Faculty Profiles - TETSUNAGA Tomoko

Papers - TETSUNAGA Tomoko

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岡山大学病院における頸椎損傷の急性期手術介入のタイミングに関する検討

魚谷弘二, 植田昌敬, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫, 尾崎敏文

中国・四国整形外科学会雑誌 34 ( 3 ) 437 - 437 2022.10

不全四肢麻痺を呈し,観血的整復固定を要した環軸椎回旋位固定の一例

植田昌敬, 魚谷弘二, 志渡澤央和, 小田孔明, 鉄永倫子, 三澤治夫

中国・四国整形外科学会雑誌 34 ( 3 ) 439 - 439 2022.10

Factors influencing caregiver burden in chronic pain patients: A retrospective study. International journal

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

Medicine 101 ( 39 ) e30802 2022.9

Language：English Publishing type：Research paper (scientific journal)

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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慢性疼痛患者を対象とした集学的治療における活動能力の継時的推移の類型化に関する検討

太田晴之, 齋藤圭介, 原田和宏, 京極真, 鉄永倫子, 西田圭一郎, 千田益生

Journal of Musculoskeletal Pain Research 14 ( 3 ) 171 - 181 2022.9

Language：Japanese Publisher：(一社)日本運動器疼痛学会

慢性疼痛患者における集学的治療が6ヵ月間可能であった集団の治療経過における継時的推移について,活動能力を指標に潜在プロフィール分析(Latent Profile Analysis:LPA)を用い集団を類型化すること,類型化された各集団の特徴について検討することである。結果,慢性疼痛患者において,活動能力の継時的推移は4つの集団に類型化できること,その治療経過は開始時の身体的パフォーマンスの状態で異なる治療経過を辿る可能性を明らかにした。(著者抄録)

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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. International journal

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

Medicine 101 ( 29 ) e29568 2022.7

Language：English Publishing type：Research paper (scientific journal)

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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【整形外科画像診断・評価の進歩】CT CTによる大腰筋評価と骨密度,骨折リスクとの関連

梶木裕矢, 辻寛謙, 三澤治夫, 鉄永倫子, 中原龍一, 尾崎敏文

整形外科 73 ( 6 ) 566 - 571 2022.5

Language：Japanese Publisher：(株)南江堂

＜文献概要＞はじめに高齢者の寝たきり率の増加は先進国の医学的,社会経済的問題となっている.この問題の原因として加齢による骨格筋の減少と骨粗鬆症性骨折があげられる.骨格筋量は40歳をすぎると毎年約1%減少すると報告されている.またサルコペニアは進行性の加齢に伴う骨格筋量と筋力の低下として定義され,日常生活動作の低下,生活の質の低下,死亡などの有害なアウトカムに関連している.European Working Group on Sarcopenia in Older People(EWGSOP)は,サルコペニアの診断に二重エネルギーX線吸収法(DXA)または生体電気インピーダンス分析(BIA)を使用し骨格筋指数を評価することを推奨している.一方,骨格筋量評価およびサルコペニアの診断にはCTの使用が有用であるとされ,CTベースのアプローチの一つであるL3椎体レベルでの骨格筋の総断面積を身長の二乗で除して求められる骨格筋指数は全身の骨格筋量と相関があることが報告されている.また最近の研究で,大腰筋指数(PMI)がより簡便な骨格筋量評価の方法として報告されている.これはL3椎体レベルでの左右の大腰筋面積の和を身長の二乗で除して測定される骨格筋指数であり,総骨格筋量と正の相関があり,サルコペニアの診断に有用であるとされている.骨粗鬆症は50歳以降の骨折の主要な原因の一つで,重篤で複雑な併存疾患を引き起こす可能性があり,骨量の減少,骨組織劣化,骨強度低下を特徴とする.骨粗鬆症の診断は主に骨塩量(BMD)に基づいて行う.BMDはDXAによって測定される単位面積当たりの骨に存在するミネラル成分の量であり,低BMDは骨強度の低下と脆弱性の増加による骨粗鬆症と骨折リスクの増加と相関している.世界保健機関(WHO)の基準によると,骨粗鬆症はTスコア(若年者の平均BMD標準値が0で標準偏差が1の指標)が-2.5以下の場合に診断される.骨折リスク評価ツール(FRAX)は,10年以内の骨粗鬆症性骨折および股関節骨折のリスクを予測するための国固有のアルゴリズムであり,2008年にWHOによって開発された.骨粗鬆症性骨折のリスクが15%以上の場合は予防的治療を開始することが推奨されている.近年DXAおよびBIAによって測定された骨格筋指数がBMDと正の相関関係があることが示されている.しかしながらCTで計測された骨格筋量とBMD,骨折リスクとの関連は明らかとなっていない.本研究の目的は,PMIとBMD,FRAXによって推定された骨折リスクとの相関を検討することである.

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00764&link_issn=&doc_id=20220527300013&doc_link_id=10.15106%2Fj_seikei73_566&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_seikei73_566&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Mechanical Study of Various Pedicle Screw Systems including Percutaneous Pedicle Screw in Trauma Treatment. International journal

Yoshiaki Oda, Tomoyuki Takigawa, Yasuo Ito, Haruo Misawa, Tomoko Tetsunaga, Koji Uotani, Toshifumi Ozaki

Medicina (Kaunas, Lithuania) 58 ( 5 ) 2022.4

Language：English Publishing type：Research paper (scientific journal)

Background and Objectives: Spine surgery using a percutaneous pedicle screw placement (PPSP) is widely implemented for spinal trauma. However, percutaneous systems have been reported to have weak screw-rod connections. In this study, conventional open and percutaneous systems were biomechanically evaluated and compared. Material and Methods: The experiments were performed in two stages: the first stage was a break test, whereas the second stage was a fatigue test. Four systems were used for the experiments. System 1 was intended for conventional open surgery (titanium rod with a 6.0 mm diameter, using a clamp connecting mechanism). System 2 was a percutaneous pedicle screw (PPS) system for trauma (titanium alloy rod with a 6.0 mm diameter, using ball ring connections). System 3 was a PPS system for trauma (cobalt-chromium alloy rod with a 6.0 mm diameter, using sagittal adjusting screw connections). System 4 was a general-purpose PPS system (titanium alloy rod with a 5.5 mm diameter, using a mechanism where the adapter in the head holds down the screw). Results: Stiffness values of 54.8 N/mm, 43.1 N/mm, 90.9 N/mm, and 39.3 N/mm were reported for systems 1, 2, 3, and 4, respectively. The average number of load cycles in the fatigue test was 134,393, 40,980, 1,550,389, and 147,724 for systems 1 to 4, respectively. At the end of the test, the displacements were 0.2 mm, 16.9 mm, 1.2 mm, and 8.6 mm, respectively. System 1, with a locking mechanism, showed the least displacement at the end of the test. Conclusion: A few PPS systems showed better results in terms on stiffness and life than the open system. The experiments showed that mechanical strength varies depending on the spinal implant. The experiments conducted are essential and significant to provide the mechanical strength required for surgical reconstruction.

DOI： 10.3390/medicina58050565

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脊椎手術を受ける患者から骨粗鬆症治療が必要な患者を見つけ出す

高尾真一郎, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 尾崎敏文

中部日本整形外科災害外科学会雑誌 65 ( 春季学会 ) 111 - 111 2022.4

慢性疼痛はコロナ禍における身体機能低下に与える影響は少ない

鉄永智紀, 鉄永倫子, 三澤治夫, 魚谷弘二, 小田孔明, 高尾真一郎, 梶木裕矢, 井上忠俊, 尾崎敏文, 田淵貴大

日本整形外科学会雑誌 96 ( 3 ) S781 - S781 2022.3

慢性疼痛はコロナ禍における身体機能低下に与える影響は少ない

鉄永智紀, 鉄永倫子, 三澤治夫, 魚谷弘二, 小田孔明, 高尾真一郎, 梶木裕矢, 井上忠俊, 尾崎敏文, 田淵貴大

日本整形外科学会雑誌 96 ( 3 ) S781 - S781 2022.3

三次元動作解析でみた2ステップテストと下肢体幹可動域の関連性

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 高尾真一郎, 梶木裕矢

日本整形外科学会雑誌 96 ( 3 ) S900 - S900 2022.3

関節リウマチ患者における胸腰椎手術後の術後合併症および再手術の検討

三澤治夫, 小田孔明, 魚谷弘二, 鉄永倫子, 高尾真一郎, 梶木裕矢, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 672 - 672 2022.3

骨密度と腸腰筋の各パラメーターとの関連 CT画像データを用いた検討

高尾真一郎, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 尾崎敏文, 梶木裕矢

日本整形外科学会雑誌 96 ( 3 ) S919 - S919 2022.3

単純CTによる脊椎転移脊柱管内進展の早期発見の可能性について

魚谷弘二, 三澤治夫, 梶木裕矢, 高尾真一郎, 小田孔明, 鉄永倫子, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 299 - 299 2022.3

2ステップテストにおける体幹と下肢の三次元動作解析

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 高尾真一郎, 梶木裕矢, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 318 - 318 2022.3

CT画像における腸腰筋評価と最大握力 DXAによる骨密度、骨折リスクとの関連

梶木裕矢, 三澤治夫, 鉄永倫子, 魚谷弘二, 小田孔明, 高尾真一郎, 尾崎敏文

Journal of Spine Research 13 ( 3 ) 568 - 568 2022.3

Psoas muscle index predicts osteoporosis and fracture risk in individuals with degenerative spinal disease. International journal

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 2022.1

Language：English Publishing type：Research paper (scientific journal)

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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麻痺性側彎側彎症を伴う重症脳性麻痺児のQOL評価

小田孔明, 三澤治夫, 鉄永倫子, 魚谷弘二, 赤澤啓史, 青木清, 尾崎敏文

日本小児整形外科学会雑誌 30 ( 3 ) S19 - S19 2021.11

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

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 2021.9

Language：English Publishing type：Research paper (scientific journal)

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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Comparison of the accuracy of CT- and accelerometer-based navigation systems for cup orientation in total hip arthroplasty. International journal

Tomonori Tetsunaga, Kazuki Yamada, Tomoko Tetsunaga, Takayuki Furumatsu, Tomoaki Sanki, Yoshi Kawamura, Toshifumi Ozaki

Hip international : the journal of clinical and experimental research on hip pathology and therapy 31 ( 5 ) 603 - 608 2021.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The accuracies of various navigation systems in total hip arthroplasty (THA) have been described; however, the accuracy of cup orientation with an accelerometer-based navigation system has not been reported. The purpose of this study was to compare the accuracies of computed tomography (CT)- and accelerometer-based navigation systems for cup orientation in THA. METHODS: In this prospective study, 30 patients who underwent cementless THA via anterolateral approach in the lateral decubitus position were analysed. A CT-based navigation system (30 hips) and an accelerometer-based navigation system (30 hips) were used simultaneously. The accuracy of cup orientation (absolute difference between intraoperative vs. postoperative measurements) was compared between the navigation systems using postoperative CT. RESULTS: The accuracy of cup inclination was 3.2 ± 2.4° in the CT-based navigation group and 4.1 ± 3.7° in the accelerometer-based navigation group (p = 0.3035). The accuracy of cup anteversion was 3.0° ± 2.5° in the CT-based navigation group and 6.8° ± 4.8° in the accelerometer-based navigation group. Cup anteversion was significantly more accurate with the CT-based navigation system than with accelerometer-based navigation (p = 0.0009). Multiple regression analysis demonstrated that the malposition in cup anteversion was positively correlated with the change in pelvic tilt and loosening of the reference antenna. CONCLUSIONS: Although, these results are only true for this specific accelerometer system, cup positioning was significantly more accurate with the CT-based navigation system than an accelerometer-based navigation in the lateral decubitus position. This is because of considerable discrepancies in the sagittal pelvic tilt, resulting in variability in cup anteversion angle with the use of an accelerometer-based navigation system.

DOI： 10.1177/1120700020904940

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