Dietary chamomile flowers extract improved performance and mitigated aflatoxin B1 toxicity in rabbits.

Aflatoxin B1 (AFB1) is among the poisonous mycotoxins that contaminate food and feed. Limited studies are available on the efficacy of chamomile (Cha) against oxidative stress, liver damage and pro-inflammatory response induced by AFB1. The present study aims to evaluate the effects of Cha on the performance and protective effects against AFB1 in growing rabbits. The experimental rabbits were divided into four different groups, including Cha (70 mg kg day-1), AFB1 (AF; 30 µg kg day-1), AFB1+Cha (AFLCha) and control (CON). The results indicated that the AFB1 treatment had lower values of performance, and carcass parameters compared to the Cha and AFLCha treatments. Furthermore, the Cha and AFLCha groups had lower values of liver and kidney function activities compared to the AFB1 treatment. The higher values of antioxidant enzymes were observed in Cha and AFLCha treatments than in the AFB1 treatment. AFB1 treatments had higher levels of malondialdehyde and liver functions with lower levels of antioxidant enzymes (glutathione and superoxide dismutase) compared to Cha and CON groups. In conclusion, dietary Cha could mitigate the oxidative stress of AFB1-induced liver deterioration.

Antitrypanosomal, Antitopoisomerase-I, and Cytotoxic Biological Evaluation of Some African Plants Belonging to Crassulaceae; Chemical Profiling of Extract Using UHPLC/QTOF-MS/MS.

In our continuous study for some African plants as a source for antitrypanosomally and cytotoxic active drugs, nine different plants belonging to the Crassulaceae family have been selected for the present study. Sedum sieboldii leaves extract showed an antitrypanosomal activity against Trypanosoma brucei with an IC50 value of 8.5 µg/mL. In addition, they have cytotoxic activities against (HCT-116), (HEPG-2) and (MCF-7), with IC50 values of 28.18 ± 0.24, 22.05 ± 0.66, and 26.47 ± 0.85 µg/mL, respectively. Furthermore, the extract displayed inhibition against Topoisomerase-1 with an IC50 value of 1.31 µg/mL. It showed the highest phenolics and flavonoids content among the other plants' extracts. In order to identify the secondary metabolites which may be responsible for such activities, profiling of the polar secondary metabolites of S. sieboldii extract via Ultra-Performance Liquid Chromatography coupled to High-Resolution QTOF-MS operated in negative and positive ionization modes, which revealed the presence of 46 metabolites, including flavonoids, phenolic acids, anthocyanidins, coumarin, and other metabolites.

Dinebra retroflexa Herbal Phytotherapy: A Simulation Study Based on Bleomycin-Induced Pulmonary Fibrosis Retraction Potential in Swiss Albino Rats.

Background and Objectives: Fibrotic lung disease is one of the main complications of many medical conditions. Therefore, the use of anti-fibrotic agents may provide a chance to prevent, or at least modify, such complication. The aim of this study was to evaluate the protective pulmonary anti-fibrotic and anti-inflammatory effects of Dinebra retroflexa. Materials and methods: Dinebra retroflexa methanolic extract and its synthesized silver nanoparticles were tested on bleomycin-induced pulmonary fibrosis. Pulmonary fibrosis was induced by intratracheal instillation of bleomycin (5 mg/5 mL/kg-Saline) as a supposed model for induced lung fibrosis. The weed evaluation was performed by intratracheal instillation of Dinebra retroflexa methanolic extract and its silver nanoparticles (35 mg/100 mL/kg-DMSO, single dose). Results: The results showed that both Dinebra retroflexa methanolic extract and its silver nanoparticles had a significant pulmonary fibrosis retraction potential, with Ashcroft scores of three and one, respectively, and degrees of collagen deposition reduction of 33.8 and 46.1%, respectively. High-resolution UHPLC/Q-TOF-MS/MS metabolic profiling and colorimetrically polyphenolic quantification were performed for further confirmation and explanation of the represented effects. Such activity was believed to be due to the tentative identification of twenty-seven flavonoids and one phenolic acid along with a phenolic content of 57.8 mg/gm (gallic acid equivalent) and flavonoid content of 22.5 mg/gm (quercetin equivalent). Conclusion: Dinebra retroflexa may be considered as a promising anti-fibrotic agent for people at high risk of complicated lung fibrosis. The results proved that further clinical trials would be recommended to confirm the proposed findings.

Effect of virtual cement gap settings on the marginal fit of cemented resin-ceramic crowns on implant abutments.

STATEMENT OF PROBLEM: Agreement on the perfect virtual cement space value for computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported resin-ceramic crowns with the best marginal adaptation is lacking. The range of cement gap settings in some CAD design software programs is wide (0 to 200 µm), and manufacturer recommendations regarding the best cement gap setting for certain types of ceramics is not specific. PURPOSE: The purpose of this in vitro study was to evaluate the effect of virtual cement gap settings on the marginal fit of cemented resin-ceramic crowns on implant abutments. MATERIAL AND METHODS: Thirty implant analogs and matching stock abutments were coupled and implanted into autopolymerizing acrylic resin blocks. Three groups (n=10) of resin-ceramic molar crowns with 3 different virtual cement space settings (40, 60, and 100 µm) were designed by using a CAD design software program. The crowns were cemented over their corresponding abutments under a static load by using a specially designed cementing device. A scanning electron microscope was used to measure the mean vertical marginal gap (MG) for each group, where a total of 120 measurements for each of the 3 groups (12 sites per crown and 10 crowns per group) were evaluated. One-way analysis of variance and the post hoc Tukey pairwise comparison tests were used to analyze the data (α=.05). RESULTS: A significant difference (P<.001) was found between the MG values of the resin-ceramic implant-supported crowns fabricated by using the 3 cement space settings. The smallest MG was obtained with the 60-µm setting as compared with the 40-µm and 100-µm settings. CONCLUSIONS: A limited inverse relation was found between the MGs of CAD-CAM-fabricated resin-ceramic implant-supported crowns and the cement gap settings in the exocad software program. The smallest MGs were obtained when a 60-µm cement space value was used (P<.001).

Phytochemical Profiling, In Vitro and In Silico Anti-Microbial and Anti-Cancer Activity Evaluations and Staph GyraseB and h-TOP-IIß Receptor-Docking Studies of Major Constituents of Zygophyllum coccineum L. Aqueous-Ethanolic Extract and Its Subsequent Fractions: An Approach to Validate Traditional Phytomedicinal Knowledge.

Zygophyllum coccineum, an edible halophytic plant, is part of the traditional medicine chest in the Mediterranean region for symptomatic relief of diabetes, hypertension, wound healing, burns, infections, and rheumatoid arthritis pain. The current study aimed to characterize Z. coccineum phytoconstituents, and the evaluations of the anti-microbial-biofilm, and anti-cancers bioactivities of the plant's mother liquor, i.e., aqueous-ethanolic extract, and its subsequent fractions. The in silico receptors interaction feasibility of Z. coccineum major constituents with Staph GyraseB, and human topoisomerase-IIß (h-TOP-IIß) were conducted to confirm the plant's anti-microbial and anti-cancer biological activities. Thirty-eight secondary metabolites of flavonoids, stilbene, phenolic acids, alkaloids, and coumarin classes identified by LC-ESI-TOF-MS spectrometric analysis, and tiliroside (kaempferol-3-O-(6''''-p-coumaroyl)-glucoside, 19.8%), zygophyloside-F (12.78%), zygophyloside-G (9.67%), and isorhamnetin-3-O-glucoside (4.75%) were identified as the major constituents. A superior biofilm obliteration activity established the minimum biofilm eradication concentration (MBEC) for the chloroform fraction at 3.9-15.63 µg/mL, as compared to the positive controls (15.63-31.25 µg/mL) against all the microbial strains that produced the biofilm under study, except the Aspergillus fumigatus. The aqueous-ethanolic extract showed cytotoxic effects with IC50 values at 3.47, 3.19, and 2.27 µg/mL against MCF-7, HCT-116, and HepG2 cell-lines, respectively, together with the inhibition of h-TOP-IIß with IC50 value at 45.05 ng/mL in comparison to its standard referral inhibitor (staurosporine, IC50, 135.33 ng/mL). This conclusively established the anti-cancer activity of the aqueous-ethanolic extract that also validated by in silico receptor-binding predicted energy levels and receptor-site docking feasibility of the major constituents of the plant's extract. The study helped to authenticate some of the traditional phytomedicinal properties of the anti-infectious nature of the plant.

Measurement and Analysis of Biomechanical Outcomes of Chiropractic Adjustment Performance in Chiropractic Education and Practice.

OBJECTIVE: The purpose of this study was to compare biomechanical measures of chiropractic adjustment performance of the McTimoney toggle-torque-recoil (MTTR) technique among students and chiropractors. METHODS: Fifty-three participants (15 year-3 [Y3] and 16 year-5 chiropractic students and 22 McTimoney chiropractors [DCs]) participated in this study. Each applied 10 MTTR thrusts to a dynamic load cell, 5 each with their left and right hands. Biomechanical variables including preload force, peak force, time to peak force, thrust duration, and total thrust time were computed from each of the force-time histories and compared within groups using a series of 2-way analysis of variance to evaluate the effects of sex and handedness, and between groups to determine the effect of experience using a series of 3-way analysis of variance. The Games-Howell post hoc test was used to further assess pairwise comparisons. RESULTS: Mean time to peak force was more than 3 × shorter for DCs (69.96 ms) compared with Y3 students (230.36 ms) (P = .030). Likewise, mean thrust duration was also found to be nearly 2.5-fold significantly shorter for DCs (117.77 ms) compared with Y3 students (283.84 ms) (P = .030). The DCs took significantly less total thrust time (mean = 1.27 seconds) in administering MTTR thrusts than Y3 students (1.89 seconds) (P = .006). No significant differences were found among any of the 3 clinician groups for peak force or in time to peak force or thrust duration for comparisons of all 10 MTTR thrusts among year-5 students and DCs. Higher peak forces were observed for thrusts delivered with clinicians' dominant hands (P = .001), and the fastest thrusts were found for the dominant hands of DCs (P = .001). Sex had no significant effect on biomechanical variables. The Y3 students had significant greater variability in thrust times for each hand and for analyses of both hands combined (P = .001). CONCLUSION: Training and experience were found to result in shorter MTTR thrust times and other biomechanical variables that have been identified as important factors in the mechanisms of chiropractic adjustments. Identification of such biomechanical markers as performance outcomes may be of assistance in providing feedback for training in chiropractic education and technique application.

Anti-Oral Pathogens of Tecoma stans (L.) and Cassia javanica (L.) Flower Volatile Oils in Comparison with Chlorhexidine in Accordance with Their Folk Medicinal Uses.

Background and Objectives: Teeth decay and plaque are complicated problems created by oral pathogens. Tecoma stans (L.) and Cassia javanica (L.) are two ornamental evergreen plants widely distributed in Egypt. These plants are traditionally used for oral hygienic purposes. This study aims to elucidate the volatile oil constituents obtained from the flowers of these plants and evaluate the antimicrobial activity of these volatile oils against specific oral pathogens in comparison to chlorhexidine. Materials and Methods: The flowers obtained from both plants were extracted by n-hexane. GC-MS spectrometry was used to identify the constituents. Minimum inhibitory concentrations (MICs) were measured using tetrazolium salt (2,3-bis[2-methyloxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxanilide) (XTT). Results: GC-MS analysis revealed the presence of 32 and 29 compounds, representing 100% of the volatile constituents of Tecoma stans and Cassia javanica, respectively. The GC-MS analysis showed more than 60% of the volatile oil constituents are represented in both plants with different proportions. Chlorhexidine exerted stronger activity than tested plants against all microorganisms. Cassia javanica flower extract was more active against all tested microorganisms than Tecoma stans. Of note was the effect on Streptococcus mutans, which was inhibited by 100% at 12.5 and 25 µg/mL of Cassia javanica and Tecoma stans, respectively. The growth of Lactobacillus acidophilus was also completely inhibited by 25 µg/mL of the Cassia javanica extract. MIC90 and MIC were also calculated, which revealed the superiority of Cassia javanica over Tecoma stans against all tested oral pathogens. Conclusion: Cassia javanica flower volatile oils showed a potential anti-oral pathogen activity at relatively low concentrations. Also, Cassia javanica and Tecoma stans demonstrated a strong activity against tooth decay's notorious bacteria Streptococcus mutans. Both plants can be potential substituents to chlorhexidine. Formulating the constituents of these plants in toothpastes and mouthwashes as anti-oral pathogen preparations can be an interesting future plan.

Tracking the Variations in Trace and Heavy Elements in Smoking Products Marketed in Oman and Egypt: Risk Assessment After Implementation of Constraining Protocols.

Tobacco smoking is becoming one of the major worldwide concerns regarding environmental pollution as well as health threats. In 2005, the World Health Organization (WHO) released the Framework Convention On Tobacco Control (FCTC), which outlined protocols for controlling tobacco products. Oman was one of the leading countries to follow these protocols; however, Egypt has only followed these protocols recently in 2020. One of the main challenges in tobacco product control is the variation in their trace element's types and amounts from country to country owing to differences in agriculture techniques and used chemical additives. Smoking releases different toxic metal ions found in them into the air, and hence, analyzing trace amounts of metals in tobacco smoking products is becoming more critical. The proposed research aims to evaluate the current levels of 11 heavy metals (namely, As, Pb, Cd, Co, Cr, Be, Ba, Mn, Ni, Fe, and Hg) in 22 tobacco products available in Egypt and Oman using inductively coupled plasma optical emission spectroscopy and a direct mercury analyzer. Although some elements such as Be, Co, and Cd were absent, the positive detection of As and Pb and the levels of Ba, Cr, and Ni are still alarming, especially for heavy smokers. The obtained results were then statistically related to previously published data in 2017 to explore the effectiveness of implementing the FCTC protocols within the Egyptian market. The outcomes suggested a positive impact of FCTC protocol implementation in Egypt, besides the lower levels of elemental content for Omani products compared to the Egyptian market.

Toxic Elemental Impurities in Herbal Weight Loss Supplements; A Study Using ICP-OES Microwave-Assisted Digestion.

The tendency of using weight loss herbal preparations is continuously increasing, especially for the widespread consumption of junk food that is characterized by high calories. Weight loss herbal preparations are considered a type of food supplement product, and, as such, the regulations governing their quality control might be minimal. These products could be locally formulated in any country or internationally imported. Being non-controlled products, the herbal weight-loss products may contain high levels of elemental impurities that might exceed the permissible ranges. Moreover, these products contribute to the total daily intake (TDI) of such elements, which might represent concerns about their potential toxicological danger. In this research, the elemental contents in such products were investigated. The inductively coupled plasma with optical emission spectrometer (ICP-OES) was used to determine the levels of 15 elemental contents, namely, Na, K, Ca, Mg, Al, Cu, Fe, Li, Mn, As, Co, Cr, Cd, Ni and Pb. The results showed that seven micro-elements, namely Cd, Co, Ni, Cr, Pb, Li and Cu, were either not detectable or at a concentration much lower than their tolerable limits. However, all studied macro-elements (Na, K, Ca and Mg), together with Fe, were found at considerable, yet safe levels. On the other hand, Mn, Al and As contents showed perturbing levels in some of the studied products. Finally, a conclusion was highlighted for the necessity for stricter surveillance of such herbal products.

Profiling of Biologically Active Metabolites of Spergula fallax L. Using High-resolution UPLC-QTOF-MS.

BACKGROUND: Medicinal plants are recognized to have a wide range of important biological activities, Spergula fallax L. is a well-known plant while phytochemical and biological activities screening of the species are rare. OBJECTIVE: This study aims to evaluate the antioxidant, anticáncer, antimicrobial, and antiviral activities of the methanol extract (ME) of the aerial parts of Spergula fallax L. and its successive fractions; n-hexane (HF), ethyl acetate (EAF), and n-butanol (BF) fractions and identify their biologically active metabolites. METHODS: Ultra-performance liquid chromatography (UPLC) coupled to quadrupole high-resolution time-of-flight mass spectrometry (QTOF-MS) was utilized to establish the metabolic profile of Sergula fallax L. Total phenol and flavonoids content were determined colorimetrically using Folin Ciocalteu and aluminum chloride reagents, respectively. 1,2-diphenyl-1-picrylhydrazyl (DPPH) was utilized for estimation of antioxidant activity, cytotoxic activity was determined on Hep-G2, HCT- 116, and MCF-7 cell lines, and agar diffusion method was used for screening of antimicrobial activity while cytopathic effect inhibition assay was utilized for antiviral assay. RESULTS: Twenty-eight metabolites were identified, flavonoids were predominated (26), it was characterized by the presence of four main aglycones (Apigenin, luteolin, quercetin and kaempferol) with their O and/or C-glycosides based on its MS fragments. ME and EAF significantly scavenged DPPH in a dose-dependent manner with IC50 16.99 and 18.74 µg.mL-1, respectively. Among the tested samples, only ME and EAF showed significant cytotoxic activity against the tested cell lines with IC50 ranging from 5.541- 9.509 µg.mL-1. All tested samples significantly inhibited the growth of the tested bacterial strains with inhibition zone diameters ranging from 11.2- 26.4 mm and showed a wide range of antiviral activity. CONCLUSION: Generally, S. fallax is potentially bioactive as evident by antioxidant, cytotoxic, antibacterial, and antiviral assays. These activities are correlated with its identified metabolites. The results proved that S. fallax has promising medicinal activities and would be examined in future clinical trials for herbal therapy.

Traditional ancient Egyptian medicine: A review.

The ancient Egyptians practiced medicine with highly professional methods. They had advanced knowledge of anatomy and surgery. Also, they treated a lot of diseases including dental, gynecological, gastrointestinal, and urinary disorders. They could diagnose diabetes and cancer. The used therapeutics extended from different plants to include several animal products and minerals. Some of these plants are still used in the present day. Fortunately, they documented their life details by carving on stone, clay, or papyri. Although a lot of these records have been lost or destroyed, the surviving documents represent a huge source of knowledge in different scientific aspects including medicine. This review article is an attempt to understand some information about traditional medicine in ancient Egypt, we will look closely at some basics, sources of information of Egyptian medicine in addition to common treated diseases and therapeutics in this great civilization.

Novel Phenolic Compounds as Potential Dual EGFR and COX-2 Inhibitors: Design, Semisynthesis, in vitro Biological Evaluation and in silico Insights.

INTRODUCTION: Epidermal growth factor receptor (EGFR) inhibition is an imperative therapeutic approach targeting various types of cancer including colorectal, lung, breast, and pancreatic cancer types. Moreover, cyclooxygenase-2 (COX-2) is frequently overexpressed in different types of cancers and has a role in the promotion of malignancy, apoptosis inhibition, and metastasis of tumor cells. Combination therapy has been emerged to improve the therapeutic benefit against cancer and curb intrinsic and acquired resistance. METHODS: Three semi-synthetic series of compounds (C1-4, P1-4, and G1-4) were prepared and evaluated biologically as potential dual epidermal growth factor receptor (EGFR) and COX-2 inhibitors. The main phenolic constituents of Amaranthus spinosus L. (p-coumaric, caffeic and gallic) acids have been isolated and subsequently subjected to diazo coupling with various amines to get novel three chemical scaffolds with potential anticancer activities. RESULTS: Compounds C4 and G4 showed superior inhibitory activity against EGFR (IC50: 0.9 and 0.5 µM, respectively) and displayed good COX-2 inhibition (IC50: 4.35 and 2.47 µM, respectively). Moreover, the final compounds were further evaluated for their cytotoxic activity against human colon cancer (HT-29), pancreatic cancer (PaCa-2), human malignant melanoma (A375), lung cancer (H-460), and pancreatic ductal cancer (Panc-1) cell lines. Interestingly, compounds C4 and G4 exhibited the highest cytotoxic activity with average IC50 values of 1.5 µM and 2.8 µM against H-460 and Panc-1, respectively. The virtual docking study was conducted to gain proper understandings of the plausible-binding modes of target compounds within EGFR and COX-2 binding sites. DISCUSSION: The NMR of prepared compounds showed characteristic peaks that confirmed the structure of the target compounds. The synthesized benzoxazolyl scaffold containing compounds showed inhibitory activities for both COXs and EGFR which are consistent with the virtual docking study.

Hordatines as a Potential Inhibitor of COVID-19 Main Protease and RNA Polymerase: An In-Silico Approach.

Total 40 natural compounds were selected to perform the molecular docking studies to screen and identify the potent antiviral agents specifically for Severe Acute Respiratory Syndrome Coronavirus 2 that causes coronavirus disease 2019 (COVID-19). The key targets of COVID-19, protease (PDB ID: 7BQY) and RNA polymerase (PDB ID: 7bV2) were used to dock our target compounds by Molecular Operating Environment (MOE) version 2014.09. We used 3 different conformations of protease target (6M0K, 6Y2F and 7BQY) and two different score functions to strengthen the probability of inhibitors discovery. After an extensive screening analysis, 20 compounds exhibit good binding affinities to one or both COVID-19 targets. 7 out of 20 compounds were predicted to overcome the activity of both targets. The top 7 hits are, flacourticin (3), sagerinic acid (16), hordatine A (23), hordatine B (24), N-feruloyl tyramine dimer (25), bisavenanthramides B-5 (29) and vulnibactins (40). According to our results, all these top hits was found to have a better binding scores than remdesivir, the native ligand in RNA polymerase target (PDB ID: 7bV2). Hordatines are phenolic compounds present in barley, were found to exhibit the highest binding affinity to both protease and polymerase through forming strong hydrogen bonds with the catalytic residues, as well as significant interactions with other receptor-binding residues. These results probably provided an excellent lead candidate for the development of therapeutic drugs against COVID-19. Eventually, animal experiment and accurate clinical trials are needed to confirm the preventive potentials of these compounds.

A COMPARATIVE STUDY OF CORE MUSCULATURE ENDURANCE AND STRENGTH BETWEEN SOCCER PLAYERS WITH AND WITHOUT LOWER EXTREMITY SPRAIN AND STRAIN INJURY.

BACKGROUND: Lower extremity sprain and strain injury constitutes a large percentage of lower extremity injuries experienced by soccer players. Yet, very limited data exists on the association between core strength and endurance and this injury. PURPOSE: The purpose of this study was to compare core muscle endurance and hip muscle strength between soccer players who experienced non-contact lower extremity sprain and/or strain injury during their season and those who did not. Additionally, the frequency of injury was correlated with core muscle endurance and hip strength, and endurance was used for predicting the risk for injury. STUDY DESIGN: Prospective cohort. METHODS: Twenty-one (35.59%) athletes experienced non-contact lower extremity sprain and/or strain injury during the season. Fifty-nine male athletes (mean age 20.92 ± 4.08 years, mass 77.34 ± 12.02 kg and height 1.79 ± 0.06m) were tested. Prior to the start of the season, prone-bridge, side-bridge, trunk flexion and horizontal back extension hold times were recorded for endurance assessment and peak hip abductor and external rotator isokinetic torques for strength assessment. RESULTS: Prone-bridge and side-bridge hold times were significantly longer in the non-injured players when compared with the times of the injured players (p=0.043 & 0.008 for the prone-bridge and side-bridge, respectively). There were significant negative correlations between the frequency of injury and both prone-bridge (r=-0.324, p=0.007) and side-bridge (r=-0.385, p=0.003) hold times. Logistic regression analysis revealed that side-bridge hold time was a significant predictor of injury (OR=0.956, CI=0.925-0.989). CONCLUSION: Soccer players with non-contact lower extremity sprain and/or strain have less core endurance than non-injured players. Reduced core endurance is associated with increased incidence of injury. Improving side-bridge hold time, specifically, may reduce the risk for injury. LEVEL OF EVIDENCE: 1b.

Does nanoscale porous titanium coating increase lumbar spinal stiffness of an interbody fusion cage? An in vivo biomechanical analysis in an ovine model.

BACKGROUND: Quantitative objective measures to determine fusion achievement further enable the comparison of new technologies, such as interbody cage surface enhancement. Our aims were to compare in vivo biomechanical responses of ovine L4/5 lumbar motion segments with two cages: 1) Polyetheretherketone or 2) Polyetheretherketone with a nanosurfaced titanium porous scaffold from Nanovis, Inc. METHODS: Fourteen Merino sheep randomly received either 1) standard Polyetheretherketone cage or 2) Nanocoated Polyetheretherketone cage at L4/L5 with autologous bone graft. At baseline and one-year follow-up, dynamic spinal stiffness was quantified in vivo using a validated mechanical assessment at 2 Hz, 6 Hz, and 12 Hz. The dorsoventral secant stiffness (ky = force/displacement, N/mm) and L4-L5 accelerations were determined at each frequency. A repeated measures analysis of variance with Bonferonni correction was used to evaluate within and between group differences among the biomechanical variables. FINDINGS: Both implants increased spinal stiffness at 2 Hz (21 and 39%, respectively, p < .005), and at 6 Hz (12 and 27%, p < .0001). Significantly greater spinal stiffness was observed with Nanocoated Polyetheretherketone at one-year for both frequencies (p < .05). No significant differences were observed at 12 Hz within or between groups. L4-L5 dorsoventral accelerations were significantly decreased one year following cage placement only with Nanocoated Polyetheretherketone (p < .05) and greater reductions in acceleration were observed with Nanocoated Polyetheretherketone compared to standard Polyetheretherketone (p < .05). INTERPRETATION: Both cages increased spinal stiffness, yet, nanosurfaced cages resulted in greater spinal stiffness changes and decreases in L4-L5 accelerations. These findings may assist in clinical decision making and post-operative recovery strategies.

Restoring lumbar spine stiffness using an interspinous implant in an ovine model of instability.

BACKGROUND: The objective of this study was to determine the effect of an interspinous implant on lumbar spine stability and stiffness during dorsoventral loading. METHODS: Twelve Merino lambs were mechanically tested in vivo. Oscillatory (2 Hz) loads were applied to L2 under load control while displacements were monitored. Tri-axial accelerometers further quantified adjacent L3-L4 accelerations. Dorsoventral lumbar spine stiffness and L3 and L4 dorsoventral and axial displacements were determined over six trials of 20 cycles of loading. Four conditions were examined: 1) initial intact, 2) following destabilization at L3-L4, 3) following the insertion of an InSwing(®) interspinous device at L3-L4, and 4) with the implant secured with a tension band. Comparisons were performed using a one-way ANOVA with repeated measures and post-hoc Bonferroni correction. FINDINGS: Compared to the intact condition, destabilization significantly decreased lumbar stiffness by 4.5% (P=.001) which was only recovered by the interspinous device with tension band. The interspinous device caused a significant 9.75% (P=.001) increase in dorsoventral stiffness from destabilization that increased 14% with the tension band added (P=.001). The tension band was responsible for decreased displacements from the intact (P=.038), instability (P=.001), and interspinous device (P=.005) conditions. Dorsoventral L3-L4 motion significantly improved with the interspinous device (P=.01) and the addition of the tension band (P=.001). No significant differences in L3-L4 intersegmental stability were noted for axial motion in the sagittal plane. INTERPRETATION: This ovine model provided objective in vivo biomechanical evidence of lumbar instability and its restoration by means of an interspinous implant during dorsoventral spinal loading.