Study Design: Global Survey Objective: To determine the accuracy, interobserver reliability, and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeons’ AO Spine region of practice (Africa, Asia, Central/South America, Europe, Middle East, and North America). Methods: A total of 275 AO Spine members assessed 25 upper cervical spine injuries and classified them according to the AO Spine Upper Cervical Injury Classification System. Reliability, reproducibility, and accuracy scores were obtained over two assessments administered at three-week intervals. Kappa coefficients (ƙ) determined the interobserver reliability and intraobserver reproducibility. Results: On both assessments, participants from Europe and North America had the highest classification accuracy, while participants from Africa and Central/South America had the lowest accuracy (P <.0001). Participants from Africa (assessment 1 (AS1):ƙ =.487; AS2:0.491), Central/South America (AS1:ƙ =.513; AS2:0.511), and the Middle East (AS1:0.591; AS2:.599) achieved moderate reliability, while participants from North America (AS1:ƙ =.673; AS2:0.648) and Europe (AS1:ƙ =.682; AS2:0.681) achieved substantial reliability. Asian participants obtained substantial reliability on AS1 (ƙ =.632), but moderate reliability on AS2 (ƙ =.566). Although there was a large effect size, the low number of participants in certain regions did not provide adequate certainty that AO regions affected the likelihood of participants having excellent reproducibility (P =.342). Conclusions: The AO Spine Upper Cervical Injury Classification System can be applied with high accuracy, interobserver reliability, and intraobserver reproducibility. However, lower classification accuracy and reliability were found in regions of Africa and Central/South America, especially for severe atlas injuries (IIB and IIC) and atypical hangman’s type fractures (IIIB injuries). © The Author(s) 2022.

Study Design: Survey Objective: In March of 2020, an original study by Louie et al investigated the impact of COVID-19 on 902 spine surgeons internationally. Since then, due to varying government responses and public health initiatives to the pandemic, individual countries and regions of the world have been affected differently. Therefore, this follow-up study aimed to assess how the COVID-19 impact on spine surgeons has changed 1 year later. Methods: A repeat, multi-dimensional, 90-item survey written in English was distributed to spine surgeons worldwide via email to the AO Spine membership who agreed to receive surveys. Questions were categorized into the following domains: demographics, COVID-19 observations, preparedness, personal impact, patient care, and future perceptions. Results: Basic respondent demographics, such as gender, age, home demographics, medical comorbidities, practice type, and years since training completion, were similar to those of the original 2020 survey. Significant differences between groups included reasons for COVID testing, opinions of media coverage, hospital unemployment, likelihood to be performing elective surgery, percentage of cases cancelled, percentage of personal income, sick leave, personal time allocation, stress coping mechanisms, and the belief that future guidelines were needed (P<.05). Conclusion: Compared to baseline results collected at the beginning of the COVID-19 pandemic in 2020, significant differences in various domains related to COVID-19 perceptions, hospital preparedness, practice impact, personal impact, and future perceptions have developed. Follow-up assessment of spine surgeons has further indicated that telemedicine and virtual education are mainstays. Such findings may help to inform and manage expectations and responses to any future outbreaks. © The Author(s) 2022.

Background:

Vertebral abnormalities in offspring of diabetic mothers make major challenges worldwide and were not sufficiently studied before.

Aim:

To investigate the effects of alloxan-induced diabetes on rats’ lumbar vertebrae, and to assess the potential beneficial impact of arachidonic acid.

Materials and Methods:

Pregnant rats were randomly equally divided into four groups: control, alloxan-induced diabetes received alloxan injection 150 mg/kg, alloxan+ arachidonic acid group received arachidonic acid 10 μg/animal then given alloxan injection, and arachidonic acid group received it, until offspring age of three weeks. Six male offspring from each group were included in this study at ages of newborn, threeweek-old, two-month-old, and their body measurements were recorded. Lumbar vertebrae and pancreas specimens were examined by light microscopy, morphometry, transmission electron microscopy

Background: Apremilast (Apre), a novel phosphodiesterase-4 (PDE4) inhibitor, has been shown to have antiinflammatory, immunomodulator, neuroprotective and senolytic properties, therefore, Apre like other PDE4 inhibitors may be a promising candidate for treatment of Alzheimer’s disease (AD).
Objective: To evaluate the effectiveness of Apre on Alzheimer’s like pathology and symptoms in an animal model.
Methods: The effects of Apre and cilostazol, a reference drug, on the behavioral, biochemical, and pathological features of Alzheimer’s disease induced by a high-fat/high-fructose diet combined with low-dose streptozotocin
(HF/HFr/L-STZ) were investigated.
Result: Apre 5 mg/kg IP/day for 3 consecutive days per week for 8 weeks attenuated memory and learning deficits tested by novel object recognition, Morris water maze and passive avoidance tests. Apre treatment significantly decreased the number of degenerating cells, and abnormal suppression of gene expression of AMPA
and NMDA receptor subunits in the cortex and hippocampus of the AD rat model compared to rats that received vehicle. A significant decrease in elevated levels of hippocampal amyloid beta, tau-positive cell count, cholinesterase activity, and hippocampal caspase-3, a biomarker of neurodegeneration, was also observed after
treatment with Apre in AD rats compared to rats that received placebo. Furthermore, a significant decrease in pro-inflammatory cytokines, oxidative stress, insulin resistance and GSK-3 was demonstrated in AD aged rats treated by Apre.
Conclusion: Our findings demonstrate that intermittent treatment with Apre can enhance cognitive function in HF/HFr/L-STZ rats which may be related to decreased pro-inflammatory cytokines, oxidative stress, insulin resistance and GSK-3β.