Objective To investigate the correlation between cervical Modic change (MC) and blood lipid and glucose levels. Methods Patients hospitalized with neck and shoulder pain in the Affiliated Hospital of North Sichuan Medical College between January 2015 and January 2021 were selected and divided into MC group and non-MC group according to whether the signal changes of cervical vertebral endplate occurred on MRI. The general data (age, gender, smoking history, drinking history), blood lipid indicators (high-density lipoprotein, low-density lipoprotein, lipoprotein a, total cholesterol, triglyceride) and blood glucose indicators (glycosylated hemoglobin, fasting blood glucose) were compared between the two groups. Multivariate logistic regression analysis was used to explore the correlation between MC and various indicators. Results A total of 160 patients were included, including 48 patients in MC group and 112 patients in non-MC group. The age [(61.46±12.10) vs. (56.22±10.65) years], total cholesterol [(5.06±1.17) vs. (4.44±1.31) mmol/L], triglyceride [(1.61±0.64) vs. (1.38±0.58) mmol/L], glycosylated hemoglobin (6.78%±1.27% vs. 5.79%±0.85%), and fasting blood glucose [(7.84±1.51) vs. (6.93±1.47) mmol/L] of the patients in MC group were significantly higher than those in non-MC group (P<0.05). There was no significant difference in gender, smoking ratio, drinking ratio, high-density lipoprotein, low-density lipoprotein or lipoprotein a between the two groups (P>0.05). Logistic regression analysisshowed that age [odds ratio (OR)=1.064, 95% confidence interval (CI) (1.022, 1.109), P=0.003], total cholesterol [OR=1.788, 95%CI (1.187, 2.694), P=0.005], triglyceride [OR=2.624, 95%CI (1.257, 5.479), P=0.010] and glycosylated hemoglobin [OR=4.942, 95%CI (2.446, 9.987), P<0.001] were risk factors of cervical MC. Conclusions Age, total cholesterol, triglyceride and glycosylated hemoglobin are risk factors of cervical MC. Elderly patients with hyperlipidemia and hyperglycemia should be alert to the occurrence of cervical MC. Controlling the levels of blood lipid and glucose may reduce the risk of cervical MC.
ObjectiveTo investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF).MethodsA clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. There was no significant difference in gender, age, body mass index, diseased segment, and preoperative hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio (INR) between the two groups (P>0.05). The hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, INR, the number of deep vein thrombosis of the lower extremities, operation time, intraoperative blood loss, postoperative drainage volume, total blood loss, and the time of drainage tube extubation in the two groups were recorded and compared.ResultsAll operations in the two groups were successfully completed. Compared with group B, the operation time and time of drainage tube extubation in group A were shortened, and the intraoperative blood loss, postoperative drainage volume, and total blood loss were reduced. The differences between the two groups were significant (P<0.05). None of the two groups received blood transfusion, and the hemoglobin level of group A at 24 hours after operation was significantly higher than that of group B (t=5.062, P=0.000). The incisions in both groups healed and sutures were removed within 2 weeks after operation, and no complications occurred. There was no significant difference between the two groups in activated partial thromboplastin time, prothrombin time, INR, and platelet count at 24 hours after operation (P>0.05).ConclusionIn multi-level continuous TOLF operation, intravenous administration of low-dose TXA can effectively reduce blood loss, shorten postoperative drainage time, and does not increase the risk of complications.