12 results on '"Tomohiro YAMADA"'
Search Results
2. Low Nutrition before Injury Is a Risk Factor for Dysphagia in Older Patients with Cervical Spinal Cord Injury: Based on a Multicenter Data of 707 Patients
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Naoki Segi, Hiroaki Nakashima, Sadayuki Ito, Jun Ouchida, Noriaki Yokogawa, Takeshi Sasagawa, Toru Funayama, Fumihiko Eto, Kota Watanabe, Satoshi Nori, Takeo Furuya, Atsushi Yunde, Yoshinori Terashima, Ryosuke Hirota, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Kenichi Kawaguchi, Yohei Haruta, Ko Hashimoto, Yoshito Onoda, Kazuo Nakanishi, Kosuke Misaki, Shota Ikegami, Masashi Uehara, Hidenori Suzuki, Yasuaki Imajo, Hiroshi Uei, Hirokatsu Sawada, Hidetomi Terai, Koji Tamai, Akiyoshi Kuroda, Gen Inoue, Nobuyuki Suzuki, Kenji Kato, Koji Akeda, Norihiko Takegami, Yoichi Iizuka, Yasushi Oshima, Hitoshi Tonomura, Katsuhito Kiyasu, Haruki Funao, Toshitaka Yoshii, Masayuki Ishihara, Takashi Kaito, Shoji Seki, Kenichiro Kakutani, Hiroyuki Tominaga, Tetsuro Ohba, Daisuke Sakai, Bungo Otsuki, Masashi Miyazaki, Seiji Okada, Shiro Imagama, and Satoshi Kato
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dysphagia ,cervical spinal cord injury ,elderly patients ,geriatric nutritional risk index ,frailty index ,Surgery ,RD1-811 - Abstract
Introduction: For older adults, dysphagia is a serious problem that can occur after spinal cord injury (SCI), but its risk factors are unclear. This study aimed to identify risk factors for dysphagia in elderly patients (65 years) with cervical SCI. Methods: This multicenter study included 707 patients with cervical SCI (mean age 75.3 years). Univariate and multivariate analyses were conducted for patient characteristics and geriatric nutritional risk index (GNRI). Results: Dysphagia occurred in 69 patients (9.8%). The significant factors were as follows: male sex (odds ratio [OR] 3.43), GNRI
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- 2024
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3. Reshrinkage of Giant-Cell Tumor of the Bone in the Thoracic Vertebrae after Resumption of Denosumab Treatment: A Case Report
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Keika Nishi, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yuh Watanabe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama
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giant-cell tumor of the bone ,denosumab ,vertebral tumor ,ct-guided needle biopsy ,Surgery ,RD1-811 - Published
- 2024
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4. Cost-Effectiveness of Corrective Fusion Surgeries for Adult Spinal Deformities: Does Unexpected Revision Surgery Affect Cost-Effectiveness?
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Hideyuki Arima, Tomohiko Hasegawa, Yu Yamato, Masashi Kato, Go Yoshida, Tomohiro Banno, Shin Oe, Koichiro Ide, Tomohiro Yamada, Keiichi Nakai, Kenta Kurosu, and Yukihiro Matsuyama
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adult spinal deformity ,cost-effectiveness ,quality-adjusted life year ,corrective fusion surgery ,medical expenses ,spinal instrumentation ,revision surgery ,rod fractures ,Surgery ,RD1-811 - Abstract
Introduction: Previous research has demonstrated that mid- to long-term health-related quality of life following corrective fusion surgery for adult spinal deformity (ASD) can be improved by appropriate revision surgery. In this study, we aim to compare the cost-effectiveness of corrective fusion surgery for ASD with and without unexpected revision surgery 5 years postoperatively. Methods: In total, 79 patients with ASD (mean age, 68.7 years) who underwent corrective fusion surgery between 2013 and 2015 were included in this study. Cost-effectiveness was evaluated based on the cost of obtaining 1 quality-adjusted life year (QALY). Patients were divided into two groups according to the presence or absence of unexpected revision surgery following corrective fusion and were subjected for comparison. Results: As per our study findings, 26 (33%) of the 79 ASD patients underwent unexpected revision surgery during the first 5 years following surgery. Although there was no significant difference in terms of inpatient medical costs at the time of initial surgery for 5 years after surgery between the two groups (no-revision group, revision group; inpatient medical costs at the time of initial surgery: USD 69,854 vs. USD 72,685, P=0.344), the total medical expenses up to 5 years after surgery were found to be higher in the revision group (USD 72,704 vs. USD 104,287, P
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- 2024
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5. Psychological Factors Can Affect the Clinical Outcome of Chemonucleolysis with Condoliase in Patients with Lumbar Disk Herniation
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Tomohiro Banno, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama
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chemonucleolysis ,condoliase therapy ,lumbar disk herniation ,psychological factors ,Surgery ,RD1-811 - Abstract
Introduction: Condoliase-based chemonucleolysis is a minimally invasive intermediate treatment option between conservative approaches and surgical interventions for lumbar disk herniation (LDH). In this study, the effects of psychological factors on the clinical outcomes of condoliase therapy for LDH were assessed. Methods: This study involved patients with LDH who received condoliase injections over a 1-year follow-up period. Data from the visual analog scale (VAS) scores for leg and back pain, Oswestry Disability Index, and Hospital Anxiety and Depression Scale (HADS), which was utilized for the psychological assessment, were collected. Using magnetic resonance imaging, changes in disk height and degeneration were evaluated. Data were assessed at baseline and 1-month, 3-month, and 1-year follow-ups. Condoliase therapy was considered effective in patients whose VAS score for leg pain improved by 50% at 1 year from baseline and who did not require surgery. The patients were divided into two groups: those who reported effective treatment (Group E) and those who did not (Group I). Between these two groups, comparative analyses were carried out. Results: In this study, a total of 102 patients (70 men; mean age, 43.8±18.2 years) were included. Condoliase therapy was effective in 76 patients (74.5%). Thirty-five patients (34.3%) showed psychological factors (HADS-Anxiety [HADS-A]8 or HADS-Depression [HADS-D]8) preoperatively and had a significantly lower rate of effectiveness than did those without psychological factors. Group I demonstrated significantly higher baseline back pain VAS, HADS, and HADS-D scores when compared with Group E. Logistic regression analysis identified females and the baseline HADS-D score as independent factors that were related to the effectiveness of condoliase therapy. Conclusions: The patients with psychological factors tended to experience residual pain resulting in adverse effects on the clinical outcomes of chemonucleolysis with condoliase.
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- 2024
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6. Is Blood Loss Greater in Elderly Patients under Antiplatelet or Anticoagulant Medication for Cervical Spine Injury Surgery? A Japanese Multicenter Survey
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Masashi Uehara, Shota Ikegami, Takashi Takizawa, Hiroki Oba, Noriaki Yokogawa, Takeshi Sasagawa, Kei Ando, Hiroaki Nakashima, Naoki Segi, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Satoshi Nori, Kazuki Takeda, Takeo Furuya, Sumihisa Orita, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Hidetomi Terai, Koji Tamai, Eiki Shirasawa, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Yasuchika Aoki, Katsumi Harimaya, Hideki Murakami, Ken Ishii, Seiji Ohtori, Shiro Imagama, and Satoshi Kato
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cervical spine injury ,elderly patients ,blood loss volume ,comorbidity ,antiplatelet/anticoagulant drugs ,Surgery ,RD1-811 - Abstract
Introduction: In elderly patients with cervical spinal cord injury, comorbidities such as cardiovascular and cerebrovascular diseases are common, with frequent administration of antiplatelet/anticoagulant (APAC) drugs. Such patients may bleed easily or unexpectedly during surgery despite prior withdrawal of APAC medication. Few reports have examined the precise relationship between intraoperative blood loss and history of APAC use regarding surgery for cervical spine injury in the elderly. The present multicenter database survey aimed to answer the question of whether the use of APAC drugs affected the amount of intraoperative blood loss in elderly patients with cervical spinal cord trauma. Methods: The case histories of 1512 patients with cervical spine injury at 33 institutes were retrospectively reviewed. After excluding cases without spinal surgery or known blood loss volume, 797 patients were enrolled. Blood volume loss was the outcome of interest. We calculated propensity scores using the inverse probability of treatment weighting (IPTW) method. As an alternative sensitivity analysis, linear mixed model analyses were conducted as well. Results: Of the 776 patients (mean age: 75.1±6.4 years) eligible for IPTW calculation, 157 (20.2%) were taking APAC medications before the injury. After weighting, mean estimated blood loss was 204 mL for non-APAC patients and 215 mL for APAC patients. APAC use in elderly patients was not significantly associated with surgical blood loss according to the IPTW method with propensity scoring or linear mixed model analyses. Thus, it appeared possible to perform surgery expecting comparable blood loss in APAC and non-APAC cases. Conclusions: This multicenter study revealed no significant increase in surgical blood loss in elderly patients with cervical trauma taking APAC drugs. Surgeons may be able to prioritize patient background, complications, and preexisting conditions over APAC use before injury when examining the surgical indications for cervical spine trauma in the elderly.
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- 2022
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7. Incidence and Predictors of Postoperative Kyphotic Deformity after Thoracic Spinal Cord Tumor Resection
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Hideyuki Arima, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tomohiro Banno, Shin Oe, Yuki Mihara, Hiroki Ushirozako, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe, Keiichi Nakai, Kenta Kurosu, and Yukihiro Matsuyama
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thoracic spine ,spinal cord tumor ,kyphosis ,laminectomy ,laminoplasty ,fixation ,Surgery ,RD1-811 - Abstract
Introduction: Kyphotic deformity is common after spinal tumor resection surgery. An adequate field of view is needed to resect the spinal cord tumor, and, in some cases, the facet joint must be removed during laminectomy, and fixation may be performed simultaneously. In this study, we investigated the incidence of postoperative deformity after spinal tumor resection and the factors associated with postoperative deformity. Methods: We retrospectively analyzed patients who underwent thoracic spinal cord tumor resection at a single institution between 2010 and 2017 and were followed up for at least 24 months after surgery. Fifty percent or more of the facet joint was removed during the laminectomy, and fixation was performed simultaneously. Patients were divided into two groups, with and without kyphotic deformity. Patient demographic characteristics (age at surgery and gender), whether they underwent primary surgery or reoperation, tumor level, pathological type, and surgical method were compared. Multiple linear regression analysis was performed to identify independent predictors of kyphotic deformity. Results: Thirty-one patients were found to be eligible. Thirteen patients had intramedullary spinal cord tumors. Laminectomy was performed in 52% (N=16), laminoplasty in 6% (N=2), and laminectomy and/or laminoplasty combined with fusion in 42% (N=13) of the patients. During a mean follow-up period of 66.8 months, 12 (39%) patients had postoperative kyphosis deformities, of which one patient (3%, a 12-year-old girl who underwent combined postoperative radiation therapy) underwent kyphosis correction surgery three years after surgery. The number of laminectomies was independently associated with kyphotic deformity. Conclusions: Although kyphotic deformity after spinal tumor surgery was observed in about 39% of the patients, corrective surgery was rarely required due to the progression of the deformity. The high number of laminectomies is a risk factor for postoperative kyphosis, and prophylactic fixation may be considered in cases of multiple laminectomies.
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- 2022
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8. Influence of the Sagittal Vertical Axis on the Risk of Falls in Community-Dwelling Elderly People: A Retrospective Longitudinal Study
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Tomohiro Yamada, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Shin Oe, Hiroki Ushirozako, Koichiro Ide, Yuh Watanabe, and Yukihiro Matsuyama
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falls ,elderly dwelling people ,sagittal vertical axis ,Surgery ,RD1-811 - Abstract
Introduction: Falling is an age-related problem that increases with age. Compared with younger people, elderly people possess increased risk factors for falls, and falling among the elderly is associated with increased mortality. Risk factors for falls have been reported in elderly outpatients; however, whether sagittal spinal posture affect the risk of falls in community residents remains unclear. Therefore, we aimed to investigate the influence of sagittal spinal posture on the risk of falls in elderly community-dwelling people using spino-plevic sagittal parameters in a retrospective longitudinal study. Methods: A total of 463 volunteers (96 men and 367 women; mean age, 72.8 years) who underwent a routine physical checkup were evaluated. Baseline whole spine and lower limb radiography, physical tests, bone mineral density (BMD), number of medications and comorbidities, patient-reported outcomes (PROs), and a history of falls in the previous four years period were examined. Results: Univariate analysis revealed older age, lower height and weight, higher prevalence of vertebral fractures, higher number of medications, poor physical test scores including one-leg standing test and prone trunk extension, poor PROs, a higher sagittal vertical axis, and higher pelvic tilt (PT) as factors significantly associated with the risk of falls, and multivariate analysis revealed a higher sagittal vertical axis [odds ratio (OR), 1.08; 95% confidence interval (CI), 1.002-1.013; P = 0.02] and locomotive syndrome assessed using the 25-Question Geriatric Locomotive Function Scale score (OR, 1.028; 95% CI, 1.004-1.053; P = 0.03) to be associated with the risk of falls, independent of other factors in the univariate analysis. Conclusions: The sagittal vertical axis was an independent risk factor for falls, and the prevalence of vertebral fractures and prone truck extension correlated with the sagittal vertical axis. Prospective and intervention studies are needed to prevent future falls in elderly community volunteers with a higher sagittal vertical axis.
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- 2020
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9. Observable Recurrence of Cervicothoracic Neurenteric Cyst after Subtotal Resection: A Case Report
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Tomohiro Yamada, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Sho Kobayashi, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yuki Mihara, Hiroki Ushirozako, Daisuke Togawa, and Yukihiro Matsuyama
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neurenteric cysts ,cyst recurrence ,subtotal excision ,Surgery ,RD1-811 - Published
- 2020
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10. Brain Activation in a Cynomolgus Macaque Model of Chymopapain-Induced Discogenic Low Back Pain: A Preliminary Study
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Hiroki Ushirozako, Go Yoshida, Daisuke Togawa, Takao Omura, Tomohiko Hasegawa, Yu Yamato, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yuki Mihara, Tomohiro Yamada, Takahiro Natsume, Shinya Ogawa, Yuji Awaga, Hiroyuki Takamatsu, and Yukihiro Matsuyama
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chymopapain ,discogenic low back pain ,nonhuman primate ,pressure test ,brain activation ,functional magnetic resonance imaging ,secondary somatosensory cortex ,insular cortex ,Surgery ,RD1-811 - Abstract
Introduction: There is currently a lack of translatable, preclinical models of low back pain (LBP). Chymopapain, a proteolytic enzyme used to treat lumbar intervertebral disc (IVD) herniation, could induce discogenic LBP. The current study developed a behavioral model of discogenic LBP in nonhuman primates. Significant brain activation is observed in clinical LBP. Thus, the current study also sought to define brain activation over time in a macaque with discogenic LBP. Methods: Responses to pressure applied to the back at L4/L5 were measured in eight adult male Macaca fasciculata using a pressure algometer. The nucleus pulpous of the IVD between L4 and L5 was aspirated and chymopapain (1 mg/mL) was injected under fluoroscopic guidance (n = 2). In two macaques, the nucleus pulpous was only aspirated. Brain activation in response to pressure applied to the lower back was assessed using a 3.0T magnetic resonance imaging scanner in four macaques before and 1, 3, 9, and 14 days after treatment. Results: The mean (±SD) response pressure before treatment was 1.4 ± 0.1 kg. One day after chymopapain treatment, the response pressure decreased to 0.6 ± 0.05 kg (P < 0.01), suggestive of pressure hypersensitivity. Over time, the pressure thresholds following chymopapain treatment gradually returned to normal. Following aspiration only, the response pressure was 1.4 ± 0.05 kg, which was not significantly different from the uninjured controls. There was activation of the secondary somatosensory cortex and insular cortex one and three days after chymopapain treatment; there was no activation following aspiration only. Conclusions: Enzymatic treatment of the nucleus pulpous leads to acute LBP and pressure-evoked activation in pain-related brain areas. The current model of discogenic LBP parallels clinical LBP and could be used to further elaborate the mechanism of acute LBP.
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- 2019
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11. Observable Recurrence of Cervicothoracic Neurenteric Cyst after Subtotal Resection: A Case Report
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Yu Yamato, Hideyuki Arima, Hiroki Ushirozako, Go Yoshida, Sho Kobayashi, Yuki Mihara, Daisuke Togawa, Tatsuya Yasuda, Shin Oe, Yukihiro Matsuyama, Tomohiko Hasegawa, Tomohiro Banno, and Tomohiro Yamada
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medicine.medical_specialty ,business.industry ,Subtotal excision ,lcsh:Surgery ,Subtotal Resection ,lcsh:RD1-811 ,Clinical Correspondence ,Surgery ,subtotal excision ,Medicine ,Orthopedics and Sports Medicine ,Neurology (clinical) ,Neurenteric cyst ,neurenteric cysts ,business ,cyst recurrence - Published
- 2020
12. Brain Activation in a Cynomolgus Macaque Model of Chymopapain-Induced Discogenic Low Back Pain: A Preliminary Study
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Daisuke Togawa, Yukihiro Matsuyama, Tomohiro Banno, Tomohiko Hasegawa, Go Yoshida, Hiroyuki Takamatsu, Hiroki Ushirozako, Tomohiro Yamada, Takao Omura, Shin Oe, Yuki Mihara, Yu Yamato, Hideyuki Arima, Takahiro Natsume, Shinya Ogawa, and Yuji Awaga
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pressure test ,lcsh:Surgery ,chymopapain ,nonhuman primate ,Insular cortex ,Chymopapain ,Macaque ,03 medical and health sciences ,0302 clinical medicine ,biology.animal ,medicine ,Orthopedics and Sports Medicine ,030203 arthritis & rheumatology ,medicine.diagnostic_test ,biology ,Secondary somatosensory cortex ,business.industry ,Proteolytic enzymes ,Magnetic resonance imaging ,lcsh:RD1-811 ,Low back pain ,functional magnetic resonance imaging ,secondary somatosensory cortex ,Anesthesia ,brain activation ,insular cortex ,biology.protein ,Surgery ,Original Article ,Neurology (clinical) ,medicine.symptom ,Functional magnetic resonance imaging ,business ,030217 neurology & neurosurgery ,discogenic low back pain - Abstract
Introduction: There is currently a lack of translatable, preclinical models of low back pain (LBP). Chymopapain, a proteolytic enzyme used to treat lumbar intervertebral disc (IVD) herniation, could induce discogenic LBP. The current study developed a behavioral model of discogenic LBP in nonhuman primates. Significant brain activation is observed in clinical LBP. Thus, the current study also sought to define brain activation over time in a macaque with discogenic LBP. Methods: Responses to pressure applied to the back at L4/L5 were measured in eight adult male Macaca fasciculata using a pressure algometer. The nucleus pulpous of the IVD between L4 and L5 was aspirated and chymopapain (1 mg/mL) was injected under fluoroscopic guidance (n = 2). In two macaques, the nucleus pulpous was only aspirated. Brain activation in response to pressure applied to the lower back was assessed using a 3.0T magnetic resonance imaging scanner in four macaques before and 1, 3, 9, and 14 days after treatment. Results: The mean (±SD) response pressure before treatment was 1.4 ± 0.1 kg. One day after chymopapain treatment, the response pressure decreased to 0.6 ± 0.05 kg (P < 0.01), suggestive of pressure hypersensitivity. Over time, the pressure thresholds following chymopapain treatment gradually returned to normal. Following aspiration only, the response pressure was 1.4 ± 0.05 kg, which was not significantly different from the uninjured controls. There was activation of the secondary somatosensory cortex and insular cortex one and three days after chymopapain treatment; there was no activation following aspiration only. Conclusions: Enzymatic treatment of the nucleus pulpous leads to acute LBP and pressure-evoked activation in pain-related brain areas. The current model of discogenic LBP parallels clinical LBP and could be used to further elaborate the mechanism of acute LBP.
- Published
- 2019
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