Relationship Between Modic Changes and Sagittal Balance Parameters in the Cervical Spine.

BACKGROUND We explored the possible relationship between Modic changes (MCs) and sagittal parameters of the cervical spine. MATERIAL AND METHODS We enrolled 150 patients with cervical MC on the magnetic resonance imaging (MRI) scans in the MC (+) group and divided them into 3 sub-groups with 50 patients each: the MC1 sub-group, the MC2 sub-group, and the MC3 sub-group. Another 150 healthy subjects receiving routine health examinations were also enrolled in the study as the MC (-) group. The sagittal parameters in the cervical spine were measured and compared and multiple logistic regression analysis was performed to analyze the risk factor for the occurrence of MC. RESULTS Four cervical sagittal parameters were measured and compared between all the enrolled groups, including neck tilt (NT), T1 slope (T1s), thoracic inlet angle (TIA), and Cobb C2-C7. The results confirmed that the parameter of Cobb C2-C7 was much smaller in the MC(+) group when compared with that in the MC(-) group (P<0.05), while no significant differences were detected between the MC(+) and MC(-) groups for the parameters of NT, T1 T1s, and TIA (P>0.05). Multiple logistic regression analysis showed that Cobb C2-C7 (less than 8.5°) could be regarded as the risk factor for the occurrence of MC, and the receiver operating characteristic (ROC) curve showed that moderate diagnostic significance was obtained with an area under curve (AUC) of 0.82. CONCLUSIONS The present study demonstrated that Cobb C2-C7 (less than 8.5°) is a potential risk factor for the development of MC.

[Treatment of fresh subtrochanteric fracture combined with old femoral neck fracture with hemiarthoplasty through anterolateral approach].

OBJECTIVE: To explore the clinical effects of one-stage hemiarthroplasty in treating fresh subtrochanteric fracture combined with old femoral neck fracture. METHODS: From October 2003 to October 2013, 7 patients with fresh subtrochanteric fracture and old femoral neck fracture were treated with hemiarthroplasty in one stage. There were 5 males and 2 females, aged from 69 to 80 years old with an average of 74.5 years. According to the Garden classification, 2 cases were type IV and 5 cases were type V. According to the A0 classification of subtrochanteric fracture, all cases were type A1 (long oblique femoral subtrochanteric fractures). Biological coating long handle femoral prosthesis was used in the patients. The hip joint functions were assessed according to Charnley scoring system after all hemiarthroplasty. RESULTS: Seven patients were followed up from 12 to 24 months with an average of 18 months. There were 1 case with urinary system infection and 1 case with deep venous thrombosis. Of all, 5 cases recovered the walk ability at 6 months after operation and 2 cases could walk with the help of the crutch at 1 year after operation. According to Charnley scoring system to assess the hip joint function, the total Charnley scores reached 15.0±2.5, and 4 cases got an excellent results, 2 good, 1 fair. CONCLUSION: Arthroplasty through anterolateral approach can obtain satisfactory clinical effects in treating fresh subtrochanteric fracture combined with old femoral neck fracture, it has advantages of good joint stability, little pain, less complication, quickly recover, early activities on fields.