation was lower in ECD (12.3%) than in non-ECD (26.7%) (p < 0.01). Acceptable insertion without perforation or <2-mm lateral/cranial position was more frequent in ECD (67.1%) than in non-ECD (56.9%) (p = 0.02). Critical ≥5-mm medial/caudal malposition was not seen in ECD (0.0%) but in non-ECD (2.4%) (p = 0.02). The perforation distance was shorter in ECD (2.2 ± 1.1 mm) than in non-ECD (2.6 ± 1.7 mm) (p = 0.01). Results involve small sample size, selection, performance, and learning curve biases; nevertheless, ECD could be useful for more accurate and safer pedicle screw placement in severe syndromic/neuromuscular scoliosis.

  Jan. 2022, Journal of clinical medicine, 11(2) (2), English, International magazine

  Scientific journal


• Delayed notochordal cell disappearance through integrin α5β1 mechanotransduction during ex-vivo dynamic loading-induced intervertebral disc degeneration.

  Yutaro Kanda, Takashi Yurube, Yusuke Morita, Yoshiki Takeoka, Takuto Kurakawa, Ryu Tsujimoto, Kunihiko Miyazaki, Yuji Kakiuchi, Shingo Miyazaki, Zhongying Zhang, Toru Takada, Yuichi Hoshino, Koichi Masuda, Ryosuke Kuroda, Kenichiro Kakutani

  The loss of nucleus pulposus (NP) notochordal cells is one of the key initial hallmarks of age-related intervertebral disc degeneration. Although the transmembrane mechanoreceptor integrin α5β1 is important in the process of disc degeneration, the relationship between integrin α5β1 and notochordal cell disappearance remains unclear. The purpose of this study was to elucidate the role of integrin α5β1 in the homeostasis of notochordal cells using an ex-vivo dynamic loading culture system that we developed. Rat tail functional spinal units (n = 80 from 40 rats) were cultured under unloading or 1.3-MPa, 1.0-Hz dynamic compressive loading for 48 or 144 h with or without an integrin α5β1 inhibitor. Disc histomorphology, cell viability, apoptosis, senescence, and phenotypic expression were investigated. Consequently, histological degenerative disc changes with decreased cell viability and increased cell apoptosis and senescence were observed with an extended loading duration. Immunofluorescence revealed that the expression of notochordal cell markers, CD24 and brachyury, and chondrocyte markers, collagen type II and SRY-box 9, declined with loading. In particular, reduction in notochordal cell marker expression was more dramatic than that in chondrocyte marker expression. Apoptotic terminal deoxynucleotidyl transferase dUTP nick-end labeling positivity was also higher in brachyury-positive notochordal cells. Furthermore, all these changes were delayed by inhibiting integrin α5β1. Findings of our dynamic loading regimen with a relatively high pressure suggest reproducibility of the cellularity and phenotypic disappearance of NP notochordal cells during adolescence, the susceptibility of notochordal cells to mechanical stimuli partially through the integrin α5β1 pathway, and future potential treatment of integrin regulation for intervertebral disc disease.

  Sep. 2021, Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 39(9) (9), 1933 - 1944, English, International magazine

  Scientific journal


• Surgical outcomes and risk factors for poor outcomes in patients with cervical spine metastasis: a prospective study.

  Yutaro Kanda, Kenichiro Kakutani, Yoshitada Sakai, Zhongying Zhang, Takashi Yurube, Shingo Miyazaki, Yuji Kakiuchi, Yoshiki Takeoka, Ryu Tsujimoto, Kunihiko Miyazaki, Hiroki Ohnishi, Yuichi Hoshino, Toru Takada, Ryosuke Kuroda

  BACKGROUND: Few studies have addressed the impact of palliative surgery for cervical spine metastasis on patients' performance status (PS) and quality of life (QOL). We investigated the surgical outcomes of patients with cervical spine metastasis and the risk factors for a poor outcome with a focus on the PS and QOL. METHODS: We prospectively analyzed patients with cervical spine metastasis who underwent palliative surgery from 2013 to 2018. The Eastern Cooperative Oncology Group PS (ECOGPS) and EuroQol 5-Dimension (EQ5D) score were assessed at study enrollment and 1, 3, and 6 months postoperatively. Neurological function was evaluated with Frankel grading. Univariate and multivariate analyses were performed to identify the risk factors for a poor surgical outcome, defined as no improvement or deterioration after improvement of the ECOGPS or EQ5D score within 3 months. RESULTS: Forty-six patients (mean age, 67.5 ± 11.7 years) were enrolled. Twelve postoperative complications occurred in 11 (23.9%) patients. The median ECOGPS improved from PS3 at study enrolment to PS2 at 1 month and PS1 at 3 and 6 months postoperatively. The mean EQ5D score improved from 0.085 ± 0.487 at study enrolment to 0.658 ± 0.356 at 1 month and 0.753 ± 0.312 at 3 months. A poor outcome was observed in 18 (39.1%) patients. The univariate analysis showed that variables with a P value of < 0.10 were sex (male), the revised Tokuhashi score, the new Katagiri score, the level of the main lesion, and the Frankel grade at baseline. The multivariate analysis identified the level of the main lesion (cervicothoracic junction) as the significant risk factor (odds ratio, 5.00; P = 0.025). CONCLUSIONS: Palliative surgery for cervical spine metastasis improved the PS and QOL, but a cervicothoracic junction lesion could be a risk factor for a poor outcome.

  Jul. 2021, Journal of orthopaedic surgery and research, 16(1) (1), 423 - 423, English, International magazine

  Scientific journal


• Inhibition of Autophagy at Different Stages by ATG5 Knockdown and Chloroquine Supplementation Enhances Consistent Human Disc Cellular Apoptosis and Senescence Induction rather than Extracellular Matrix Catabolism.

  Masaaki Ito, Takashi Yurube, Yutaro Kanda, Yuji Kakiuchi, Yoshiki Takeoka, Toru Takada, Ryosuke Kuroda, Kenichiro Kakutani

  The intervertebral disc is the largest avascular organ. Autophagy is an important cell survival mechanism by self-digestion and recycling damaged components under stress, primarily nutrient deprivation. Resident cells would utilize autophagy to cope with the harsh disc environment. Our objective was to elucidate the roles of human disc cellular autophagy. In human disc cells, serum deprivation and pro-inflammatory interleukin-1β (IL-1β) stimulation increased autophagy marker microtubule-associated protein 1 light chain 3 (LC3)-II and decreased autophagy substrate p62/sequestosome 1 (p62/SQSTM1), indicating enhanced autophagy. Then, RNA interference (RNAi) of autophagy-related gene 5 (ATG5), essential for autophagy, showed decreases in ATG5 protein (26.8%-27.4%, p < 0.0001), which suppressed early-stage autophagy with decreased LC3-II and increased p62/SQSTM1. Cell viability was maintained by ATG5 RNAi in serum-supplemented media (95.5%, p = 0.28) but reduced in serum-free media (80.4%, p = 0.0013) with IL-1β (69.9%, p = 0.0008). Moreover, ATG5 RNAi accelerated IL-1β-induced changes in apoptosis and senescence. Meanwhile, ATG5 RNAi unaffected IL-1β-induced catabolic matrix metalloproteinase release, down-regulated anabolic gene expression, and mitogen-activated protein kinase pathway activation. Lysosomotropic chloroquine supplementation presented late-stage autophagy inhibition with apoptosis and senescence induction, while catabolic enzyme production was modest. Disc-tissue analysis detected age-related changes in ATG5, LC3-II, and p62/SQSTM1. In summary, autophagy protects against human disc cellular apoptosis and senescence rather than extracellular matrix catabolism.

  Apr. 2021, International journal of molecular sciences, 22(8) (8), English, International magazine

  Scientific journal


• A novel topical treatment for bone metastases using a gelatin hydrogel incorporating cisplatin as a sustained release system.

  Yutaro Kanda, Kenichiro Kakutani, Takashi Yurube, Zhongying Zhang, Shingo Miyazaki, Yuji Kakiuchi, Yoshiki Takeoka, Ryu Tsujimoto, Kunihiko Miyazaki, Teruya Kawamoto, Toru Takada, Yuichi Hoshino, Yasuhiko Tabata, Ryosuke Kuroda

  Management of bone metastasis is becoming increasingly important. Thus, local and systemic treatment options have been developed for control. Although systemic administration of anticancer agents is effective for bone metastasis, it is often stopped because of poor general conditions or side effects. Therefore, it is highly desirable to develop a more effective and safer local treatment for bone metastasis. The purpose of the current study was to investigate the antitumor effects and safety of gelatin hydrogel microspheres incorporating cisplatin (GM-CDDP), which we developed as a sustained release system without harmful substances. First, we assessed GM-CDDP for its in vitro degradability and potential for sustained release. Second, in vivo antitumor and side effects were evaluated using a murine bone metastasis model of MDA-MB-231 human breast cancer cells incorporating GFP. In vitro, initial bursts were observed within 2 h and CDDP was released gradually with gelatin hydrogel degradation, which reached 100% at 48 h. In vivo, local administration of GM-CDDP (2 mg/kg) significantly suppressed tumor growth and bone osteolysis compared with the control, and local and systemic administration of free CDDP (2 mg/kg; p < 0.05). Local administration of GM-CDDP significantly reduced loss of body weight and elevation of blood urea nitrogen compared with the systemic administration of free CDDP (p < .05). The current study suggests that local administration of GM-CDDP achieves higher antitumor effects with a potential for lesser side effects compared with local or systemic administration of free CDDP.

  Mar. 2021, Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 39(3) (3), 525 - 535, English, International magazine

  Scientific journal


• Prospective cohort study of surgical outcome for spinal metastases in patients aged 70 years or older.

  Yutaro Kanda, Kenichiro Kakutani, Yoshitada Sakai, Takashi Yurube, Shingo Miyazaki, Toru Takada, Yuichi Hoshino, Ryosuke Kuroda

  AIMS: With recent progress in cancer treatment, the number of advanced-age patients with spinal metastases has been increasing. It is important to clarify the influence of advanced age on outcomes following surgery for spinal metastases, especially with a focus on subjective health state values. METHODS: We prospectively analyzed 101 patients with spinal metastases who underwent palliative surgery from 2013 to 2016. These patients were divided into two groups based on age (< 70 years and ≥ 70 years). The Eastern Cooperative Oncology Group (ECOG) performance status (PS), Barthel index (BI), and EuroQol-5 dimension (EQ-5D) score were assessed at study enrolment and at one, three, and six months after surgery. The survival times and complications were also collected. RESULTS: In total, 65 patients were aged < 70 years (mean 59.6 years; 32 to 69) and 36 patients were aged ≥ 70 years (mean 75.9 years; 70 to 90). In both groups, the PS improved from PS3 to PS1 by spine surgery, the mean BI improved from < 60 to > 80 points, and the mean EQ-5D score improved from 0.0 to > 0.7 points. However, no significant differences were found in the improvement rates and values of the PS, BI, and EQ-5D score at any time points between the two groups. The PS, BI, and EQ-5D score improved throughout the follow-up period in approximately 90% of patients in each group. However, the improved PS, BI, and EQ-5D scores subsequently deteriorated in some patients, and the redeterioration rate of the EQ-5D was significantly higher in patients aged ≥ 70 than < 70 years (p = 0.027). CONCLUSION: Palliative surgery for spinal metastases improved the PS, activities of daily living, and quality of life, regardless of age. However, clinicians should be aware of the higher risk of redeterioration of the quality of life in advanced-age patients. Cite this article: Bone Joint J 2020;102-B(12):1709-1716.

  Dec. 2020, The bone & joint journal, 102-B(12) (12), 1709 - 1716, English, International magazine

  Scientific journal


• Reduced nucleotomy-induced intervertebral disc disruption through spontaneous spheroid formation by the Low Adhesive Scaffold Collagen (LASCol).

  Yoshiki Takeoka, Takashi Yurube, Koichi Morimoto, Saori Kunii, Yutaro Kanda, Ryu Tsujimoto, Yohei Kawakami, Naomasa Fukase, Toshiyuki Takemori, Kaoru Omae, Yuji Kakiuchi, Shingo Miyazaki, Kenichiro Kakutani, Toru Takada, Kotaro Nishida, Masanori Fukushima, Ryosuke Kuroda

  Back pain is a global health problem with a high morbidity and socioeconomic burden. Intervertebral disc herniation and degeneration are its primary cause, further associated with neurological radiculopathy, myelopathy, and paralysis. The current surgical treatment is principally discectomy, resulting in the loss of spinal movement and shock absorption. Therefore, the development of disc regenerative therapies is essential. Here we show reduced disc damage by a new collagen type I-based scaffold through actinidain hydrolysis-Low Adhesive Scaffold Collagen (LASCol)-with a high 3D spheroid-forming capability, water-solubility, and biodegradability and low antigenicity. In human disc nucleus pulposus and annulus fibrosus cells surgically obtained, time-dependent spheroid formation with increased expression of phenotypic markers and matrix components was observed on LASCol but not atelocollagen (AC). In a rat tail nucleotomy model, LASCol-injected and AC-injected discs presented relatively similar radiographic and MRI damage control; however, LASCol, distinct from AC, decelerated histological disc disruption, showing collagen type I-comprising LASCol degradation, aggrecan-positive and collagen type II-positive endogenous cell migration, and M1-polarized and also M2-polarized macrophage infiltration. Reduced nucleotomy-induced disc disruption through spontaneous spheroid formation by LASCol warrants further investigations of whether it may be an effective treatment without stem cells and/or growth factors for intervertebral disc disease.

  Mar. 2020, Biomaterials, 235, 119781 - 119781, English, International magazine

  Scientific journal


• Improved bone bonding of hydroxyapatite spacers with a high porosity in a quantitative computed tomography-image pixel analysis: A prospective 1-year comparative study of the consecutive cohort undergoing double-door cervical laminoplasty.

  Yoshiki Takeoka, Takashi Yurube, Koichiro Maeno, Yutaro Kanda, Ryu Tsujimoto, Kunihiko Miyazaki, Yuji Kakiuchi, Shingo Miyazaki, Zhongying Zhang, Toru Takada, Kotaro Nishida, Minoru Doita, Ryosuke Kuroda, Kenichiro Kakutani

  Laminoplasty using hydroxyapatite (HA) spacers is widely performed in patients with cervical myelopathy. However, spacer dislocation is a critical complication caused by bone absorption and inadequate bone conductivity, and can result in dural damage and restenosis. We thus designed a prospective cohort study to clarify the feasibility of increased porosity HA spacers for double-door laminoplasty by analyzing computed tomography (CT) images. Forty-seven patients underwent cervical laminoplasty. Two different types of CERATITE HA spacer were used, either high porosity (50%) or low porosity (35%). These HA spacers were placed in an alternating manner into the laminae in each patient. In total, 85 high-porosity (50%) HA spacers and 84 low-porosity (35%) HA spacers were implanted. At postoperative 2 weeks, 3 months, 6 months, and 1 year, CT images were obtained. In both groups, the percentage of bone-bonding boundary area of the HA spacer in contact with laminae and bone volume of the spinous process relative to the 2-week value were calculated by a 3D and 2D CT-image pixel analysis. The bone-bonding ratio was significantly higher in high-porosity (50%) than low-porosity (35%) HA spacers at 3 months and thereafter (1 year, 69.3 ± 27.8% and 49.7 ± 32.9% respectively, P < .01). The bone volume in both groups significantly decreased with time (1 year, 73.2 ± 29.8% and 69.0 ± 30.4% respectively, P < .01), indicating bone absorption. This showed no significant difference between the HA spacers (P = .15) but was higher in high-porosity (50%) than low-porosity (35%) HA spacers throughout the study period. Meanwhile, spacer breakage was found in 4.7% of high-porosity (50%) HA spacers and 1.2% of low-porosity (35%) HA spacers (P = .37). In summary, high-porosity (50%) HA spacers have the advantages of accelerated bone bonding and relatively decelerated bone absorption compared to low-porosity (35%) HA spacers; however, possibly more frequent breakage of HA spacers with a high porosity (50%) requires careful, extended postoperative follow-up.

  Mar. 2020, JOR spine, 3(1) (1), e1080, English, International magazine

  Scientific journal


• Pharmacological inhibition of mTORC1 but not mTORC2 protects against human disc cellular apoptosis, senescence, and extracellular matrix catabolism through Akt and autophagy induction.

  Y Kakiuchi, T Yurube, K Kakutani, T Takada, M Ito, Y Takeoka, Y Kanda, S Miyazaki, R Kuroda, K Nishida

  OBJECTIVE: The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that integrates nutrients to execute cell growth. We hypothesized that mTOR is influential in the intervertebral disc-largest avascular, low-nutrient organ. Our objective was to identify the optimal mTOR inhibitor for treating human degenerative disc disease. DESIGN: mTOR complex 1 (mTORC1) regulates p70/ribosomal S6 kinase (p70/S6K), negatively regulates autophagy, and is controlled by Akt. Akt is controlled by phosphatidylinositol 3-kinase (PI3K) and mTOR complex 2 (mTORC2). mTORC1 inhibitors-rapamycin, temsirolimus, everolimus, and curcumin, mTORC1&mTORC2 inhibitor-INK-128, PI3K&mTOR inhibitor-NVP-BEZ235, and Akt inhibitor-MK-2206-were applied to human disc nucleus pulposus (NP) cells. mTOR signaling, autophagy, apoptosis, senescence, and matrix metabolism were evaluated. RESULTS: mTORC1 inhibitors decreased p70/S6K but increased Akt phosphorylation, promoted autophagy with light chain 3 (LC3)-II increases and p62/sequestosome 1 (p62/SQSTM1) decreases, and suppressed pro-inflammatory interleukin-1 beta (IL-1β)-induced apoptotic terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) positivity (versus rapamycin, 95% confidence interval (CI) -0.431 to -0.194; temsirolimus, 95% CI -0.529 to -0.292; everolimus, 95% CI -0.477 to -0.241; curcumin, 95% CI -0.248 to -0.011) and poly (ADP-ribose) polymerase (PARP) and caspase-9 cleavage, senescent senescence-associated beta-galactosidase (SA-β-gal) positivity (versus rapamycin, 95% CI -0.437 to -0.230; temsirolimus, 95% CI -0.534 to -0.327; everolimus, 95% CI -0.485 to -0.278; curcumin, 95% CI -0.210 to -0.003) and p16/INK4A expression, and catabolic matrix metalloproteinase (MMP) release and activation. Meanwhile, dual mTOR inhibitors decreased p70/S6K and Akt phosphorylation without enhanced autophagy and suppressed apoptosis, senescence, and matrix catabolism. MK-2206 counteracted protective effects of temsirolimus. Additional disc-tissue analysis found relevance of mTOR signaling to degeneration grades. CONCLUSION: mTORC1 inhibitors-notably temsirolimus with an improved water solubility-but not dual mTOR inhibitors protect against inflammation-induced apoptosis, senescence, and matrix catabolism in human disc cells, which depends on Akt and autophagy induction.

  Jun. 2019, Osteoarthritis and cartilage, 27(6) (6), 965 - 976, English, International magazine

  Scientific journal


• Intraoperative soft tissue balance using novel medial preserving gap technique in posterior-stabilized total knee arthroplasty: comparison to measured resection technique.

  Kanto Nagai, Hirotsugu Muratsu, Yutaro Kanda, Masanori Tsubosaka, Tomoyuki Kamenaga, Hidetoshi Miya, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda, Tomoyuki Matsumoto

  PURPOSE: To investigate intraoperative soft tissue balance with femoral component trial in place using a novel medial preserving gap technique, focusing on medial compartment stability and allowing lateral physiological laxity, with compared with using a measured resection technique in posterior-stabilized (PS) total knee arthroplasty (TKA). METHODS: Primary PS TKA, using either medial preserving gap technique (n = 127) or measured resection technique (n = 148), was performed in 275 subjects with varus knee osteoarthritis. Intraoperative soft tissue balance with femoral component in place was assessed using Offset Repo-Tensor with 40 lbs. of joint distraction force throughout the range of motion, and medial and lateral compartment gaps (mm) were calculated. Medial and lateral joint gap changes (mm) were calculated by subtracting the medial/lateral compartment gap at 0° from the medial/lateral compartment gap at each knee flexion angle, respectively. RESULTS: Medial and lateral joint gap changes in medial preserving gap technique were significantly smaller than measured resection technique respectively (mean difference between two procedures: medial; 0.9 ± 0.2 mm, lateral; 1.0 ± 0.3 mm). Medial and lateral joint gaps were significantly changed during knee flexion in measured resection technique, whereas medial and lateral joint gaps were not significantly changed during mid-to-deep knee flexion (30°-90° in medial, 30°-120° in lateral) in medial preserving gap technique. CONCLUSIONS: Medial preserving gap technique provided more consistent intraoperative soft tissue balance during knee flexion than the measured resection technique, suggesting that this novel technique can be utilized to obtain a more stable joint gap in PS TKA. LEVEL OF EVIDENCE: III.

  Nov. 2018, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 26(11) (11), 3474 - 3481, English, International magazine

  Scientific journal


• The Influence of Postoperative Knee Stability on Patient Satisfaction in Cruciate-Retaining Total Knee Arthroplasty.

  Tomoyuki Kamenaga, Hirotsugu Muratsu, Yutaro Kanda, Hidetoshi Miya, Ryosuke Kuroda, Tomoyuki Matsumoto

  BACKGROUND: Although knee stability is well known as an important element for the success of total knee arthroplasty (TKA), the direct relationship between clinical outcomes and knee stability is still unknown. The purpose of this study was to determine if postoperative knee stability and soft-tissue balance affect the functional outcomes and patient satisfaction after cruciate-retaining (CR) TKA. METHODS: Fifty-five patients with varus osteoarthritis of the knee who underwent CR TKA were included in this study, and their postoperative knee stability was assessed by stress radiography at extension and flexion 1 month postoperatively. Timed Up and Go test, patient-derived clinical scores using the 2011 Knee Society Score, and Forgotten Joint Score-12 were also assessed at 1 year postoperatively. The effects of stability parameters on clinical outcomes were analyzed using Spearman's rank correlation. RESULTS: Medial stability at both knee extension and flexion had significant correlations with the shorter Timed Up and Go test and the higher patient satisfaction. Moreover, lateral laxity at extension was significantly correlated with the better patient satisfaction and Forgotten Joint Score-12. However, these correlation coefficients in this study were low in the range of 0.32-0.51. CONCLUSION: Medial stability and lateral laxity play an important role in influencing 1-year postoperative clinical outcomes after CR TKA. However, we should keep in mind that these correlations are weak with coefficients at 0.50 or less and the clinical results are also affected by various other factors.

  Aug. 2018, The Journal of arthroplasty, 33(8) (8), 2475 - 2479, English, International magazine

  Scientific journal

• 特集 骨転移による病的骨折への挑戦 脊椎病的骨折に対する手術適応とその実績

  角谷 賢一朗, 由留部 崇, 辻本 武尊, 武岡 由樹, 神田 裕太郎, 黒田 良祐

  メジカルビュー社, 19 Apr. 2025, 関節外科 基礎と臨床, 44(4) (4), 393 - 398


• 特集 どんと来い,肺がん診療-それぞれの立場で患者を支えるために [Chapter 2] 肺がん治療に伴う全身症状:どんと来い,他科症状･他科疾患 [整形外科領域]局所痛,しびれ

  神田 裕太郎, 角谷 賢一朗

  南江堂, 01 Feb. 2025, 内科, 135(2) (2), 248 - 253, Japanese


• 診断に難渋した胸椎くも膜嚢腫を合併した脊髄炎の1例

  野間啓佑, 神田裕太郎, 武岡由樹, 辻本武尊, 由留部崇, 黒田良祐, 角谷賢一朗

  2025, 中部日本整形外科災害外科学会雑誌, 68(3) (3)


• Two-year effects of locomotion training-based outpatient rehabilitation on the global sagittal alignment in locomotive syndrome

  由留部崇, 竹岡亨, 平中良明, 武岡由樹, 神田裕太郎, 辻本武尊, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 宮崎邦彦, 角谷賢一朗, 黒田良祐, 稲岡秀陽, 渡邉信佳

  2025, Journal of Spine Research (Web), 16(3) (3)


• Prospective study of postoperative complications following spinal metastasis surgery in the cancer board registry

  松尾智哉, 神田裕太郎, 酒井良忠, 由留部崇, 辻本武尊, 武岡由樹, 劉正夫, 熊谷直利, 黒島康平, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• Transient Receptor Potential Vanilloid 4 activation promotes autophagy and extracellular matrix synthesis in rat intervertebral disc

  黒島康平, 武岡由樹, 由留部崇, 辻本武尊, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 平中良明, 古屋誠彦, 中川大輔, 井上悠, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• RNA interference of RAPTOR/mTORC1 protects against disc degeneration and improves the microenvironment of degenerated discs in a rat tail

  熊谷直利, 由留部崇, 劉正夫, 辻本武尊, 武岡由樹, 神田裕太郎, 松尾智哉, 黒島康平, 平中良明, 井上悠, 中川大輔, 古屋誠彦, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• Does the surgeon’s experience affect the postoperative outcome of spinal metastasis surgery?

  辻本武尊, 由留部崇, 武岡由樹, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 井上悠, 古屋誠彦, 中川大輔, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• A review of clinical features and countermeasures for infection after spine surgery in a satellite hospital: A 10-year retrospective study

  熊谷直利, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 劉正夫, 松尾智哉, 黒島康平, 平中良明, 井上悠, 中川大輔, 古屋誠彦, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• Locomotion training improves sagittal spinal alignment through reduced fat infiltration and increased volume of paraspinal muscles

  平中良明, 由留部崇, 竹岡亨, 稲岡秀陽, 武岡由樹, 辻本武尊, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 角谷賢一朗, 黒田良祐, 渡邉信佳

  2025, Journal of Spine Research (Web), 16(3) (3)


• A review of risk factors for surgical site infection following spine surgery in a single satellite hospital: A 10-year retrospective study

  熊谷直利, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 劉正夫, 松尾智哉, 黒島康平, 平中良明, 井上悠, 中川大輔, 古屋誠彦, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• The accuracy of freehand insertion of C1 lateral mass screw and C2 pedicle screw for pediatric atlantoaxial instability

  武岡由樹, 宇野耕吉, 平中良明, 黒島康平, 熊谷直利, 松尾智哉, 劉正夫, 神田裕太郎, 辻本武尊, 伊藤雅明, 由留部崇, 鈴木哲平, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• Safety of pedicle screw insertion into metastatic vertebral bodies during posterior fusion surgery for metastatic spinal tumors

  平中良明, 由留部崇, 武岡由樹, 辻本武尊, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 中川大輔, 古屋誠彦, 井上悠, 黒田良祐, 角谷賢一朗

  2025, Journal of Spine Research (Web), 16(3) (3)


• Predictors of change in the size of retro-odontoid pseudotumor after C1 laminectomy

  黒島康平, 角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 平中良明, 川口航希, 竹上徳彦, 明田浩司, 川端走野, 藤田順之

  2025, Journal of Spine Research (Web), 16(3) (3)


• 遺伝子治療による椎間板の恒常性維持を目指した変性予防へのアプローチ

  由留部崇, 平中良明, 熊谷直利, 劉正夫, 井上悠, 武岡由樹, 神田裕太郎, 辻本武尊, 宮崎邦彦, 黒田良祐, 角谷賢一朗

  2025, 日本整形外科学会雑誌(CD-ROM), 99(3) (3)


• 高齢者がん脊椎転移手術において予後予測に対するフレイルの影響

  神田裕太郎, 角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐

  2025, 日本整形外科学会雑誌(CD-ROM), 99(3) (3)


• ロコモ患者へのロコトレ外来通院リハビリテーション介入による全脊柱矢状面アライメント改善効果-2年間の前向き追跡調査-

  由留部崇, 竹岡亨, 平中良明, 武岡由樹, 神田裕太郎, 辻本武尊, 宮崎邦彦, 角谷賢一朗, 黒田良祐, 稲岡秀陽, 渡邉信佳

  2025, 日本整形外科学会雑誌(CD-ROM), 99(3) (3)


• 特集 転移性脊椎腫瘍治療大全 第3章 治療の適応と手技 脊椎転移に対する最小侵襲脊椎安定術

  角谷 賢一朗, 由留部 崇, 辻本 武尊, 武岡 由樹, 神田 裕太郎, 黒田 良祐

  三輪書店, 25 Dec. 2024, 脊椎脊髄ジャーナル, 37(10) (10), 791 - 796


• 特集 見逃さない 間違えない骨･軟部腫瘍と骨転移 転移性脊椎腫瘍は,いつ,どう治療するか?

  角谷 賢一朗, 由留部 崇, 辻本 武尊, 武岡 由樹, 神田 裕太郎, 黒田 良祐

  メジカルビュー社, 19 Dec. 2024, 関節外科 基礎と臨床, 43(12) (12), 1261 - 1267


• Risk factors for postoperative complications following spinal metastasis surgery

  Matsuo Tomoya, Kanda Yutaro, Sakai Yoshitada, Yurube Takashi, Kuroda Ryosuke, Kakutani Kenichiro

  Introduction: Evaluating the risk of postoperative complications is essential for making decisions in patients with spinal metastases. Recent studies have shown that frailty is a predictor of surgical outcomes in cancer surgery and spinal surgery. However, the association of frailty with postoperative complications in spinal metastasis surgery remains controversial. Therefore, the aim of this study was to elucidate the risk factors for postoperative complications in spinal metastasis surgery with a focus on frailty. Methods: A total of 241 patients with spinal metastases who underwent palliative surgery from 2015 to 2021 at our institution were enrolled. The Clavien-Dindo classification was used to assess postoperative complications with scores ≥ Grade II defined as complications. Data regarding demographics (age, sex, body mass index, and primary cancer) and preoperative clinical factors (new Katagiri score, Frankel grade, performance status, radiotherapy, chemotherapy, spinal instability neoplastic score, modified Frailty Index-11 (mFI), diabetes mellitus, and serum albumin levels) were collected. Univariable and multivariable analyses were performed to identify independent risk factors for postoperative complications (p < 0.05). Results: In 47 of 241 (19.5%) patients, 57 postoperative complications were observed. The most common complications were wound infection/dehiscence, urinary tract infection, and pneumonia. On univariable analysis, male sex (p = 0.098), preoperative radiotherapy (p = 0.028), mFI (p < 0.001), Frankel classification (p = 0.051) and preoperative molecular targeted drugs (p = 0.030) were considered potential risk factors. The cut-off value of mFI was calculated to be 0.23 (sensitivity, 46.8%; specificity, 79.9%). On multivariate analysis, mFI ≥ 0.23 (odds ratio (OR), 2.82; 95% confidence interval (CI), 1.39-5.70; p = 0.003) and preoperative radiotherapy (OR, 2.11; 95% CI, 1.00-4.44; p = 0.049) were identified as significant risk factors. In particular, urinary tract infection (p = 0.012) and pneumonia (p = 0.037) were associated with mFI ≥ 0.23. Furthermore, the severity of postoperative complications was positively correlated with mFI (p < 0.001). Conclusions: An mFI ≥ 0.23 and history of preoperative radiotherapy were associated with postoperative complications of spinal metastasis surgery.

  The Japanese Society for Spine Surgery and Related Research, 20 Jun. 2024, Journal of Spine Research, 15(6) (6), 893 - 900, Japanese


• ロコモ患者へのロコトレ通院リハビリテーションによる傍脊柱筋の脂肪変性・筋量改善効果-2年間の前向き追跡調査-

  平中良明, 由留部崇, 竹岡亨, 稲岡秀陽, 辻本武尊, 武岡由樹, 神田裕太郎, 大西洋輝, 角谷賢一朗, 黒田良祐, 渡邉信佳

  2024, 日本整形外科学会雑誌, 98(2) (2)


• 放射線治療施行後に脊椎転移手術が必要となった症例の検討-術後創離開リスク低減のために-

  張鍾穎, 張鍾穎, 由留部崇, 武岡由樹, 神田裕太郎, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌, 98(2) (2)


• 80歳以上脊椎転移患者に対する手術成績-216例の前向き検討-

  神田裕太郎, 角谷賢一朗, 由留部崇, 武岡由樹, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐

  2024, 日本整形外科学会雑誌, 98(3) (3)


• 腎癌脊椎転移に対する手術成績

  武岡由樹, 由留部崇, 辻本武尊, 神田裕太郎, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌, 98(3) (3)


• 脊椎転移手術とフレイルの関連-mFI-5を用いた検討-

  辻本武尊, 由留部崇, 武岡由樹, 神田裕太郎, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌, 98(3) (3)


• 脊椎転移手術における原発巣悪性度別手術成績比較

  大西洋輝, 神田裕太郎, 由留部崇, 武岡由樹, 辻本武尊, 酒井良忠, 秋末敏宏, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌, 98(3) (3)


• 脊椎転移に対する手術療法の予後延長効果

  角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 大西洋輝, 松尾智哉, 劉正夫, 黒島康平, 熊谷直利, 黒田良祐

  2024, 日本整形外科学会雑誌, 98(3) (3)


• Risk factors for postoperative complications following spinal metastasis surgery

  松尾智哉, 神田裕太郎, 酒井良忠, 由留部崇, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(6) (6)


• 転移性脊椎腫瘍に対する緊急手術成績と緊急手術に至るリスク因子の前向き検討

  神田裕太郎, 角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 黒田良祐

  2024, 日本整形外科学会雑誌, 98(3) (3)


• ロコモ患者へのロコトレ通院リハビリテーション介入による脊椎骨盤矢状面アライメント改善効果-2年間の前向き追跡調査-

  由留部崇, 竹岡亨, 平中良明, 稲岡秀陽, 大西洋輝, 辻本武尊, 神田裕太郎, 武岡由樹, 角谷賢一朗, 黒田良祐, 渡邉信佳

  2024, 日本整形外科学会雑誌, 98(3) (3)


• Surgical outcome of spine surgery for symptomatic spinal metastasis

  角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 大西洋輝, 松尾智哉, 劉正夫, 黒島康平, 熊谷直利, 平中良明, 黒田良祐

  2024, Journal of Spine Research (Web), 15(3) (3)


• Selective RNA interference of Raptor/mTORC1 protects against disc degeneration in a rat tail temporary static compression model

  熊谷直利, 由留部崇, 劉正夫, 武岡由樹, 神田裕太郎, 辻本武尊, 大西洋輝, 松尾智哉, 黒島康平, 平中良明, 宮崎邦彦, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• The prediction of early mortality after spinal metastasis surgery with preoperative blood test

  ZHANG Z., ZHANG Z., 由留部崇, 武岡由樹, 神田裕太郎, 辻本武尊, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• Surgical outcomes of, and risk factors for emergency surgery in patients with spinal metastases: A prospective cohort study

  神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 辻本武尊, 武岡由樹, 宮崎邦彦, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐

  2024, Journal of Spine Research (Web), 15(3) (3)


• Predictors for the incidence of cervical spine instabilities in rheumatoid arthritis: an over 10-year prospective multicenter cohort study

  神田裕太郎, 由留部崇, 平田裕亮, 鷲見正敏

  2024, Journal of Spine Research (Web), 15(3) (3)


• Development of gene therapy strategies for preventing degenerative disc disease through homeostasis maintenance

  由留部崇, 劉正夫, 熊谷直利, 平中良明, 武岡由樹, 神田裕太郎, 辻本武尊, 大西洋輝, 松尾智哉, 黒島康平, 宮崎邦彦, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• Comparison of surgical outcomes in metastatic spine tumors according to the grade of the primary site

  大西洋輝, 神田裕太郎, 由留部崇, 武岡由樹, 辻本武尊, 宮崎邦彦, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 酒井良忠, 秋末敏弘, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• Targeting mTOR signaling with RNA interference and CRISPR-Cas9 systems is a new biological intervention to intervertebral disc degeneration

  劉正夫, 由留部崇, 武岡由樹, 神田裕太郎, 辻本武尊, 大西洋輝, 松尾智哉, 熊谷直利, 黒島康平, 平中良明, 宮崎邦彦, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• 脊椎転移に対する手術療法の予後延長効果

  角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 神田裕太郎, 黒田良祐

  2024, 中部日本整形外科災害外科学会雑誌, 67


• Effects of locomotion training-based outpatient rehabilitation on the fat infiltration ratio and cross-sectional area of paraspinal muscles

  平中良明, 由留部崇, 竹岡亨, 稲岡秀陽, 神田裕太郎, 武岡由樹, 辻本武尊, 宮崎邦彦, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 角谷賢一朗, 黒田良祐, 渡邉信佳

  2024, Journal of Spine Research (Web), 15(3) (3)


• Relationships between surgical outcomes and frailty of metastatic spine tumors

  辻本武尊, 松尾智哉, 由留部崇, 武岡由樹, 神田裕太郎, 大西洋輝, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2024, Journal of Spine Research (Web), 15(3) (3)


• Effects of locomotion training-based rehabilitation on the spinopelvic alignment in locomotive syndrome: a 2-year prospective cohort study

  由留部崇, 竹岡亨, 平中良明, 稲岡秀陽, 武岡由樹, 神田裕太郎, 辻本武尊, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 宮崎邦彦, 角谷賢一朗, 黒田良祐, 渡邉信佳

  2024, Journal of Spine Research (Web), 15(3) (3)


• リウマチ患者頚椎不安定性新規発生のリスク因子-10年以上前向き多施設共同研究-

  神田裕太郎, 由留部崇, 平田裕亮, 鷲見正敏

  2024, 中部日本整形外科災害外科学会雑誌, 67


• 化膿性椎間板炎に対するゼラチンハイラジゲルを用いた新たなる治療法の開発

  神田裕太郎, 宮崎邦彦, 由留部崇, 辻本武尊, 武岡由樹, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 田畑泰彦, 黒田良祐, 角谷賢一朗

  2024, DDS再生医療研究会・多血小板血漿(PRP)療法研究会プログラム・抄録集(Web), 14th-16th


• 高齢者がん脊椎転移手術におけるフレイルの予後予測に対する影響

  神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 武岡由樹, 黒田良祐

  2024, Japanese Journal of Rehabilitation Medicine (Web), 61(Autumn) (Autumn)


• 高齢者脊椎転移手術においてフレイルは生命予後予測因子である

  神田裕太郎, 角谷賢一朗, 由留部崇, 辻本武尊, 武岡由樹, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐

  2024, 日本整形外科学会雑誌(CD-ROM), 98(6) (6)


• Transient receptor potential vanilloid4(TRPV4)活性化はラット椎間板のオートファジーと細胞外基質合成を促進する

  黒島康平, 武岡由樹, 由留部崇, 辻本武尊, 神田裕太郎, 松尾智哉, 劉正夫, 熊谷直利, 平中良明, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• Separation surgeryの効果と限界

  角谷賢一朗, 辻本武尊, 由留部崇, 武岡由樹, 神田裕太郎, 黒田良祐

  2024, 中部日本整形外科災害外科学会雑誌, 67


• 椎間板の恒常性維持を目指した遺伝子治療による変性予防へのアプローチ

  由留部崇, 劉正夫, 熊谷直利, 平中良明, 武岡由樹, 神田裕太郎, 辻本武尊, 松尾智哉, 黒島康平, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• RNA干渉法とCRISPR-Cas9を用いたmTORシグナル経路の選択的阻害による椎間板保護作用の比較検討

  劉正夫, 由留部崇, 武岡由樹, 神田裕太郎, 辻本武尊, 松尾智哉, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• ラット椎間板におけるtransient receptor potential vanilloid4(TRPV4)阻害がオートファジーと細胞外基質合成を抑制する

  松尾智哉, 武岡由樹, 由留部崇, 辻本武尊, 神田裕太郎, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 角谷賢一朗, 黒田良祐

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• 脊椎転移手術とフレイルの関連についてmFI-5を用いた検討

  辻本武尊, 由留部崇, 武岡由樹, 神田裕太郎, 角谷賢一朗, 黒田良祐

  2024, 中部日本整形外科災害外科学会雑誌, 67


• ラット椎間板髄核細胞に対するカチオン化ゼラチンナノ粒子を用いたRaptorを標的とした徐放型RNA干渉の有用性

  平中良明, 由留部崇, 鷲坂太一, 熊谷直利, 劉正夫, 宮崎邦彦, 神田裕太郎, 武岡由樹, 黒田良祐, 角谷賢一朗, 田畑泰彦

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• RAPTOR/mTORC1への生体内RNA干渉はラット椎間板において椎間板変性抑止作用を示す

  熊谷直利, 由留部崇, 劉正夫, 辻本武尊, 武岡由樹, 神田裕太郎, 松尾智哉, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2024, 日本整形外科学会雑誌(CD-ROM), 98(8) (8)


• 特集 椎間板の基礎と臨床 椎間板変性とオートファジー

  由留部 崇, 武岡 由樹, 神田 裕太郎, 伊藤 雅明, 垣内 裕司, 辻本 龍, 黒田 良祐, 角谷 賢一朗

  三輪書店, 17 Apr. 2023, 脊椎脊髄ジャーナル, 36(1) (1), 13 - 18

  [Refereed]


• 難治性骨軟部疾患に対するゼラチンハイドロゲルを用いた新たなる治療法の開発

  宮崎邦彦, 神田裕太郎, 由留部崇, 武岡由樹, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 田畑泰彦, 黒田良祐, 角谷賢一朗

  2023, 日本再生医療学会総会(Web), 22nd


• 「ロコモ」患者の脊柱・骨盤・下肢アライメントにおける「ロコトレ」リハビリテーション介入効果-2年以上の前向き追跡調査-

  由留部崇, 渡邉信佳, 竹岡亨, 稲岡秀陽, 平中良明, 宮崎邦彦, 神田裕太郎, 武岡由樹, 張鍾穎, 黒田良祐, 角谷賢一朗

  2023, 日本整形外科学会雑誌, 97(3) (3)


• Selective interference of Raptor/mTORC1 is protective against intervertebral disc degeneration through autophagy induction in rat tails

  熊谷直利, 由留部崇, 劉正夫, 張鍾穎, 武岡由樹, 神田裕太郎, 宮崎邦彦, 大西洋輝, 松尾智哉, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2023, Journal of Spine Research (Web), 14(3) (3)


• Risk factors for wound dehiscence after spinal metastasis surgery and a new approach to prevention-Curved Skin Incision-

  宮崎邦彦, 神田裕太郎, 武岡由樹, 張鍾穎, 由留部崇, 大西洋輝, 松尾智哉, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2023, Journal of Spine Research (Web), 14(3) (3)


• Development of treatment for degenerative disc disease by selective interference of the mTOR signaling pathway using the CRISPR-Cas9 system

  劉正夫, 由留部崇, 張鍾穎, 武岡由樹, 神田裕太郎, 宮崎邦彦, 大西洋輝, 松尾智哉, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2023, Journal of Spine Research (Web), 14(3) (3)


• 脊椎転移術後創離開のリスク因子の検討と予防のための新たな試み-Curved skin incision-

  宮崎邦彦, 神田裕太郎, 武岡由樹, 張鍾穎, 由留部崇, 大西洋輝, 松尾智哉, 劉正夫, 秋末敏宏, 黒田良祐, 角谷賢一朗

  2023, 日本整形外科学会雑誌, 97(2) (2)


• Effects of locomotion training on the spine-pelvis-lower extremity alignment in locomotive syndrome: a prospective>2-year cohort study

  由留部崇, 竹岡亨, 渡邉信佳, 稲岡秀陽, 平中良明, 黒島康平, 熊谷直利, 劉正夫, 松尾智哉, 大西洋輝, 宮崎邦彦, 神田裕太郎, 武岡由樹, 張鍾穎, 黒田良祐, 角谷賢一朗

  2023, Journal of Spine Research (Web), 14(3) (3)


• Prospective study for risk factors of postoperative complication of surgery for spinal metastases

  松尾智哉, 神田裕太郎, 酒井良忠, 張鍾穎, 由留部崇, 武岡由樹, 宮崎邦彦, 大西洋輝, 劉正夫, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2023, Journal of Spine Research (Web), 14(3) (3)


• 転移性脊椎腫瘍手術における術後合併症リスク因子の検討

  松尾智哉, 神田裕太郎, 酒井良忠, 張鍾穎, 由留部崇, 武岡由樹, 宮崎邦彦, 大西洋輝, 劉正夫, 黒田良祐, 角谷賢一朗

  2023, 日本整形外科学会雑誌, 97(3) (3)


• 脊椎転移手術における悪性度別手術成績比較

  大西洋輝, 角谷賢一朗, 由留部崇, 武岡由樹, 神田裕太郎, 宮崎邦彦, 平中良明, 酒井良忠, 秋末敏宏, 黒田良祐

  2023, 日本整形外科学会雑誌, 97(6) (6)


• CRISPR-Cas9 versus RNA interference for degenerative disc disease treatment by the selective inhibition of mTOR signaling

  由留部崇, 劉正夫, 辻本龍, 武岡由樹, 神田裕太郎, 宮崎邦彦, 大西洋輝, 松尾智哉, 熊谷直利, 黒島康平, 平中良明, 黒田良祐, 角谷賢一朗

  2023, 日本軟骨代謝学会プログラム・抄録集, 35th


• 症候性脊椎転移に対する後方除圧固定術は術後化学療法の継続/導入を可能にする

  武岡由樹, 神田裕太郎, 由留部崇, 黒田良祐, 角谷賢一朗

  2023, Japanese Journal of Rehabilitation Medicine, 60(Supplement) (Supplement)


• 脊椎転移手術における術後合併症発生リスクの前向き検討

  松尾智哉, 神田裕太郎, 酒井良忠, 由留部崇, 黒田良祐, 角谷賢一朗

  2023, 中部日本整形外科災害外科学会雑誌, 66


• 椎間板再生の基礎と臨床(未来)

  由留部崇, 武岡由樹, 神田裕太郎, 垣内裕司, 辻本龍, 伊藤雅明, 平田裕亮, 張鐘穎, 黒田良祐, 角谷賢一朗

  2022, 日本整形外科学会雑誌, 96(2) (2)


• The retrospective study about the outcome of spinal metastasis surgery for patients aged 80 years or older

  張鍾穎, 神田裕太郎, 由留部崇, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 大西洋輝, 松尾智哉, 劉正夫, 黒田良祐, 角谷賢一朗

  2022, Journal of Spine Research (Web), 13(3) (3)


• Prospective study for risk factors of postoperative complication for spinal metastases

  松尾智哉, 神田裕太郎, 酒井良忠, 張鍾穎, 由留部崇, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 大西洋輝, 劉正夫, 黒田良祐, 角谷賢一朗

  2022, Journal of Spine Research (Web), 13(3) (3)


• Improved sagittal spinal alignment and stabilometric body balance by “locomotion training” exercises in patients with “locomotive syndrome”

  由留部崇, 竹岡亨, 渡邉信佳, 稲岡秀陽, 辻本龍, 宮崎邦彦, 大西洋輝, 松尾智哉, 劉正夫, 神田裕太郎, 武岡由樹, 垣内裕司, 張鍾穎, 黒田良祐, 角谷賢一朗

  2022, Journal of Spine Research (Web), 13(3) (3)


• Efficacy of growth differentiation factor-6 for intervertebral disc using a rat tail puncture model

  宮崎邦彦, 宮崎真吾, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 大西洋輝, 松尾智哉, 劉正夫, 黒田良祐, 角谷賢一朗

  2022, Journal of Spine Research (Web), 13(3) (3)


• 椎間板恒常性維持を目指した変性予防・組織修復の試み

  由留部崇, 武岡由樹, 神田裕太郎, 辻本龍, 垣内裕司, 伊藤雅明, 平田裕亮, 張鍾穎, 黒田良祐, 角谷賢一朗

  2022, 日本整形外科学会雑誌, 96(8) (8)


• Involvement of Atg5-dependent autophagy in the maintenance of rat intervertebral disc homeostasis: in-vitro and in-vivo study

  TAKEOKA Yoshiki

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 01 Sep. 2021, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 64(5) (5), 615 - 616, Japanese

  [Refereed]


• 脊椎転移に対する集学的治療の効果と限界

  角谷賢一朗, 酒井良忠, 張鍾穎, 由留部崇, 垣内裕司, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 宮崎真吾, 高田徹, 黒田良祐

  2021, 日本整形外科学会雑誌, 95(2) (2)


• 費用対効用から見た脊椎転移に対する手術加療の効果と課題

  角谷賢一朗, 宮崎真吾, 酒井良忠, 張鍾穎, 由留部崇, 垣内裕司, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 黒田良祐

  2021, 日本整形外科学会雑誌, 95(2) (2)


• 広範囲矯正固定手術における固定近位端のポリエチレンテープの使用はproximal junctional kyphosisに伴う再手術率を低下させる

  垣内裕司, 角谷賢一朗, 張鍾穎, 由留部崇, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 黒田良祐

  2021, 日本整形外科学会雑誌, 95(3) (3)


• 「ロコモ」患者へ「ロコトレ」体操が及ぼす脊柱アライメントと立位バランスの改善効果

  由留部崇, 渡邉信佳, 竹岡亨, 稲岡秀陽, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 垣内裕司, 張鍾穎, 黒田良祐, 角谷賢一朗

  2021, 日本整形外科学会雑誌, 95(3) (3)


• 術前血液検査結果から見た脊椎転移手術後全身状態早期悪化の危険因子の検討

  ZHANG Zhongying, 角谷賢一朗, 由留部崇, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 黒田良祐

  2021, 日本整形外科学会雑誌, 95(3) (3)


• Trends and measures against postoperative wound dehiscence after surgery for spinal metastasis

  角谷賢一朗, 張鍾穎, 由留部崇, 山本潤哉, 垣内裕司, 酒井良忠, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 黒田良祐

  2021, Journal of Spine Research (Web), 12(3) (3)


• The use of polyethylene tapes reduces the revision rate associated with Proximal Junctional Kyphosis in long spinal fusions

  垣内裕司, 角谷賢一朗, 張鍾穎, 由留部崇, 山本潤哉, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 黒田良祐

  2021, Journal of Spine Research (Web), 12(3) (3)


• Improvement of the sagittal alignment of the spine and standing body balance through “locomotion training” exercise in patients with “locomotive syndrome”

  由留部崇, 竹岡亨, 渡邉信佳, 稲岡秀陽, 神田裕太郎, 辻本龍, 宮崎邦彦, 大西洋輝, 武岡由樹, 垣内裕司, 山本潤哉, 張鍾穎, 高田徹, 黒田良祐, 角谷賢一朗

  2021, Journal of Spine Research (Web), 12(3) (3)


• Levels of autophagy in lumbar degenerative and herniated discs depend on the patients’ age and degeneration grade rather than on the type of disease

  由留部崇, 垣内裕司, 伊藤雅明, 辻本龍, 神田裕太郎, 宮崎邦彦, 大西洋輝, 武岡由樹, 宮崎真吾, 山本潤哉, 張鍾穎, 高田徹, 田所浩, 黒田良祐, 角谷賢一朗

  2021, Journal of Spine Research (Web), 12(3) (3)


• The efficacy of growth differentiation factor-6 on the three-dimensionally cultured human intervertebral disc cells and rat tail puncture model

  宮崎邦彦, 宮崎真吾, 宮崎真吾, 由留部崇, 武岡由樹, 神田裕太郎, 辻本龍, 大西洋輝, 垣内裕司, 山本潤哉, 張鍾穎, 高田徹, 黒田良祐, 角谷賢一朗

  2021, Journal of Spine Research (Web), 12(3) (3)


• Involvement of Atg5-dependent autophagy in maintaining rat intervertebral disc homeostasis

  辻本龍, 由留部崇, 武岡由樹, 神田裕太郎, 宮崎邦彦, 大西洋輝, 垣内裕司, 張鍾穎, 高田徹, 黒田良祐, 角谷賢一朗

  2021, Journal of Spine Research (Web), 12(3) (3)


• Effect of Adiponectin receptor agonist AdipoRon on human intervertebral disc cell in a three-dimensional cell cultur

  大西洋輝, 張鍾穎, 宮崎邦彦, 辻本龍, 神田裕太郎, 垣内裕司, 山本潤哉, 由留部崇, 高田徹, 黒田良祐, 角谷賢一朗

  2021, Journal of Spine Research (Web), 12(3) (3)


• GCIB照射がPEEK製椎弓根スクリューの引き抜き強度に与える影響

  角谷賢一朗, 豊田紀章, 長宗高樹, 張鐘穎, 由留部崇, 垣内裕司, 神田裕太郎, 黒田良祐

  2021, 日本脊椎インストゥルメンテーション学会抄録集, 30th


• 三次元細胞培養を用いたアディポネクチン受容体アゴニストAdipoRon投与に対するヒト椎間板細胞へ与える影響の検討

  大西洋輝, 張鍾穎, 由留部崇, 垣内裕司, 神田裕太郎, 辻本龍, 宮崎邦彦, 高田徹, 土井田稔, 黒田良祐, 角谷賢一朗

  2021, 日本整形外科学会雑誌, 95(8) (8)


• 当院における脊椎転移術後創離開のリスク因子の検討と予防のための新たな試み-Curved Skin Incision-

  宮崎邦彦, 神田裕太郎, 張鍾穎, 由留部崇, 黒田良祐, 角谷賢一朗

  2021, 中部日本整形外科災害外科学会雑誌, 64


• 転移性脊椎腫瘍に対する手術の効果と限界

  角谷賢一朗, 張鍾穎, 由留部崇, 垣内裕司, 神田裕太郎, 黒田良祐

  2021, 中部日本整形外科災害外科学会雑誌, 64


• 頸椎転移患者の手術成績と成績不良因子の検討 PS、QOLの推移から

  神田 裕太郎, 角谷 賢一朗, 酒井 良忠, 由留部 崇, 垣内 裕司, 武岡 由樹, 辻本 龍, 河本 旭哉, 原 仁美, 秋末 敏宏, 黒田 良祐

  (公社)日本リハビリテーション医学会, Jul. 2020, The Japanese Journal of Rehabilitation Medicine, 57(特別号) (特別号), 3 - 2, Japanese


• 筋ジストロフィーに伴う脊柱変形の手術経験

  角谷賢一朗, 張鍾穎, 由留部崇, 垣内裕司, 宮崎真吾, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎邦彦, 鈴木哲平, 宇野耕吉, 黒田良祐

  2020, 日本整形外科学会雑誌, 94(2) (2)


• Long fusionにおける固定近位端の固定法の違いによるproximal junctional kyphosis(PJK)に伴う再手術率の比較検討

  垣内裕司, 角谷賢一朗, 張鍾穎, 由留部崇, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎邦彦, 高田徹, 黒田良祐

  2020, 日本整形外科学会雑誌, 94(2) (2)


• ゼラチンハイドロゲルを用いた徐放化シスプラチン局所投与による新たなる骨転移治療

  神田裕太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 宮崎真吾, 高田徹, 田畑泰彦, 黒田良祐

  2020, 日本整形外科学会雑誌, 94(6) (6)


• ラット椎間板の恒常性維持におけるAtg5依存性オートファジーの関与

  辻本龍, 由留部崇, 神田裕太郎, 宮崎邦彦, 武岡由樹, 垣内裕司, 張鍾穎, 高田徹, 土井田稔, 黒田良祐, 角谷賢一朗

  2020, 日本整形外科学会雑誌, 94(8) (8)


• GCIB照射がPEEK製椎弓根スクリューの引き抜き強度に与える影響

  角谷賢一朗, 豊田紀章, 長宗高樹, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 土井田稔, 黒田良祐

  2020, 日本整形外科学会雑誌, 94(8) (8)


• 三次元培地を用いた成長因子growth differentiation factor-6投与がヒト椎間板細胞に与える影響の検討-

  宮崎邦彦, 宮崎真吾, 宮崎真吾, 由留部崇, 張鍾穎, 垣内裕司, 神田裕太郎, 辻本龍, 高田徹, 土井田稔, 黒田良祐, 角谷賢一朗

  2020, 日本整形外科学会雑誌, 94(8) (8)


• がん骨転移局所制御に対する徐放化抗がん剤の有効性と安全性についての検討

  神田裕太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 山本潤哉, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 大西洋輝, 高田徹, 田畑泰彦, 黒田良祐

  2020, 多血小板血漿(PRP)療法研究会プログラム・抄録集, 12th


• The retrospective study about early deterioration of general condition after spinal metastasis surgery: A study focusing on the results of their preoperative blood test

  ZHANG Z., 武岡由樹, 由留部崇, 垣内裕司, 神田裕太郎, 辻本龍, 宮崎邦彦, 高田徹, 黒田良祐, 角谷賢一朗

  2020, Journal of Spine Research (Web), 11(3) (3)


• The efficacy of Growth differentiation factor-6 on human intervertebral disc nucleus pulposus cells cultured in threedimensional culture system

  宮崎邦彦, 宮崎真吾, 宮崎真吾, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 高田徹, 田所浩, 田所浩, 黒田良祐, 角谷賢一朗

  2020, Journal of Spine Research (Web), 11(3) (3)


• A novel new therapy for spinal metastases by sustained release system of cisplatin

  神田裕太郎, 角谷賢一朗, 張鍾穎, 由留部崇, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 高田徹, 田畑泰彦, 黒田良祐

  2020, Journal of Spine Research (Web), 11(3) (3)


• Surgical outcome for cervical spinal metastases and analysis of risk factor of poor outcome

  神田裕太郎, 角谷賢一朗, 酒井良忠, 張鍾穎, 由留部崇, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 宮崎真吾, 高田徹, 黒田良祐

  2020, Journal of Spine Research (Web), 11(3) (3)


• Use of polyethylene tapes at the proximal end of fusion constructs reduces the revision surgery rates associated with Proximal Junctional Kyphosis (PJK) in long spinal fusions.

  垣内裕司, 角谷賢一朗, 張鍾穎, 由留部崇, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎邦彦, 高田徹, 黒田良祐

  2020, Journal of Spine Research (Web), 11(3) (3)


• Lumbosacral Stabilization of Sacral Fractures Using Sacral-Aral-Iliac Screw: Technique a Medium to Long Term Results

  高田徹, 角谷賢一朗, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎邦彦, 宮崎真吾, 黒田良祐

  2020, Journal of Spine Research (Web), 11(3) (3)


• Involvement of Atg5-dependent autophagy in homeostasis maintenance of rat intervertebral discs

  辻本龍, 由留部崇, 垣内裕司, 高田徹, 武岡由樹, 神田裕太郎, 宮崎邦彦, 張鍾穎, 宮崎真吾, 黒田良祐, 角谷賢一朗

  2020, Journal of Spine Research (Web), 11(3) (3)


• 脊椎腫瘍に対するseparation surgeryとIMRTの併用による治療成績-7例のケースシリーズ-

  神田裕太郎, 角谷賢一郎, 酒井良忠, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 宮崎真吾, 高田徹, 黒田良祐

  2020, 日本整形外科学会雑誌, 94(6) (6)


• 頸椎転移に対する後方手術成績と術後成績不良因子の検討

  神田裕太郎, 角谷賢一朗, 酒井良忠, 張鍾穎, 由留部崇, 黒田良祐

  2020, 中部日本整形外科災害外科学会雑誌, 63


• 「ロコトレ」体操が及ぼす「ロコモ」患者の脊柱アライメントと体幹バランス改善効果

  由留部崇, 渡邉信佳, 竹岡亨, 稲岡秀陽, 神田裕太郎, 辻本龍, 宮崎邦彦, 垣内裕司, 張鍾穎, 高田徹, 黒田良祐, 角谷賢一朗

  2020, 日本整形外科学会雑誌, 94(3) (3)


• 転移性脊椎腫瘍に対する手術加療の費用対効用を低下させる因子の検討

  宮崎 真吾, 角谷 賢一朗, 酒井 良忠, 高田 徹, 由留部 崇, 張 鍾穎, 垣内 裕司, 神田 裕太郎, 辻本 龍, 原 仁美, 河本 旭哉, 秋末 敏宏, 黒田 良祐, 西田 康太郎

  (一社)日本脊椎脊髄病学会, Mar. 2019, Journal of Spine Research, 10(3) (3), 269 - 269, Japanese


• 転移性脊椎腫瘍に対する手術加療の費用対効用を低下させる因子の検討

  宮崎 真吾, 角谷 賢一朗, 酒井 良忠, 高田 徹, 由留部 崇, 張 鍾穎, 垣内 裕司, 神田 裕太郎, 辻本 龍, 原 仁美, 河本 旭哉, 秋末 敏宏, 黒田 良祐, 西田 康太郎

  (一社)日本脊椎脊髄病学会, Mar. 2019, Journal of Spine Research, 10(3) (3), 269 - 269, Japanese


• 症候性側弯症手術における電磁気センサー付き椎弓根プローブの有用性

  由留部崇, 角谷賢一朗, 宇野耕吉, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎真吾, 張鍾穎, 高田徹, 黒田良祐, 西田康太郎

  2019, Journal of Spine Research, 10(3) (3)


• 「ロコトレ」リハビリプログラムによる「ロコモ」患者の脊柱アライメントと体幹バランス改善効果

  由留部崇, 竹岡亨, 渡邉信佳, 稲岡秀陽, 角谷賢一朗, 高田徹, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎真吾, 張鍾穎, 黒田良祐, 西田康太郎

  2019, Journal of Spine Research, 10(3) (3)


• 70歳以上の転移性脊椎腫瘍患者における手術成績

  神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 張鍾穎, 宮崎真吾, 垣内裕司, 辻本龍, 高田徹, 西田康太郎, 黒田良祐

  2019, Journal of Spine Research, 10(3) (3)


• 脊椎椎間板におけるオートファジー活性は疾患よりも年齢と変性度に依存する(腰椎椎間板ヘルニア検体と固定術検体との比較)

  由留部崇, 垣内裕司, 伊藤雅明, 角谷賢一朗, 高田徹, 田所浩, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎真吾, 張鍾穎, 黒田良祐, 西田康太郎

  2019, Journal of Spine Research, 10(3) (3)


• 成人脊柱変形手術において多椎間TLIFとPonte osteotomyのみで十分な腰椎前弯を獲得できるか?

  西田康太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 宮崎真吾, 高田徹, 垣内裕司, 神田裕太郎, 辻本龍, 黒田良祐

  2019, Journal of Spine Research, 10(3) (3)


• 脊椎インスツルメント術後創部感染に対する局所閉鎖陰圧療法の有用性と失敗因子の検討

  高田徹, 高田徹, 角谷賢一朗, 由留部崇, 張鍾穎, 宮崎真吾, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 黒田良祐, 西田康太郎

  2019, Journal of Spine Research, 10(3) (3)


• 「ロコトレ」理学療法プログラムによる「ロコモ」患者の脊柱アライメントと体幹バランス改善効果

  由留部崇, 渡邉信佳, 角谷賢一朗, 垣内裕司, 武岡由樹, 神田裕太郎, 辻本龍, 黒田良祐

  2019, Japanese Journal of Rehabilitation Medicine, 56(Supplement) (Supplement)


• 動的圧迫負荷による脊索由来細胞の変化とintegrinα5β1の果たす役割

  神田裕太郎, 角谷賢一朗, 森田有亮, 由留部崇, 張鍾穎, 宮崎真吾, 垣内裕司, 辻本龍, 蔵川拓外, 高田徹, 西田康太郎, 黒田良祐

  2019, Journal of Spine Research, 10(3) (3)


• mTOR阻害薬テムシロリムスはAktとオートファジーの誘導しヒト椎間板髄核細胞に保護作用を来す

  垣内裕司, 由留部崇, 角谷賢一朗, 高田徹, 武岡由樹, 神田裕太郎, 辻本龍, 宮崎真吾, 張鍾穎, 黒田良祐, 西田康太郎

  2019, Journal of Spine Research, 10(3) (3)


• ゼラチンハイドロゲルを用いた徐放化シスプラチン局所投与によるがん骨転移局所制御

  神田裕太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 垣内裕司, 武岡由樹, 辻本龍, 宮崎邦彦, 高田徹, 田畑泰彦, 黒田良祐

  2019, 多血小板血漿(PRP)療法研究会プログラム・抄録集, 11th


• 腰椎椎間板におけるオートファジー活性は疾患よりも年齢と変性度に依存する

  由留部崇, 垣内裕司, 角谷賢一朗, 高田徹, 田所浩, 武岡由樹, 神田裕太郎, 辻本龍, 土井田稔, 黒田良祐, 西田康太郎

  2019, 日本整形外科学会雑誌, 93(8) (8)


• ラット脊椎椎間板の恒常性維持におけるAtg5依存性オートファジーの関与

  辻本龍, 由留部崇, 垣内裕司, 角谷賢一朗, 高田徹, 武岡由樹, 神田裕太郎, 宮崎真吾, 土井田稔, 黒田良祐, 西田康太郎

  2019, 日本整形外科学会雑誌, 93(8) (8)


• 70歳以上の脊椎転移患者における手術効果とその経時的推移

  神田裕太郎, 神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 張鍾穎, 宮崎真吾, 垣内裕司, 辻本龍, 高田徹, 西田康太郎, 黒田良祐

  2019, 日本整形外科学会雑誌, 93(3) (3)


• 70歳以上の脊椎転移患者における手術成績

  神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 西田康太郎, 黒田良祐

  2019, 中部日本整形外科災害外科学会雑誌, 62


• 徐放化抗がん剤局所投与による新たなる骨転移制御の試み

  神田裕太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 垣内裕司, 辻本龍, 高田徹, 田畑泰彦, 土井田稔, 西田康太郎, 黒田良祐

  2019, 日本整形外科学会雑誌, 93(8) (8)


• 椎間板変性治療 : オートファジー—Biological Treatment of Intervertebral Disc Degeneration : autophagy—シンポジウム 椎間板研究の最前線

  由留部 崇, 伊藤 雅明, 垣内 裕司, 角谷 賢一朗, 高田 徹, 武岡 由樹, 神田 裕太郎, 辻本 龍, 宮崎 真吾, 張 鍾穎, 黒田 良祐, 西田 康太郎

  東京 : 医学書院, Nov. 2018, 臨床整形外科, 53(11) (11), 975 - 980, Japanese


• 70歳以上の脊椎転移患者の手術成績 PS、ADL、QOLの推移から

  神田 裕太郎, 角谷 賢一朗, 酒井 良忠, 河本 旭哉, 原 仁美, 深瀬 直政, 辻本 龍, 武岡 由樹, 垣内 裕司, 由留部 崇, 秋末 敏宏, 黒田 良祐

  (公社)日本リハビリテーション医学会, Oct. 2018, The Japanese Journal of Rehabilitation Medicine, 55(秋季特別号) (秋季特別号), S274 - S274, Japanese


• 脊椎転移の症候化リスク因子の前向き検討

  神田 裕太郎, 角谷 賢一朗, 酒井 良忠, 河本 旭哉, 原 仁美, 深瀬 直政, 辻本 龍, 武岡 由樹, 垣内 裕司, 由留部 崇, 秋末 敏宏, 黒田 良祐

  (公社)日本リハビリテーション医学会, Oct. 2018, The Japanese Journal of Rehabilitation Medicine, 55(秋季特別号) (秋季特別号), S367 - S367, Japanese


• ATG5の抑制を介したオートファジーの阻害はストレス環境下でヒト椎間板細胞においてアポトーシスとセネッセンスを誘導し,生存率を低下させる—Inhibition of Autophagy through ATG5 Knock-Down Reduces Human Disc Cell Viability Associated with Apoptosis and Senescence under Stress Conditions—日本脊椎脊髄病学会 特集号 ; 第46回日本脊椎脊髄病学会優秀論文

  伊藤 雅明, 由留部 崇, 垣内 裕司, 武岡 由樹, 神田 裕太郎, 角谷 賢一朗, 高田 徹, 黒田 良祐, 西田 康太郎

  東京 : 日本脊椎脊髄病学会, Sep. 2018, Journal of spine research : official journal of the Japanese Society for Spine Surgery and Related Research / Journal of spine research編集委員会 編, 9(9) (9), 1388 - 1393, Japanese


• 前向きコホート研究による症候性脊椎転移の発生リスクに関する検討

  神田裕太郎, 角谷賢一朗, 酒井良忠, 由留部崇, 黒田良祐, 西田康太郎

  2018, 中部日本整形外科災害外科学会雑誌, 61


• ロコモティブシンドロームに対するロコモ体操の脊椎・骨盤・下肢矢状断アライメント改善効果

  由留部崇, 伊藤雅明, 渡邉信佳, 竹岡亨, 角谷賢一朗, 高田徹, 垣内裕司, 武岡由樹, 神田裕太郎, 黒田良祐, 西田康太郎

  2018, 日本整形外科学会雑誌, 92(3) (3)


• 仙骨骨折を合併した骨盤輪骨折に対するSacral-Aal-Iliac Screwを用いた腰仙椎後側法固定術の有用性

  高田徹, 高田徹, 角谷賢一朗, 由留部崇, 伊藤雅明, 垣内裕司, 武岡由樹, 神田裕太郎, 黒田良祐, 西田康太郎

  2018, Journal of Spine Research, 9(3) (3)


• ロコモティブシンドロームに関連した脊椎・骨盤・下肢矢状面アライメント障害に対するロコモ体操の改善効果

  由留部崇, 伊藤雅明, 渡邉信佳, 竹岡亨, 角谷賢一朗, 高田徹, 垣内裕司, 武岡由樹, 神田裕太郎, 黒田良祐, 西田康太郎

  2018, Journal of Spine Research, 9(3) (3)


• 椎間板動的圧迫負荷が脊索由来髄核細胞に及ぼした影響

  神田裕太郎, 角谷賢一朗, 森田有亮, 由留部崇, 伊藤雅明, 垣内裕司, 垣内裕司, 武岡由樹, 蔵川拓外, 寺嶋良樹, 高田徹, 黒田良祐, 西田康太郎

  2018, Journal of Spine Research, 9(3) (3)


• mTORC1阻害薬テムシロリムスのヒト椎間板髄核細胞保護効果はオートファジー及びAktの活性化に由来する

  垣内裕司, 由留部崇, 角谷賢一朗, 高田徹, 伊藤雅明, 武岡由樹, 神田裕太郎, 黒田良祐, 西田康太郎

  2018, Journal of Spine Research, 9(3) (3)


• ゼラチンハイドロゲルを用いた徐放化抗がん剤局所投与による骨転移局所制御

  神田裕太郎, 神田裕太郎, 角谷賢一朗, 由留部崇, 張鍾穎, 宮崎真吾, 垣内裕司, 武岡由樹, 辻本龍, 高田徹, 西田康太郎, 田畑泰彦, 黒田良祐

  2018, 多血小板血漿(PRP)療法研究会プログラム・抄録集, 10th


• 動的圧迫負荷が,integrinα5β1を介して脊索由来細胞に与える影響

  神田裕太郎, 角谷賢一朗, 森田有亮, 由留部崇, 垣内裕司, 垣内裕司, 武岡由樹, 蔵川拓外, 高田徹, 土井田稔, 西田康太郎, 黒田良祐

  2018, 日本整形外科学会雑誌, 92(8) (8)


• mTORC1阻害薬テムシロリムスはヒト椎間板髄核細胞の細胞死,細胞老化,細胞外基質分解を抑制する

  垣内裕司, 由留部崇, 角谷賢一朗, 高田徹, 伊藤雅明, 武岡由樹, 神田裕太郎, 黒田良祐, 西田康太郎

  2017, 移植(Web), 52(6) (6)


• Effect of a new gap balancing technique named as medial preserving gap technique aiming at better patient satisfaction

  KANDA Yutaro

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 2017, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 60(5) (5), 911 - 912, Japanese


• Clinical results of pyogenic spondylitis

  KANDA Yutaro

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 2016, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 59(4) (4), 685 - 686, Japanese


• A Case Report:Pseudomeningocele after Thoracic Posterior Decompression with Instrumented Fusion Causing Spinal Cord Compression

  神田 裕太郎, 乾 義弘, 張 鍾穎, 鈴木 哲平, 川北 晃平, 宇野 耕吉

  三輪書店, 25 Mar. 2015, 脊椎脊髄ジャーナル, 28(3) (3), 205 - 209


• Intradural enterogenous cyst containing nevus cells in cervical spine: a case report

  KANDA Yutaro

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 2015, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 58(5) (5), 949 - 950, Japanese


• Clinical result of 100 cases of femoral neck fracture using Dual SC screw system

  KANDA Yutaro

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 2013, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 56(5) (5), 1171 - 1172, Japanese


• Clinical result of surgical treatment for femoral neck fracture using Dual SC Screw system

  KANDA Yutaro

  The Central Japan Association of Orthopaedic Surgery and Traumatology, 2012, The Central Japan Journal of Orthopaedic Surgery & Traumatology, 55(5) (5), 999 - 1000, Japanese

• Research on a treatment system for degenerative intervertebral discs using silk elastin - Attempts to create artificial intervertebral discs -

  角谷 賢一朗, 由留部 崇, 辻本 武尊, 武岡 由樹, 神田 裕太郎, 田畑 泰彦, 西田 英高

  Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Kobe University, 01 Apr. 2025 - 31 Mar. 2029


• メカノレセプターPiezo1による椎間板変性に対する治療アプローチ

  神田 裕太郎

  日本学術振興会, 科学研究費助成事業, 若手研究, 神戸大学, 01 Apr. 2025 - 31 Mar. 2028