研究者詳細 - 岡本　昌士

論文 - 岡本　昌士

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Slot scanning 3D X-ray imagerを用いた立位脊柱骨盤アライメント評価に関する研究

岡本昌士

新潟大学(新大院博（保）) 2022年3月

The anterior center edge angle has limited ability to predict three-dimensional coverage of the femoral head in patients with developmental dysplasia of the hip undergoing curved periacetabular osteotomy 査読国際誌

Keisuke Uemura, Toshihito Hiraiwa, Masashi Okamoto, Kunihiko Tokunaga, Andrew E. Anderson

Archives of Orthopaedic and Trauma Surgery 143 ( 3 ) 1323 - 1330 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

INTRODUCTION: Femoral head coverage in patients with hip dysplasia (DDH) is typically quantified using 2D measurements of the lateral center edge angle (LCEA) and anterior center edge angle (ACEA). However, as the morphology of DDH is complex and varies between patients, 2D measurements may not predict the true 3D femoral head coverage. Herein, 2D and 3D coverage were quantified before and after curved periacetabular osteotomy (CPO) and their relationships were assessed. MATERIALS AND METHODS: Forty-three hips that underwent CPO for DDH were analyzed. For 2D evaluation, LCEA was quantified from X-rays and CT images. The ACEA was measured from CT images (CT-ACEA) and digitally reconstructed radiographs generated from CT images (DRR-ACEA). Three-dimensional coverage was quantified from CT reconstructions of the hip and evaluated in the anterior, superior, posterior, and inferior regions of the femoral head. Two-dimensional measurements were correlated to 3D coverage to assess their relationships. RESULTS: The median preoperative 3D percent coverage was 17.7, 36.1, 56.1, and 14.6% for the anterior, superior, posterior, and inferior region, respectively. After CPO, all LCEAs and ACEAs increased significantly (all p < 0.001). For the 3D coverage, anterior and superior coverage significantly increased while the posterior and inferior coverage decreased (all p < 0.001). Moderate to strong correlations were detected between the two LCEAs and the 3D superior coverage in both the preoperative and postoperative period. For the correlation between 3D anterior coverage, no significant correlation was found between the CT-ACEA while a moderate correlation was found between the DRR-ACEA (rs = 0.41, p = 0.023). CONCLUSIONS: Our results indicate that the LCEA can be used to predict 3D coverage in the superior region of the femoral head. However, as the CT-ACEA or DRR-ACEA had no or only moderate correlation between the 3D anterior coverage, these measurements are not recommended for evaluating/estimating the 3D anterior coverage in patients with DDH.

DOI： 10.1007/s00402-021-04258-4

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その他リンク： https://link.springer.com/article/10.1007/s00402-021-04258-4/fulltext.html

The Patient-Specific Combined Target Zone for Morpho-Functional Planning of Total Hip Arthroplasty 査読

Juliana Habor, Maximilian Fischer, Kunihiko Tokunaga, Masashi Okamoto, Klaus Radermacher

Journal of Personalized Medicine 11 ( 8 ) 817 - 817 2021年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

Background Relevant criteria for total hip arthroplasty (THA) planning have been introduced in the literature which include the hip range of motion, bony coverage, anterior cup overhang, leg length discrepancy, edge loading risk, and wear. The optimal implant design and alignment depends on the patient’s anatomy and patient-specific functional parameters such as the pelvic tilt. The approaches proposed in literature often consider one or more criteria for THA planning. but to the best of our knowledge none of them follow an integrated approach including all criteria for the definition of a patient-specific combined target zone (PSCTZ). Questions/purposes (1) How can we calculate suitable THA implant and implantation parameters for a specific patient considering all relevant criteria? (2) Are the resulting target zones in the range of conventional safe zones? (3) Do patients who fulfil these combined criteria have a better outcome score? Methods A method is presented that calculates individual target zones based on the morphology, range of motion and load acting on the hip joint and merges them into the PSCTZ. In a retrospective analysis of 198 THA patients, it was calculated whether the patients were inside or outside the Lewinnek safe zone, Dorr combined anteversion range and PSCTZ. The postoperative Harris Hip Scores (HHS) between insiders and outsiders were compared. Results 11 patients were inside the PSCTZ. Patients inside and outside the PSCTZ showed no significant difference in the HHS. However, a significant higher HHS was observed for the insiders of two of the three sub-target zones incorporated in the PSCTZ. By combining the sub-target zones in the PSCTZ, all PSCTZ insiders except one had an HHS higher than 90. Conclusions The results might suggest that, for a prosthesis implanted in the PSCTZ a low outcome score of the patient is less likely than using the conventional safe zones by Lewinnek and Dorr. For future studies, a larger cohort of patients inside the PSCTZ is needed which can only be achieved if the cases are planned prospectively with the method introduced in this paper. Clinical Relevance The method presented in this paper could help the surgeon combining multiple different criteria during THA planning and find the suitable implant design and alignment for a specific patient.

DOI： 10.3390/jpm11080817

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Influence of lumbosacral transitional vertebrae on spinopelvic parameters using biplanar slot scanning full body stereoradiography―analysis of 291 healthy volunteers 査読

Masashi Okamoto, Kazuhiro Hasegawa, Shun Hatsushikano, Koichi Kobayashi, Makoto Sakamoto, Masayuki Ohashi, Kei Watanabe

Journal of Orthopaedic Science 2021年5月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Elsevier BV

BACKGROUND: Proper identification of lumbosacral transitional vertebrae (LSTV) is important to characterize the relationship between the transitional segment and adjacent levels. Classical classification schemes are inaccurate with respect to the whole spine. We propose a precise vertebral numbering method and investigated the relationship between LSTV and whole-body sagittal alignment. METHODS: A total of 291 healthy adult volunteers with no history of spinal disease were evaluated with biplanar slot scanning full body stereoradiography to determine the prevalence of LSTV. Vertebrae were counted from the first cervical vertebra using both coronal and sagittal plane images. We then investigated the influence of LSTV on whole-body sagittal alignment in 279 participants. Whole-body key parameters descriptive statistics were compared among groups according to the number of vertebrae (L4, L5, and L6). Statistical analysis was performed between normal and LSTV cases using the Steel-Dwass analysis. RESULTS: Of the 291 subjects, 14 (4.8%) had 23 vertebrae and 16 (5.5%) had 25 vertebrae. Eleven (3.8%) had Th11, 3 (1.0%) had L4, and 1 (0.3%) had Th11 + L6, 16 (5.5%) had L6. Compared with the normal group, the sacral base in relation to the pelvis was higher in the L4 group and lower in the L6 group. The C2-C7 angle and lumbar lordosis (LL) were increased in both the L4 and L6 groups. All remaining parameters were decreased in the L4 group and increased in the L6 group. The relationship between LL and PI was similar in the normal and LSTV groups, despite the difference in the sacral base location. CONCLUSIONS: We propose a precise method for numbering the vertebrae using coronal and sagittal full body images. The spinopelvic parameters of the LSTV population significantly differed from those in the normal spine population due to differences in the sacral base location.

DOI： 10.1016/j.jos.2021.03.009

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Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment 査読

Yasuhito Takahashi, Kei Watanabe, Masashi Okamoto, Shun Hatsushikano, Kazuhiro Hasegawa, Naoto Endo

BMC Musculoskeletal Disorders 22 ( 1 ) 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

<title>Abstract</title><sec>
<title>Background</title>
Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters.

</sec><sec>
<title>Methods</title>
One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability.

</sec><sec>
<title>Results</title>
Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI (<italic>R</italic> = 0.96) and pelvic tilt (PT) (<italic>R</italic> = 0.92). PI could be predicted according to the regression equation: PI = − 9.92 + 0.905 * SIP (<italic>R</italic> = 0.9596, <italic>p</italic> < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age (<italic>R</italic> = 0.6033, <italic>p</italic> < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age (<italic>R</italic> = 0.6177, <italic>p</italic> < 0.001).

</sec><sec>
<title>Conclusions</title>
Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment.

</sec><sec>
<title>Trial registration</title>
This study was retrospectively registered with the UMIN Clinical Trials Registry (<ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049060">UMIN000042979</ext-link>; January 13, 2021).

</sec>

DOI： 10.1186/s12891-021-04093-z

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その他リンク： http://link.springer.com/article/10.1186/s12891-021-04093-z/fulltext.html

Preoperative factors improving the prediction of the postoperative sagittal orientation of the pelvis in standing position after total hip arthroplasty 査読

Maximilian C. M. Fischer, Kunihiko Tokunaga, Masashi Okamoto, Juliana Habor, Klaus Radermacher

Scientific Reports 10 ( 1 ) 2020年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

<title>Abstract</title>
The aims of this study were to investigate if the sagittal orientation of the pelvis (SOP) in the standing position changes after total hip arthroplasty (THA) and evaluate what preoperative factors may improve the prediction of the postoperative standing SOP in the context of a patient-specific functional cup orientation. 196 primary THA patients from Japan were retrospectively selected for this study. Computed tomography imaging of the pelvis, EOS imaging of the lower body and lateral radiographs of the lumbar spine in the standing position were taken preoperatively. Common biometrics and preoperative Harris Hip Score were recorded. The EOS imaging in the standing position was repeated three months following THA. A 3D/2.5D registration process was used to determine the standing SOP. Thirty-three preoperative biometric, morphological and functional parameters were measured. Important preoperative parameters were identified that significantly improve the prediction of the postoperative standing SOP by using multiple linear LASSO regression. On average, the SOP changed significantly (<italic>p</italic> < 0.001) between the preoperative and postoperative standing position three months after THA by 3° ± 4° in the posterior direction. The age, standing lumbar lordosis angle (LLA) and preoperative supine and standing SOP significantly (<italic>p</italic> < 0.001) improve the prediction of the postoperative standing SOP. The linear regression model for the prediction of the postoperative standing SOP is significantly (<italic>p</italic> < 0.001) improved by adding the parameters preoperative standing SOP and LLA, in addition to the preoperative supine SOP, reducing the root mean square error derived from a leave-one-out cross-validation by more than 1°. The mean standing SOP in Japanese patients changes already three months after THA in comparison to the preoperative value. The preoperative factors age, LLA, supine and standing SOP can significantly improve the prediction of the postoperative standing SOP and should be considered within the preoperative planning process of a patient-specific functional cup orientation.

DOI： 10.1038/s41598-020-72782-1

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その他リンク： http://www.nature.com/articles/s41598-020-72782-1

Correction surgery for adult spinal deformity improves not only spinopelvic alignment but also the three-dimensional alignment of the lower extremities 査読

Yusuke Sato, Kazuhiro Hasegawa, Masashi Okamoto, Shun Hatsushikano, Yoshinori Ishii, Kei Watanabe, Yasushi Oshima, Haruka Shimoda, Takao Homma

Journal of Orthopaedic Science 25 ( 6 ) 946 - 952 2020年11月

Bayesian U-netを用いた股関節形成不全症例の筋萎縮の評価

上村圭亮, 大竹義人, 岡本昌士, 徳永邦彦, 高尾正樹, 菅野伸彦, 佐藤嘉伸

日本コンピュータ外科学会誌 22 ( 4 ) 298 - 299 2020年11月

Compensation for standing posture by whole-body sagittal alignment in relation to health-related quality of life 査読国際誌

Kazuhiro Hasegawa, Masashi Okamoto, Shun Hatsushikano, Kei Watanabe, Masayuki Ohashi, Jean-Marc Vital, Jean Dubousset

The Bone & Joint Journal 102-B ( 10 ) 1359 - 1367 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：British Editorial Society of Bone & Joint Surgery

<sec><title>Aims</title> The aim of this study is to test the hypothesis that three grades of sagittal compensation for standing posture (normal, compensated, and decompensated) correlate with health-related quality of life measurements (HRQOL).

</sec><sec><title>Methods</title> A total of 50 healthy volunteers (normal), 100 patients with single-level lumbar degenerative spondylolisthesis (LDS), and 70 patients with adult to elderly spinal deformity (deformity) were enrolled. Following collection of demographic data and HRQOL measured by the Scoliosis Research Society-22r (SRS-22r), radiological measurement by the biplanar slot-scanning full body stereoradiography (EOS) system was performed simultaneously with force-plate measurements to obtain whole body sagittal alignment parameters. These parameters included the offset between the centre of the acoustic meatus and the gravity line (CAM-GL), saggital vertical axis (SVA), T1 pelvic angle (TPA), McGregor slope, C2-7 lordosis, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL, sacral slope (SS), pelvic tilt (PT), and knee flexion. Whole spine MRI examination was also performed. Cluster analysis of the SRS-22r scores in the pooled data was performed to classify the subjects into three groups according to the HRQOL, and alignment parameters were then compared among the three cluster groups.

</sec><sec><title>Results</title> On the basis of cluster analysis of the SRS-22r subscores, the pooled subjects were divided into three HRQOL groups as follows: almost normal (mean 4.24 (SD 0.32)), mildly disabled (mean 3.32 (SD 0.24)), and severely disabled (mean 2.31 (SD 0.35)). Except for CAM-GL, all the alignment parameters differed significantly among the cluster groups. The threshold values of key alignment parameters for severe disability were TPA > 30°, C2-7 lordosis > 13°, PI-LL > 30°, PT > 28°, and knee flexion > 8°. Lumbar spinal stenosis was found to be associated with the symptom severity.

</sec><sec><title>Conclusion</title> This study provides evidence that the three grades of sagittal compensation in whole body alignment correlate with HRQOL scores. The compensation grades depend on the clinical diagnosis, whole body sagittal alignment, and lumbar spinal stenosis. The threshold values of key alignment parameters may be an indication for treatment. Cite this article: Bone Joint J 2020;102-B(10):1359–1367.

</sec>

DOI： 10.1302/0301-620x.102b10.bjj-2019-1581.r2

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Etiology and clinical manifestations of double-level versus single-level lumbar degenerative spondylolisthesis 査読

Kazuhiro Hasegawa, Masashi Okamoto, Shun Hatsushikano, Haruka Shimoda, Yusuke Sato, Kei Watanabe

Journal of Orthopaedic Science 25 ( 5 ) 812 - 819 2020年9月

立位姿勢維持機構と健康関連QOL 全身骨アライメント・バランス・筋量の関与

長谷川和宏, 岡本昌士, 初鹿野駿, 下田晴華, 本間隆夫, 渡辺慶, 大橋正幸

日本整形外科学会雑誌 94 ( 8 ) S1778 - S1778 2020年9月

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination? 査読国際誌

Keisuke Uemura, Penny R. Atkins, Masashi Okamoto, Kunihiko Tokunaga, Andrew E. Anderson

Journal of Orthopaedic Research 38 ( 7 ) 1477 - 1485 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

Pelvic sagittal inclination (PSI) is often evaluated in patients with hip pathology using lateral radiographs. However, it would be useful if PSI could be predicted from an anteroposterior radiograph since this film is ubiquitous in the evaluation of hip pathology. Herein, computer-modeling was applied to predict PSI from radiographic measurements assessed in the anteroposterior plane. Three-dimensional surface models of the pelvis, femur, and sacrum were reconstructed from computed tomography images of 50 women with hip dysplasia. This study cohort was selected as changes in PSI alter femoral head coverage, which is relevant to the diagnosis and treatment of hip dysplasia, a known cause of hip osteoarthritis. Five radiographic parameters commonly used to independently estimate PSI were evaluated after bone surfaces were projected to an anteroposterior plane, including the symphysis to sacrococcygeal joint distance (S-S distance), the pelvic foramen aspect ratio (PF ratio), the distance between the symphysis and a line connecting the femoral head centers (S-H distance), the sacro-femoral-pubic angle (SFP angle), and the pelvic vertical ratio (PVR). Regression models determined the ability of these parameters to predict PSI from -20° to 20° at 1° increment. All five parameters showed a strong correlation with the PSI (all r > 0.9). From the regression models, PSI was estimated with a median (maximum) absolute error of 3.6° (18.4°), 3.8° (17.7°), 5.2° (17.9°), 5.8° (28.8°), and 3.2° (23.5°) for the S-S distance, PF ratio, S-H distance, SFP angle, and PVR, respectively. The regression model for S-S distance had a mean slope of 2.18 that ranged from 1.98 to 2.41 when the sacrococcygeal joint was located superior to the symphysis. Results indicated that substantial errors occur when estimating the actual value of PSI from an anteroposterior radiograph. However, the change in PSI could be estimated from the S-S distance, which may aid surgeons to successfully increase head coverage through periacetabular osteotomy and to locate the acetabular cup in a functional position for total hip arthroplasty.

DOI： 10.1002/jor.24701

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jor.24701

Relative position of sacral base in the pelvis and its correlation with spino-pelvic parameters 査読

Masashi Okamoto, Kazuhiro Hasegawa, Shun Hatsushikano, Kei Watanabe, Haruka Shimoda, Koichi Kobayashi, Makoto Sakamoto

European Spine Journal 29 ( 3 ) 446 - 454 2020年3月

Curved periacetabular osteotomy術前後における骨頭の2D、3D被覆に関して

上村圭亮, 岡本昌士, 徳永邦彦, Anderson Andrew

日本CAOS研究会・日本最小侵襲整形外科学会プログラム・抄録集 14回・26回 172 - 172 2020年3月

Patient-specific ROM and load-based target zone for total hip arthroplasty and its application in a retrospective analysis 査読

Juliana Habor, Maximilian, C.M. Fischer, Kunihiko Tokunaga, Masashi Okamoto, Klaus Rademacher

EPiC Series in Health Science 3 161 - 165 2019年10月

腰椎変性疾患に対する除圧術および固定術前後の立位全身矢状面アライメントおよびバランスの変化査読

初鹿野駿, 長谷川和宏, 岡本昌士, 佐藤雄亮, 下田晴華

Journal of Spine Research 10 ( 9 ) 1362 - 1366 2019年9月

Lumbar lordosis does not correlate with pelvic incidence in the cases with the lordosis apex located at L3 or above 査読

Osamu Tono, Kazuhiro Hasegawa, Masashi Okamoto, Shun Hatsushikano, Haruka Shimoda, Kei Watanabe, Katsumi Harimaya

European Spine Journal 28 ( 9 ) 1948 - 1954 2019年9月

Proximal femoral asymmetry in Japanese patients before total hip arthroplasty. 査読

Maximilian, C.M. Fischer, Kunihiko Tokunaga, Masashi Okamoto, Klaus Rademacher

EPiC Series in Health Science 3 127 - 132 2019年6月

Difference in whole spinal alignment between supine and standing positions in patients with adult spinal deformity using a new comparison method with slot-scanning three-dimensional X-ray imager and computed tomography through digital reconstructed radiography 査読

Kazuhiro Hasegawa, Masashi Okamoto, Shun Hatsushikano, Gabriel Caseiro, Kei Watanabe

BMC Musculoskeletal Disorders 19 ( 1 ) 2018年12月

Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images 査読

Masashi Okamoto, Fouad Jabour, Kenichiro Sakai, Shun Hatsushikano, J. C. Le Huec, Kazuhiro Hasegawa

European Radiology 28 ( 11 ) 4570 - 4577 2018年11月

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