ミタニ　シゲル   Shigeru Mitani   三谷　茂    所属   川崎医科大学  医学部 臨床医学　脊椎・関節整形外科学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Investigation of the Usefulness of Implants With Locking Mechanisms for Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Induced Thoracic and Lumbar Fractures in Patients Operated in the Prone Position.
掲載誌名	正式名：Cureus 略　 称：Cureus ISSNコード：21688184/21688184
掲載区分	国外
巻・号・頁	16(8),pp.e67071
著者・共著者	Seiya Watanabe, Kazuo Nakanishi, Kazuya Uchino, Hideaki Iba, Yoshihisa Sugimoto, Shigeru Mitani
担当区分	最終著者
発行年月	2024/08/17
概要	Background Diffuse idiopathic skeletal hyperostosis (DISH) is a disease that causes bone growth in the spine and musculoskeletal system, and even minor trauma can cause fractures that often require surgery. DISH-induced fractures show a tendency for bone loss when operated in the prone position, which can lead to poor fusion and implant failure; therefore, surgery in the lateral recumbent position is often recommended. However, inserting a pedicle screw (PS) in the lateral recumbent position is technically difficult. This study examined the effectiveness of the repair and fixation of thoracic and lumbar spine fractures using implants with locking mechanisms in the prone position in patients with DISH. Methods We retrospectively analyzed the data from 11 patients (six males and five females; mean age: 87 years) who underwent surgery for thoracic and lumbar fractures caused by DISH between December 2023 and June 2024. Surgery was performed in the prone position using PSs or transdiscal screws (TSDs) for DISH. Ennovate® implants manufactured by B-BRAUN were used. The fixed range was three above-three below for PSs and two above-two below for TSDs. The evaluation parameters were the height/level of injury, operative time, blood loss, local kyphosis angle, anterior wall height ratio, and complications. The local kyphosis angle was measured as the angle between the upper and lower endplates of the fractured vertebrae. The ratio of the anterior wall height was evaluated. Results The average operative time was 87 min (52-172 min), and the average blood loss was 40ml (10-140 ml). The preoperative and postoperative local kyphosis angle was -8.7° and -2.4°, respectively, and the average local kyphosis angle improvement was 6.3° (0.1-14°). The preoperative and postoperative anterior wall height ratio was 132% and 110%, respectively, and the average anterior wall height ratio improvement was 22% (2-82%). No complications, such as screw deviation, implant loosening, loss of corre
DOI	10.7759/cureus.67071
PMID	39286719