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Biomedical subjects

Hiroshi Moridaira

Publications and source records attributed to Hiroshi Moridaira.

4 recordsLinked to original sources
PubMed2006

Comparative study of radiographic disc height changes using two different interbody devices for transforaminal lumbar interbody fusion: open box vs. fenestrated tube interbody cage.

STUDY DESIGN: Retrospective comparative study of the postoperative subsidence of two interbody devices following posterior or transforaminal lumbar interbody fusion (PLIF/TLIF) for degenerative spondylolisthesis of the lumbar spine. OBJECTIVE: To assess certain radiograph characteristics of PLIF/TLIF using two interbody fusion devices at L4-L5. SUMMARY OF BACKGROUND DATA: PLIF can achieve spinal stabilization with vertebral body support and direct neural decompression. Although various interbody devices have been used in PLIF procedures, no radiographic studies have compared the load-bearing capabilities of open box and fenestrated tube interbody cages. METHODS: Seventy-five patients who underwent one-level PLIF in the L4-L5 [corrected] segment for degenerative spondylolisthesis were retrospectively reviewed with a minimum 2-year follow-up. Fenestrated tube (Group FT: n = 30 [corrected]) or open box (Group OB: n = 45 [corrected]) cages were used for the PLIF procedure. The following radiographic parameters were evaluated to compare the load-bearing capabilities: disc space height (DH); percent increase and decrease of disc height (% IDH and % DDH, respectively); and percent coverage of the cage on the endplate (% CC). RESULTS: There were no significant differences in the baseline data, including age, segmental instability and osteoporotic status, between the two groups. Anterior %IDH and % CC were significantly higher in Group OB than in Group FT (% IDH: 69.4% vs. 57.3%; % OC: 24.5% vs. 12.9%), and anterior and posterior % DDH were significantly higher in Group FT than in Group OB (anterior: -2.9% vs. -.1%; posterior: -6.6% vs. -.3%). Although the restored DH gradually reduced over time in both groups, significant reduction to the preoperative level only occurred in Group FT. CONCLUSIONS: The load-bearing capabilities of the open box cage are superior to those of the fenestrated tube cage. Since there were no significant differences between the baseline status of the two groups, the larger cross-sectional area and stable framework design of the open box cage appears to bring about a greater load-bearing capability. Therefore, the open box cage seems to be biomechanically more advantageous as an interbody device for PLIF than the fenestrated tube cage.

Aged↗
PubMed2006

Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period.

OBJECT: There are no published reports of unilateral transforaminal lumbar interbody fusion (TLIF) in which two Brantigan I/F cages were placed per level through a single portal to achieve bilateral anterior-column support. The authors describe such a surgical technique and evaluate the clinical outcomes of this procedure. METHODS: Data obtained in 86 (93.5%) of the first 92 consecutive patients who underwent the procedure were retrospectively reviewed; the minimum follow-up duration was 2 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scoring system. Disc height, disc angle, cage positioning in the axial plane, and fusion status were radiographically evaluated. The mean follow-up period was 33.8 months. The mean improvement in the JOA score was 77.2%. Fusion was successful in 93% of the cases. According to the Farfan method, the mean anterior and posterior disc heights increased from 20.2 and 16.9% preoperatively to 35.9 and 22.7% at follow up, respectively (p < 0.01). The mean disc angle increased from 4.8degrees preoperatively to 7.5degrees at last follow-up examination (p < 0.01). Two cages were correctly placed to achieve bilateral anterior-column support in greater than 85% of the cases. The following complications occurred: hardware migration in two patients and deep infection cured by intravenous antibiotic therapy in one patient. CONCLUSIONS: Unilateral TLIF involving the placement of two Brantigan cages per level led to good clinical results. Two Brantigan cages were adequately placed via a single portal, and reliable bilateral anterior-column support was achieved. Although the less invasive unilateral approach was used, the outcomes were as good as those in many reported series of posterior lumbar interbody fusion in which the Brantigan cages were placed via the bilateral approach.

Adult↗
PubMed2004

Iliac crest reconstruction with a bioactive ceramic spacer.

This study aimed to investigate the long-term clinical results of the apatite wollastonite-containing glass ceramic (AWGC) iliac spacer and to discuss its efficacy in reconstruction of the bone graft donor site at the iliac crest. Thirty-one patients were studied for more than 10 years. All patients underwent anterior spinal fusion using autogenous tricortical iliac bone graft. After harvest of tricortical iliac bone graft, an AWGC iliac spacer ranging from 15 mm to 70 mm in length was press-fitted into the gap. Long-term clinical results were obtained from radiological and blood examinations. Thirty patients (97%) were satisfied with the spacer. There was new bone formation around the spacer on the radiograph. There was no abnormal silicon concentration in blood examinations. AWGC iliac spacer appears to be useful in the reconstruction of harvested iliac crest. New bone formation occurs, reducing the defect size.

Adolescent↗