2026/08/31 更新

写真a

ツジ ヒロノリ
辻 寛謙
Hironori Tsuji
所属
医歯薬学域 助教(特任)
職名
助教(特任)
外部リンク

研究キーワード

  • 運動機能再建

  • 整形外科

  • 脊椎外科

  • 慢性疼痛

  • 脊髄刺激

経歴

  • 岡山大学   運動器先端リハビリテーション講座   助教

    2026年4月 - 現在

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  • 日本学術振興会 特別研究員 PD   東京都医学総合研究所 脳機能再建プロジェクト   研究員

    2023年4月 - 2026年3月

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  • 岡山赤十字病院   整形外科   副部長

    2022年4月 - 2023年3月

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  • 岡山赤十字病院   整形外科   医長

    2021年4月 - 2022年3月

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  • 岡山大学大学院医歯薬学総合研究科博士課程

    2017年4月 - 2021年3月

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所属学協会

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論文

  • Non-invasive closed-loop spinal stimulation restores leg stepping control in humans with paraplegia. 国際誌

    Toshiki Tazoe, Syusaku Sasada, Takashi Murayama, Yaoki Nakao, Kenji Kato, Suguru Kadowaki, Susumu Yoshida, Hironori Tsuji, Ayane Ozaki, Tomoyoshi Komiyama, Yoshikazu Ugawa, Yukio Nishimura

    Brain : a journal of neurology   2025年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gait disturbance in individuals with spinal cord injury (SCI) at levels rostral to the lumbar locomotor centre results from disconnection between the supraspinal system and the spinal locomotor centre. Here, we present a non-invasive volition-controlled spinal stimulation paradigm that empowers paraplegic individuals to regain stepping control in their impaired legs. Using hand muscle-controlled magnetic stimulation targeting the lumbar spinal motor circuits in the preserved lumber cord, individuals with chronic SCI achieved control of start-stop motion, step length and cadence of bilateral cyclic stepping in paralysed legs. Stimulus-induced cyclic stepping with leg muscle EMG activity was evoked in all participants with complete or incomplete SCI, regardless of the lesion site between the thoracic and lumbar spinal cord. Combining voluntary gait effort with closed-loop stimulation further enhanced leg movements. Repeated application of this closed-loop stimulation led to progressive improvement in stimulus-induced stepping and muscle responses, particularly in participants with thoracic SCI, and in stimulus-free stepping, particularly in participants with incomplete SCI. Our findings indicate that the preserved lumbar spinal motor circuit plays a crucial role in improving stimulus-induced stepping, whereas the preserved descending pathway is required for improving stimulus-free stepping. This non-invasive closed-loop spinal stimulation paradigm bypasses the lesion site on the spinal cord and strengthens both the preserved spinal circuits and the descending pathways to allow bilateral stepping control to be regained after SCI. This approach holds great promise for SCI-related gait rehabilitation because it has the potential to lead to functional recovery. Furthermore, this approach offers a viable alternative for individuals with contraindications to invasive procedures or those who do not consent to surgical treatments.

    DOI: 10.1093/brain/awaf230

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  • Could the Trabecular Bone Score Be a Complementary Tool for Evaluating Degenerative Lumbar Vertebrae?

    Shinichiro Takao, Koji Uotani, Haruo Misawa, Tomoko Tetsunaga, Kensuke Shinohara, Kentaro Yamane, Yoshiaki Oda, Hironori Tsuji, Yuya Kajiki, Toshifumi Ozaki

    Acta medica Okayama   79 ( 1 )   39 - 45   2025年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Evaluating vertebral bone mass and quality in the elderly poses challenges due to degenerative changes. This study aims to elucidate the usefulness of the trabecular bone score (TBS) by examining the relationship between bone mineral density (BMD), TBS, and Hounsfield unit (HU) values. A retrospective analysis of 599 vertebrae from 152 patients (mean age 69.0 years; range 44-89; 74 males and 78 females) undergoing dual-energy X-ray absorptiometry (DXA) and CT scans was conducted. Vertebrae were categorized into three grades based on the degree of degeneration. The TBS was calculated from DXA images, and the HU value was measured by placing a region of interest on an axial image of the vertebral mid-body. One-way analysis of variance and Pearson's correlation tests were employed to investigate the relationship between BMD and TBS or HU values. While lumbar BMD significantly increased (p<0.01) with degenerative changes, TBS and HU values showed no significant differences. The correlations between lumbar BMD and TBS values, and between BMD and HU values, were stronger without degenerative changes than with degenerative changes. Significantly different HU values were observed between the right and left sides of severely degenerated vertebrae. Severe degenerative changes, particularly those associated with sclerosis, may impact HU values. TBS exhibits greater potential than HU values as a complementary tool.

    DOI: 10.18926/AMO/68360

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  • An osteoinductive surface by adhesive bone morphogenetic protein-2 prepared using the bioorthogonal approach for tight binding of titanium with bone. 国際誌

    Xueli Ren, Hironori Tsuji, Takahiko Uchino, Izumi Kono, Takashi Isoshima, Akimitsu Okamoto, Noriyuki Nagaoka, Toshifumi Ozaki, Akihiro Matsukawa, Hideyuki Miyatake, Yoshihiro Ito

    Journal of materials chemistry. B   12 ( 12 )   3006 - 3014   2024年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Inorganic biomaterials are used in various orthopedic and dental implants. Nevertheless, they cause clinical issues such as loosening of implants and patient morbidity. Therefore, inspired by mussel adhesive proteins, we aimed to design an adhesive and dimer-forming highly active bone morphogenetic protein-2 (BMP-2) using bioorthogonal chemistry, in which recombinant DNA technology was combined with enzymatic modifications, to achieve long-term osseointegration with titanium. The prepared BMP-2 exhibited substantially higher binding activity than wild-type BMP-2, while the adhered BMP-2 was more active than soluble BMP-2. Therefore, the adhesive BMP-2 was immobilized onto titanium wires and screws and implanted into rat bones, and long-term osteogenesis was evaluated. Adhesive BMP-2 promoted the mechanical binding of titanium to bones, enabling efficient bone regeneration and effective stabilization of implants. Thus, such adhesive biosignaling proteins can be used in regenerative medicine.

    DOI: 10.1039/d3tb02838k

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  • Associations among Preoperative Malnutrition, Muscle Loss, and Postoperative Walking Ability in Intertrochanteric Fractures: A Retrospective Study.

    Kohei Sato, Hironori Tsuji, Masanori Yorimitsu, Takenori Uehara, Yuki Okazaki, Shinichiro Takao, Toshiaki Hata, Shiro Fukuoka, Tomoyuki Noda, Hideyuki Kanda, Toshifumi Ozaki

    Acta medica Okayama   77 ( 5 )   511 - 516   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either "gait disturbance" or "independent gait". Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required.

    DOI: 10.18926/AMO/65973

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  • Association of phase angle with sarcopenia in chronic musculoskeletal pain patients: a retrospective study. 国際誌

    Hironori Tsuji, Tomoko Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

    Journal of orthopaedic surgery and research   18 ( 1 )   87 - 87   2023年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: In chronic musculoskeletal pain patients, detection of sarcopenia is of significant clinical interest. Phase angle, which can be measured through bioelectrical impedance analysis (BIA), can detect sarcopenia; however, the evidence in chronic musculoskeletal pain patients is limited. This study aimed to assess the relationship between phase angle and sarcopenia in patients with chronic musculoskeletal pain. Our hypothesis was that phase angle would be a useful indicator to identify sarcopenia in patients with chronic musculoskeletal pain. METHODS: A total of 190 patients (51 men and 139 women) with chronic musculoskeletal pain were included in this retrospective cross-sectional study. Patient data of backgrounds, numeric rating scale score for pain, skeletal muscle index, and phase angle assessed using BIA were retrospectively reviewed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. RESULTS: A total of 51 patients (26.7%), including 10 men (19.6%) and 41 women (29.5%), were diagnosed with sarcopenia. Phase angle, sarcopenia-related factors, age, and body mass index (BMI) differed significantly in patients with and without sarcopenia. On multiple logistic regression analysis, the prevalence of sarcopenia was significantly correlated with phase angle and BMI. The areas under the curve exhibited high accuracy in discriminating sarcopenia in men and moderate accuracy in both sexes and in women. CONCLUSIONS: Phase angle may be a valid discriminator of sarcopenia in patients with chronic musculoskeletal pain.

    DOI: 10.1186/s13018-023-03567-1

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  • Factors influencing caregiver burden in chronic pain patients: A retrospective study. 国際誌

    Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Yoshiaki Oda, Shinichiro Takao, Keiichiro Nishida, Toshifumi Ozaki

    Medicine   101 ( 39 )   e30802   2022年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Chronic pain coexists with disability, anxiety, depression, and sleep disturbances, which are factors of pain chronicity in the fear-avoidance model. Self-efficacy for managing pain plays a protective role against pain chronicity. For chronic pain sufferers, social support from caregivers is important. However, such caregivers face enormous physical and mental burdens. This study aimed to assess how self-efficacy and factors related to the fear-avoidance model affect caregiver burden. Participants were 135 chronic pain patients and their caregivers who visited our outpatient pain special clinic. In clinical assessments, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), pain disability assessment scale (PDAS), pain self-efficacy questionnaire (PSEQ) for the patients and Zarit Burden Interview (ZBI) for their caregivers were evaluated. Participants were divided into 2 groups (L group ZBI < 24 points and H group ZBI ≥ 24 points) and compared. Regression analyses were conducted to identify factors correlated with the ZBI scores. Compared to L group, H group showed significantly higher NRS and HADs depression scores, and lower PSEQ scores. In univariate regression analysis, ZBI scores were significantly correlated with NRS, PCS, HADS anxiety, HADS depression, PDAS and PSEQ. Multiple linear regression analysis revealed that ZBI scores were significantly correlated with PSEQ. The caregivers who perceived high caregiver burden had significantly higher patients' pain intensity, depression, and lower self-efficacy than those who perceived low caregiver burden. Caregiver burden correlated with the pain intensity, pain catastrophizing, anxiety, depression, disability, and self-efficacy of chronic pain patients. Among these factors, self-efficacy was the most negatively correlated with caregiver burden. Treatments focused on increasing self-efficacy for managing pain have the potential to reduce caregiver burden.

    DOI: 10.1097/MD.0000000000030802

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  • Evaluation of SARC-F and SARC-CalF for sarcopenia screening in patients with chronic musculoskeletal pain: A prospective cross-sectional study. 国際誌

    Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Yoshiaki Oda, Shinichiro Takao, Keiichiro Nishida, Toshifumi Ozaki

    Medicine   101 ( 29 )   e29568   2022年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Early sarcopenia detection using screening tools, such as SARC-F and SARC-CalF, has been proven reliable. However, the relationship between chronic musculoskeletal pain with sarcopenia is unknown. This study assessed sarcopenia morbidity as well as the reliability of sarcopenia screening with SARC-F and SARC-CalF in patients with chronic musculoskeletal pain. METHODS: Overall, 172 patients with chronic musculoskeletal pain were included in this cross-sectional study. All participants completed the SARC-F, SARC-CalF, numeric rating scale (NRS), and pain disability assessment scale (PDAS) assessments. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. Correlations between SARC-F and SARC-CalF scores and each measured variable were evaluated using univariate and multiple linear regression analyses. A receiver operating characteristic curve analysis was conducted, and reliabilities of SARC-F and SARC-CalF scores for diagnosing sarcopenia were compared. RESULTS: Thirty-nine patients were diagnosed with sarcopenia. Among these, 10 patients were <65 years old, and 29 were >65 years old. Both SARC-F and SARC-CalF scores significantly correlated with grip power, gait speed, skeletal mass index, numeric rating scale score, and PDAS score. In multiple linear regression analysis, SALC-F and SALC-CalF scores significantly correlated with PDAS score, skeletal mass index, and gait speed. The area under the curve were 0.70 for SARC-F and 0.88 for SARC-CalF; SARC-CalF had a significantly higher area under the curve than SARC-F. DISCUSSION: Sarcopenia was diagnosed in patients aged <65 years with chronic musculoskeletal pain. SALC-F and SARC-CalF scores showed a significant correlation with disability due to pain and were reliable sarcopenia screening tools for chronic musculoskeletal pain. SARC-CalF was more reliable than SARC-F.

    DOI: 10.1097/MD.0000000000029568

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  • Psoas muscle index predicts osteoporosis and fracture risk in individuals with degenerative spinal disease. 国際誌

    Yuya Kajiki, Hironori Tsuji, Haruo Misawa, Ryuichi Nakahara, Tomoko Tetsunaga, Kentaro Yamane, Yoshiaki Oda, Shinichiro Takao, Toshifumi Ozaki

    Nutrition (Burbank, Los Angeles County, Calif.)   93   111428 - 111428   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Skeletal muscle loss and osteoporosis are major medical and socioeconomic concerns as the global population ages. Studies have reported that skeletal muscle mass correlates to bone mineral density (BMD). The psoas muscle index (PMI), measured as the L3 cross-sectional areas of the right and left psoas divided by the square of height, has a positive correlation with the total volume of skeletal muscle in the body. This study aimed to evaluate relationships between PMI and BMD and fracture risk estimated by the Fracture Risk Assessment Tool (FRAX). METHODS: Preoperatively acquired, plain computed tomography images at the L3 level were used to measure PMI in 87 people with degenerative spinal diseases. We evaluated the correlation between PMI and BMD and fracture risk estimated by FRAX. RESULTS: PMI was significantly correlated with BMD in the entire lumbar spine and femoral neck (r = 0.413 and 0.525, both P < 0.001). People with osteoporosis showed significantly lower PMI than those without (P < 0.05). PMI was also significantly correlated with FRAX score (r = -0.545, P < 0.001). Furthermore, based on the recommendation of osteoporosis treatment, participants were divided into two groups: FRAX ≥15% (R group) and FRAX <15% (C group). The R group showed significantly lower PMI than the C group (P < 0.001). Receiver operating characteristic curve analysis revealed that PMI has moderate accuracy in diagnosing osteoporosis and FRAX ≥15%. CONCLUSIONS: PMI was significantly associated with BMD and fracture risk. PMI measurement is straightforward and may increase the diagnosis rate of osteoporosis and fracture risk.

    DOI: 10.1016/j.nut.2021.111428

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  • Quantification of patellar tendon reflex using portable mechanomyography and electromyography devices. 国際誌

    Hironori Tsuji, Haruo Misawa, Tomoyuki Takigawa, Tomoko Tetsunaga, Kentaro Yamane, Yoshiaki Oda, Toshifumi Ozaki

    Scientific reports   11 ( 1 )   2284 - 2284   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Deep tendon reflexes are one of the main components of the clinical nervous system examinations. These assessments are inexpensive and quick. However, evaluation can be subjective and qualitative. This study aimed to objectively evaluate hyperreflexia of the patellar tendon reflex using portable mechanomyography (MMG) and electromyography (EMG) devices. This study included 10 preoperative patients (20 legs) who had a pathology that could cause bilateral patellar tendon hyperreflexia and 12 healthy volunteers (24 legs) with no prior history of neurological disorders. We attached MMG/EMG sensors onto the quadriceps and tapped the patellar tendon with maximal and constant force. Our results showed a significantly high amplitude of the root mean square (RMS) and low frequency of the mean power frequency (MPF) in the rectus femoris, vastus medialis, and vastus lateralis muscles in both EMG and MMG with both maximal and constant force. Especially in the patients with cervical and thoracic myelopathy, the receiver operating characteristic (ROC) curve for diagnosing hyperreflexia of the patellar tendon showed a moderate to very high area under the curve for all EMG-RMS, EMG-MPF, MMG-RMS, and MMG-MPF values. The use of EMG and MMG for objectively quantifying the patellar tendon reflex is simple and desirable for future clinical applications and could help diagnose neurological disorders.

    DOI: 10.1038/s41598-021-81874-5

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  • Cognitive factors associated with locomotive syndrome in chronic pain patients: A retrospective study. 査読

    Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Haruo Misawa, Keiichiro Nishida, Toshifumi Ozaki

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association   26 ( 5 )   896 - 901   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Prevention and treatment for locomotive syndrome (LS) are important for extending healthy life expectancy. The 25-question geriatric locomotive function scale (GLFS-25) was developed to diagnose LS. The Fear-Avoidance model was proposed to explain pain chronicity. LS and chronic pain decrease activities of daily living; however, the relationships between LS and factors related to chronic pain in the Fear-Avoidance model are unknown. Objective of the current study was to assess the prevalence of LS and examine the factors of the Fear-Avoidance model and the GLFS-25 that affect the prevalence of LS in patients with chronic pain. METHODS: Participants included 281 patients (99 men, 182 women) aged over 40 years with chronic pain who visited our outpatient clinic for chronic pain. All participants completed the GLFS-25, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), and Athene insomnia scale (AIS). According to a GLFS-25 cutoff point, participants were divided into three groups (LS-2; GLFS-25 ≥ 16, LS-1; 7 ≤ GLFS-25 < 16, and non-LS; GLFS-25 < 7 points) and each parameter was compared among the groups, followed by multiple logistic regression analysis. Next, multiple linear regression analysis was performed to determine the factors associated with the GLFS-25. RESULTS: Of all 281 patients, 241 (85.8%) patients were diagnosed with LS-2. Univariate analysis revealed there were significant differences in NRS, PCS, HADS anxiety, HADS depression, and AIS among groups. Multiple logistic regression analyses showed PCS was significantly associated with LS-2 prevalence. The GLFS-25 was positively correlated with NRS, HADS depression, AIS in multiple linear regression analysis. CONCLUSIONS: We found that patients with chronic pain in our outpatient clinic had a significant rate of LS-2. The prevalence of LS-2 was significantly correlate with pain catastrophizing, and the GLFS-25 was significantly correlated with higher pain intensity, depression, and insomnia.

    DOI: 10.1016/j.jos.2020.08.007

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  • 高度変形を来した特発性側彎症の1例

    村岡 聡介, 瀧川 朋亨, 三澤 治夫, 辻 寛謙, 高尾 真一郎, 尾崎 敏文

    中国・四国整形外科学会雑誌   32 ( 2 )   247 - 251   2020年9月

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    記述言語:日本語   出版者・発行元:中国・四国整形外科学会  

    18歳男性。6歳時に特発性側彎症の診断にて装具治療を開始されたが、徐々に側彎の進行を認めたため当院紹介となった。初診時に高度の側彎を認め、術前にハローリングを用いた頭蓋直達牽引を行ったところ、Cobb角(T6-L2)は141度から116度に改善し、牽引開始から3週間後に手術を施行した。手術は術中CTナビゲーションを用いて後方からの椎間板解離によるリリースを行った。最終的にT2-L4間を固定し、Cobb角は79度に改善した。術後は合併症なく良好に経過し、術後1年の時点でCobb角は80度であり、疼痛なく独歩可能である。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J02438&link_issn=&doc_id=20201001180006&doc_link_id=%2Fcm4ortho%2F2020%2F003202%2F006%2F0247-0251%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2020%2F003202%2F006%2F0247-0251%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • Short-term outcomes of mirogabalin in patients with peripheral neuropathic pain: a retrospective study. 査読 国際誌

    Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Tomoyuki Takigawa, Kentaro Yamane, Hironori Tsuji, Yoshitaka Takei, Toshifumi Ozaki

    Journal of orthopaedic surgery and research   15 ( 1 )   191 - 191   2020年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin. METHODS: We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests. RESULTS: The mean age of the patients was 72.3 years (range, 30-94 years), and the mean duration of disease was 37 months (range, 3-252 months). After treatment with mirogabalin for 1 week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8 weeks, NRS scores improved by ≥ 30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. CONCLUSIONS: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.

    DOI: 10.1186/s13018-020-01709-3

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  • The factors driving self-efficacy in intractable chronic pain patients: a retrospective study. 査読 国際誌

    Hironori Tsuji, Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Haruo Misawa, Toshifumi Ozaki

    Journal of orthopaedic surgery and research   14 ( 1 )   473 - 473   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The fear-avoidance model is a theoretical paradigm for explaining acute and chronic pain. In this model, pain catastrophizing plays an important role. On the other hand, self-efficacy influences whether patients view their pain optimistically, ultimately preventing the conversion of pain into intractable pain. The aim of the present study was to evaluate the factors that influence self-efficacy in patients with chronic pain. METHODS: Study participants included 147 outpatients (35 men, 112 women) with intractable chronic pain who visited our hospital between September 2014 and July 2015. Their mean age was 71.0 (range 32-92) years. Pain sites were as follows: low back, 97 patients; knee, 71 patients; shoulder, 34 patients; and hip, 15 patients. All patients were assessed using the following measures: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). All participants were further divided into two groups based on median PSEQ scores (group L: PSEQ of 35 points or less, n = 74; group H: PSEQ greater than 35 points, n = 73). The factors that influenced self-efficacy in these patients were analyzed using univariate and multiple linear regression analyses. RESULTS: Significant differences were observed in gender; pain duration; and NRS, PDAS, HADS, and PCS scores between group L and group H. Multiple linear regression analysis revealed that self-efficacy was correlated with PDAS score, HADS depression score, and pain duration. CONCLUSIONS: Patients with longer pain duration indicated greater self-efficacy and patients with higher pain disability and depression exhibited lower self-efficacy.

    DOI: 10.1186/s13018-019-1535-9

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  • Minimally Invasive Percutaneous Spinopelvic Fixation for Unstable Pelvic Ring Fracture Performed With the Patient in a Lateral Position. 査読 国際誌

    Hironori Tsuji, Tomoyuki Takigawa, Haruo Misawa, Yasuyuki Shiozaki, Yasuaki Yamakawa, Tomoyuki Noda, Toshifumi Ozaki

    Clinical spine surgery   32 ( 5 )   191 - 197   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Spinopelvic fixation provides a strong fixation for unstable pelvic ring fractures. However, the technique is usually performed with the patient in the prone position, with the applied weight on the anterior superior iliac crests aggravating fracture displacement. We developed a novel approach for minimally invasive percutaneous spinopelvic fixation that is performed with the patient in a lateral (side lying) position. We describe the application of our technique for the treatment of a bilateral pelvic ring and acetabulum fracture in a 79-year-old woman injured in a traffic accident. Initial posterior fixation was performed with the patient in the left-side lying position, using bilateral pedicle screws at L3 and L4 and a left sacral-alar iliac screw and 2 right iliac screws inserted under navigation. The lateral and cranial displacement of the right pelvic ring was reduced percutaneously. One week after this initial surgery, we proceeded with an open anterior reduction and internal fixation of the left pelvic ring and acetabulum fracture. The postoperative course was uneventful and clinical outcomes were satisfactory. Reduction of a pelvic ring fracture in a lateral position, with subsequent spinopelvic fixation, is a reasonable option for the treatment of an unstable pelvic ring fracture.

    DOI: 10.1097/BSD.0000000000000798

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  • 「ロコモ・サルコペニアのup to date」 招待

    辻 寛謙

    テリボンWEBプラス講演会  2021年11月29日 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • サルコペニアと骨粗鬆症性骨折リスクとの関連~脊椎変性疾患術前患者における検討~

    辻 寛謙, 三澤, 治夫, 鉄永, 倫子, 山根, 健太郎, 小田, 孔明, 高尾, 真一郎, 梶木, 裕矢, 尾崎 敏文

    第24回日本低侵襲脊椎外科学会学術集会 シンポジウム「脊椎低侵襲手術とSarcopenia」  2021年11月25日 

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    会議種別:シンポジウム・ワークショップ パネル(指名)  

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  • 慢性疼痛とロコモティブシンドローム

    辻 寛謙

    第1回痛みセンター多職種連携研修会(岡山)  2020年9月16日 

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  • ロコモとは何ぞや

    辻 寛謙

    岡山県歯科衛生士会  2019年12月15日 

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受賞

  • 第11回OSG アワード

    2024年2月  

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  • 第2回児玉記念奨学会賞

    2023年6月  

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  • 第10回OSG アワード

    2020年2月  

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共同研究・競争的資金等の研究

  • 慢性期脳卒中後上肢麻痺の社会参加支援を目指した、運動位相同期型経脊髄磁気刺激リハビリテーション支援システムの開発

    2026年09月 - 2027年08月

    公益財団法人 橋本財団  2026年度1期 福祉機器等開発助成 

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    担当区分:研究代表者 

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  • 上肢運動機能再建を目的とした反復経頚椎磁気刺激法の機能的誘発運動評価

    2026年04月 - 2027年03月

    公益財団法人 渡邉財団  第32回磁気健康科学研究助成 

    辻 寛謙

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    担当区分:研究代表者 

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  • 中枢神経損傷に対する上肢運動機能再建を目的とした反復経頚椎磁気刺激法の基盤確立

    研究課題/領域番号:25K20958  2025年04月 - 2028年03月

    日本学術振興会  科学研究費助成事業  若手研究

    辻 寛謙

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    配分額:4940000円 ( 直接経費:3800000円 、 間接経費:1140000円 )

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  • 脊髄損傷治療に対する侵襲型人工神経接続 ― 臨床応用への挑戦 ―

    研究課題/領域番号:23KJ2192  2023年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業  特別研究員奨励費

    辻 寛謙

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    配分額:3900000円 ( 直接経費:3000000円 、 間接経費:900000円 )

    本研究課題は、脊髄損傷患者に対する侵襲型人工神経接続の実現を目的として開始された。本研究課題で計画している具体的な方法としては、運動不全麻痺を有する中枢神経損傷患者を対象に、麻痺筋から随意的に出力された微弱な筋活動を検出し、その信号を使って麻痺した筋肉を支配する脊髄領域に埋め込まれた硬膜外電極を通じて電気刺激を行う事を想定している。
    このシステムの実現に向けた第一段階として、「脊髄硬膜外電極からの電気刺激によって筋活動を誘発することが可能かを検証すること」を目的としたヒト実験を実施した。対象として、すでに慢性疼痛治療目的で頚髄硬膜外電極が埋め込まれている被験者を選定し、上肢の随意運動中に頚髄硬膜外電気刺激が筋活動に与える影響を検討した。被験者には右上肢を用いた運動課題(ボトルを移動させる、ダンベルを保持する)を実施し、その最中に頚髄硬膜外電気刺激を行った。筋活動は上肢の近位から前腕までの両側8筋ずつの表面筋電図を記録し、刺激条件は刺激周波数を10Hzに固定し、刺激部位は1つの電極対のみに電流を流し、これを電極対ごとに順次実施、刺激強度は被験者が不快に感じない範囲内で調整した。実験の結果、(1)右上肢随意運動中に頚髄硬膜外電気刺激を加えることで背景筋活動と比較して促通性の筋活動が誘発された、(2)その促通成分は刺激強度に依存して増強した、(3)C6髄節の背側正中やや右側に埋め込まれた硬膜外電極からの電気刺激により、右上肢全体及び対側である左上腕二頭筋にも筋活動が誘発されたという結果を得た。

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  • 進化分子工学的接着技術による成長因子コーティングインプラント創成と実用化への挑戦

    研究課題/領域番号:20K18064  2020年04月 - 2023年03月

    日本学術振興会  科学研究費助成事業 若手研究  若手研究

    辻 寛謙

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    2020年度はDOPAコーティングに使用する成長因子を探索した。IGF-1及びBMP-2の両者のDOPAコーティングスクリューを作成しラット骨内に挿入、IGF-1では骨形成がみられず、BMP-2で形成がみられる印象であった。その結果BMP-2コーティングの可能性を検索していく方針となった。
    2021年度はその流れを受けてBMP-2/DOPAコーティングインプラントの可能性を探っていった。BMP-2/DOPAコーティングスクリューのラット骨内埋入実験を行った。スクリュー挿入手技は10週SDラットのメスを使用し、全身麻酔下にラット脛骨内側を展開、脛骨を剥離し骨端線を確認。骨端線やや遠位に1.2mmドリルで骨孔作成し、スクリュー挿入し、閉創を行う手技で行った。両側脛骨にスクリューを挿入し、評価は全て左右差で検討を行った。
    術後2週、4週でサクリファイスを行い、評価項目としてはトルクテストによるスクリュー抜去時の最大トルク、μCTによる骨形成評価、病理組織切片を作成し、検討を行った。
    スクリュー抜去時のトルク評価はBMP-2/DOPAコーティングスクリューはコントロール群と比較して有意に術後2週、4週で抜去時のトルクが高い結果を得た。μCTによる骨形成評価はスクリュー周囲の骨形成評価を行った。術後2週では有意差を認めなかったが、術後4週で有意にBMP-2/DOPAコーティングスクリュー周囲の骨形成がみられた。病理学的検討は切片作成後であり今後詳細に検討を行う予定である。得られた結果は学会発表を行いフィードバックを受けた。今後は論文として公表する予定である。
    インプラント自体に成長因子を保持して骨癒合に有利に働かせるという発想は独自の発想であると考えており、将来的に高齢者にも使用可能なバックアウトしにくいインプラントを開発する事を目標として研究を続けていきたい。

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