Hirofumi Kosaka’s scientific contributions in Lumbar Vertebrae and Lumbar Spine escoliosis lumbar levoconvexa

• la evolución con tratamiento conservador suele ser favorable, no hay diferencias significativas con la evolución de los pacientes sometidos a cirugía, 2 por lo cual la mayoría de los autores coincide en reservar el tratamiento quirúrgico para pacientes con compromiso neurológico o gran desplazamiento del fragmento hacia el canal, ya que se corre el riesgo de lesionar las estructuras de estabilización posteriores con la consiguiente inestabilidad residual. 2,5 como conclusión, se puede afirmar que es una patología poco frecuente, cuyo diagnóstico muchas veces se pasa por alto y que debe incluirse en el diagnóstico diferencial obligado de un atleta de alto rendimiento con dolor lumbar. El tratamiento conservador suele lograr un buen resultado a corto plazo y permite el retorno a la actividad competitiva, pero a mediano y largo plazo, lleva a cambios degenerativos articulares vertebrales.Escoliosis lumbar levoconvexa


[show abstract] [hide abstract] ABSTRACT: p>numerosos estudios han demostrado cambios radiológicos en columnas de jóvenes atletas, especialmente en aquellos deportes con altas cargas a nivel del raquis, como la lucha, gimnasia artística o deportes acuáticos de salto.

El objetivo del presente estudio es el reporte de la evolución de una gimnasta de elite con lesión del anillo apofisario y lesión consecuente del disco intervertebral. Para ello se realizó el seguimiento clínico y radiográfico de dicha paciente por 5 años.

La fractura del núcleo de osificación epifisario es una entidad muy rara, descrita excepcionalmente en la literatura. Existe un predominio en el varón y más frecuentemente en adolescentes y adultos jóvenes, que practican actividades deportivas de competición.Escoliosis lumbar levoconvexa las localizaciones más típicas son a nivel del margen inferior de L4, seguidas del margen superior de S1 y del superior de L5.

Es una patología poco frecuente, muchas veces subdiagnosticada que debe ser diagnostico diferencial obligado en un atleta de alto rendimiento con dolor lumbar. Y si bien el tratamiento conservador suele tener buen resultado a corto plazo permitiendo el retorno deportivo competitivo conduce a mediano y largo plazo a cambios degenerativos articulares vertebrales

[show abstract] [hide abstract] ABSTRACT: the aim of this study was to evaluate the influence of mechanical unloading on the repair of bone defects with implantation of biodegradable bone substitutes. Spherical granules of biodegradable hydroxyapatite composed of rod-shaped particles (RHA) or beta-tricalcium phosphate composed of rod-shaped particles (RTCP) were implanted into a bone defect created in the distal end of the right femur of 8-week-old wistar rats.Escoliosis lumbar levoconvexa two, 6, 10, and 22 weeks after implantation, part of the sciatic nerve in the thigh was resected and exposed to mechanical unloading for 2 weeks. Then, 4, 8, 12 and 24 weeks after implantation, repair of the bone defect was analyzed. As a control, the bone defect without implantation of ceramic granules was also analyzed. Both RHA and RTCP tended to be reduced, but the reduction was not obvious during the experimental period. At 12 and 24 weeks after implantation, the amount of newly formed bone in the animal implanted with RHA was significantly greater than that at 4 weeks after implantation, but that in the animal implanted with RTCP or without implantation was not significantly different. The number of osteoclasts in the region implanted with RHA was significantly larger than that of the region implanted with RTCP or without implantation at 12 and 24 weeks.Escoliosis lumbar levoconvexa the activities of alkaline phosphatase in osteoblasts and tartrate-resistant acid phosphatase in osteoclasts were remarkably increased in the bone defects with implantation compared with those in the bone defects without implantation. These results suggested that RHA stimulated osteogenesis and osteoclastogenesis even after 2 weeks of mechanical unloading, and that RHA could be expected to improve the repair of bone defects in patients under the condition of skeletal unloading.

[show abstract] [hide abstract] ABSTRACT: bony defects in the spine are divided into three main types: spondylolysis, pediculolysis, and laminolysis. Lumbar spondylolysis is a well-known stress fracture that occurs frequently in adolescent athletes. Pediculolysis means stress fracture of the pedicle, which sometimes occurs subsequent to unilateral spondylolysis.Escoliosis lumbar levoconvexa laminolysis is a rarely reported stress fracture similar to spondylolysis and pediculolysis that sometimes causes low back pain (LBP). However, its pathomechanism has not been elucidated. Recently, we encountered four adolescent athletes with symptomatic laminolysis. Mean age was 15.8 (range 15-17) years. All subjects reported severe LBP exacerbated by extension of the lumbar spine, and radiology revealed two types of laminolysis: hemilaminar type and intralaminar type. To elucidate the mechanisms of each type, we reviewed a biomechanical study, and found that the hemilaminar type was thought to be subsequent to contralateral spondylolysis, while the intralaminar type might be a result of a stress fracture due to repetitive extension loading.