PubMed Health⌕ Search

Biomedical subjects

A Okawa

Publications and source records attributed to A Okawa.

32 records · Page 2Linked to original sources
PubMed1996

The cervical spine in athetoid cerebral palsy. A radiological study of 180 patients.

We have reviewed the cervical spine radiographs of 180 patients with athetoid cerebral palsy and compared them with those of 417 control subjects. Disc degeneration occurred earlier and progressed more rapidly in the patients, with advanced disc degeneration in 51%, eight times the frequency in normal subjects. At the C3/4 and C4/5 levels, there was listhetic instability in 17% and 27% of the patients, respectively, again six and eight times more frequently than in the control subjects. Angular instability was seen, particularly at the C3/4, C4/5 and C5/6 levels. We found a significantly higher incidence of narrowing of the cervical canal in the patients, notably at the C4 and C5 levels, where the average was 14.4 mm in the patients and 16.4 mm in normal subjects. The combination of disc degeneration and listhetic instability with a narrow canal predisposes these patients to relatively rapid progression to a devastating neurological deficit.

Adolescent↗
PubMed1996

Inverse relation between vertebral body deformity and intervertebral disk narrowing in lumbar spine of elderly women.

To investigate the relation between vertebral body deformity and disk narrowing in the lumbar spine of elderly patients, a longitudinal radiographic study of 56 aged women was retrospectively performed. We measured disk areas and body heights on two lateral lumbar radiograph sets obtained with an average interval between examinations of 10 years. The absolute values of disk areas on first examination and the rates of change of area of disks adjacent to nondeformed bodies were smaller than the corresponding values for the deformed bodies. Conversely, deformed bodies tended to have normal or expanded disks regardless of the mode of deformity. Despite the small number of subjects studied, our findings suggested that an inverse relation may exist between vertebral body deformity and disk narrowing.

Aged↗
PubMed1996

Monitoring of anterior cervical spinal cord function.

Anterior surgery is frequently chosen for treatment of cervical myelopathy. However, intraoperative spinal cord recording has rarely been used to monitor the function of the ventral columns. We report a method of monitoring evoked spinal cord potentials useful for detection of minor injury of the anterior spinal cord. Evoked spinal cord potentials elicited in cats by thoracic spinal cord and labyrinth stimulation were studied. Evoked intraspinal field potentials recorded after labyrinth stimulation were confirmed to originate from the vestibulospinal tract in the ventral columns. Low-amplitude potentials were recorded from the posterior epidural space. However, this method has not been used clinically because of difficulty in obtaining selective stimulation in humans. Spinal cord potentials evoked by thoracic stimulation were recorded from the anterior and posterior epidural spaces. The amplitude of the potentials was large enough to permit quantitation of neural function. We confirmed that anterior recording was more sensitive in detecting ventral column injury than posterior recording was. Based on these findings, we used anterior recording from the disc clinically for anterior spinal cord monitoring during anterior cervical surgery.

Acoustic Stimulation↗
PubMed1996

A cadaveric study on the stability of lumbar segment after partial laminotomy and facetectomy with intact posterior ligaments.

This study aimed to biomechanically investigate a change in the stability of decompressed segments in the degenerative lumbar spine. Cyclic loading tests to the cadaveric spinal unit were conducted in compressive and bending directions with a stepwise resection of the posterior elements such as wide fenestration (partial laminotomy), unilateral and bilateral facetectomy with the intact supra- and interspinous ligaments and spinous process. Flexion stability did not decrease significantly, and may reflect the fact that the aforementioned ligamentous structures were preserved throughout the resection process. After wide fenestration, the loss of compression stiffness amounted to only half that of bilateral facetectomy, and extension stiffness dropped to this same level. Lateral bending stiffness was maintained until unilateral facetectomy was performed. We recommend restricted decompression surgeries for a single-level central stenosis in the degenerative lumbar spine.

Aged↗
PubMed1994

Morphology of C5 ventral nerve rootlets as part of dissociated motor loss of deltoid muscle.

STUDY DESIGN: This study analyzed anatomic characteristics of cervical ventral rootlets. After total vertebrectomy, detailed morphology of the ventral rootlets was studied from the anterior. SUMMARY OF BACKGROUND DATA: The clinical study showed the predominance of ventral root lesion. There are few studies concerning the morphologic pathogenesis of cervical amyotrophy and detailed cervical ventral rootlet anatomy. METHODS: Thirty-six embalmed adult human cadavers were studied. The measurements for the ventral rootlets of C5 to C8 were made as follows: 1) angle between the rootlet and spinal cord, 2) longitudinal width of the ventral rootlet origin, and 3) length of the ventral rootlets. RESULTS: The C5 ventral rootlets were shorter and issued more obtusely from the cervical spinal cord than lower rootlets. The spinal cord segment of the deltoid muscle, indicated by the longitudinal widths of the C5 and C6 ventral rootlet exits from the spinal cord, were wider than the C7 and C8 segments. Preforaminal anterior compression at the C4-C5 disc level might affect the lower part of the C5 ventral rootlets and upper part of the C6 ventral rootlets. CONCLUSION: Short C5 ventral rootlets appeared to become taut and easily injured by hemilateral anterior compression. Spinal cord lesion resulting from localized anterior compression at the single disc level might not play as important a role in the pathogenesis of dissociated motor loss of the deltoid muscle because of the wider spinal segments of C5 and C6.

Aged↗
PubMed1990

Physical therapeutic and surgical management in spastic diplegia. A Japanese experience.

With the development of intensive neonatal care, spastic diplegia associated with prematurity has become the most common type of cerebral palsy. The principles of the present authors' treatment for children with the disease are physical therapy (involving neurodevelopmental treatment) and surgical treatment for contractures and deformities. The authors studied the long-term results of physical therapy and its effect on the necessity for surgery and the improvement of locomotor function. From 1973 to 1988, 355 children with spastic diplegia were treated at the authors' facility. From this group, the authors selected and studied 71 children who received systematic treatment for a minimum of one year and who could be followed at the age of six years or older. At the follow-up examination, 41 of these children were free ambulators, 28 were crutch ambulators, and two were not ambulatory. Of the 41 freely ambulatory children, four achieved free ambulation after the age of seven years. Of the 28 crutch ambulators, relatively small hip-flexion contractures were found in 11 children who had received the early developmental treatment program.

Cerebral Palsy↗
PubMed1989

[A case of congenital diaphragmatic hernia due to left central tendon defect in pregnancy].

A twenty-seven-year-old 25 weeks gestation female was admitted with recurrent symptoms of nausea, vomiting and epigastric pain. She was diagnosed as left diaphragmatic hernia by chest X-ray film, CT and esophago-gastrography. During operation, a left central tendon defect was observed, and was 3.5 cm in diameter. The margin of the defect was smooth and round. It was associated with diaphragmatic eventration. The small intestine and transverse colon were herniated into the left thoracic cavity. The central tendon defect was closed with direct mattress sutures and was reinforced by overlap-technique of the diaphragm. To our knowledge, this type of defect has not been described previously in Japan. Diaphragmatic hernia in pregnancy is very rare, and presents abdominal pain, vomiting and dyspnea. Usually the diagnosis is achieved by chest X-ray film. However, esophago-gastrography should be added, if the diagnosis could not be confirmed by chest X-ray film. Conservative management is reported to bring high mortality, therefore, prompt surgical repair is advisable.

Adult↗
PubMedDate not supplied

Relation between the painful shoulder and the cervical spine with narrow canal in patients without obvious radiculopathy.

It is well known that cervical radiculopathy sometimes causes shoulder pain. Hypothesizing that the cause of painful shoulder is related to the cervical spine in the absence of obvious radiculopathy, we measured the anteroposterior diameter of the spinal canal and the range of motion of the cervical spine in patients with painful shoulder on lateral cervical radiographs of the spine. Painful shoulder was diagnosed in 76 patients (24 men and 52 women; mean age 57.6 years). Patients who reported neck pain or numbness of the upper limbs and patients with neurologic abnormalities were excluded from this study. A control group of 54 asymptomatic volunteers (27 men and 27 women; mean age 55.5 years) was formed. The difference in age between the patient group and the control group was not significant. The anteroposterior diameter of the spinal canal at C5 and C6 in the painful-shoulder group (C5: 12.74 mm; C6: 12.76 mm) was significantly narrower than in the control group (C5: 13.60 mm; C6: 13.79 mm). The range of motion was greatest at C4-5 and smallest at C2-3 in both groups; and there was no significant difference in the range of motion between the painful-shoulder group and the control group. When women only or men only were assessed, the results were nearly the same between groups. The cervical spine without obvious radiculopathy appears to be involved in patients with a painful shoulder. We speculate that the shoulder is affected by irritation of a cervical nerve root or referred pain.

Adult↗