Objective: This study aimed to develop an augmented reality (AR)-based system for spine surgical training that enables precise alignment of physical and virtual models and provides real-time feedback for depth perception using Unity and the Vuforia Engine. Methods: The system uses Vuforia’s Model Target to track and superimpose a virtual spine model onto a 3-dimensional-printed spine model without the need for external markers. The alignment accuracy was measured using positional and rotational error calculations via Unity’s built-in functions. The tool tracking was performed for the pedicle screw driver using ArUco markers. Results: The system achieved precise superimposition with minimal positional and rotational misalignment errors. Unity's tracking and real-time feedback ensured robust performance of the system. The system also achieved real-time tool tracking and superimposition of the real and virtual models of the tool. The system successfully demonstrated its ability to maintain spatial accuracy and provide immersive visual guidance, critical for spine surgical training. Conclusion The developed AR-based system presents a cost-effective and markerless solution for enhancing depth perception and alignment accuracy in spinal surgical education. It is suitable for use in resource-limited settings due to its reliance on widely accessible hardware and software, with potential future enhancements including real patient data and automated feedback mechanisms.

Objective: Spinal cord injury (SCI) often results in irreversible neurological deficits and poses a critical public health issue. The molecular mechanisms governing cellular responses postinjury remain incompletely understood. Wnt signaling is known to influence neurogenesis and axonal regeneration. In particular, Wnt ligands and their antagonists, such as secreted frizzled-related protein 4 (SFRP4), are differentially expressed following SCI. This study investigated the role of the Wnt3a/SFRP4 signaling axis in regulating neuronal cell fate. Methods: Human neuroblastoma SH-SY5Y and rat pheochromocytoma PC12 cell lines were obtained from the American Type Culture Collection. The metabolic activity of cells—used as a surrogate marker for proliferation—was assessed using the Alamar Blue assay. To mimic neurodegeneration associated with SCI, cells were treated with lipopolysaccharide (LPS). The effects of Wnt3a and SFRP4 were analyzed both individually and in combination under normal conditions and LPS-induced stress. Results: Wnt3a treatment alone significantly increased metabolic activity in untreated and LPS-treated cells, indicating a proliferative effect. However, cotreatment with Wnt3a and SFRP4 reduced proliferation, particularly in the presence of LPS. SFRP4 alone demonstrated variable effects depending on cellular conditions, with some enhancement of metabolic activity in the LPS model but reduced activity when combined with Wnt3a. Conclusion These findings suggest that the effect of SFRP4 on Wnt3a-mediated signaling is context-dependent, potentially promoting proliferation in normal conditions but antagonizing Wnt3a activity under stress. A deeper understanding of the Wnt signalosome and SFRP family interactions could shed light on novel therapeutic strategies for modulating neuroinflammation and promoting repair after SCI.

STUDY DESIGN: Retrospective cohort study. PURPOSE: To compare the clinical and radiological outcomes of modified mini-open transforaminal lumbar interbody fusion (modMOTLIF) and open TLIF (OTLIF). OVERVIEW OF LITERATURE: Minimally invasive transforaminal lumbar interbody fusion (MTLIF) is associated with less blood loss, shorter hospital stay, and less pain. However, it has concerns like increased radiation exposure, steep learning curve, and instrumentation cost. We modified the MTLIF technique by direct freehand insertion of pedicle screws using stab incisions without tubular retractors. METHODS: The study included 24 patients in the modMOTLIF group and 27 patients in the OTLIF group. The average follow-up period was 25.6 months. Clinical outcomes were measured using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Serial X-rays were acquired at 1, 3, 6, 12, and 24 months to assess the union and presence of instability. We also compared blood loss and length of hospital stay in both groups. RESULTS: All patients showed progressive improvement in VAS and ODI scores. No differences were observed in the preoperative and postoperative ODI and VAS leg scores between the groups. The immediate postoperative VAS back score was significantly higher in the OTLIF group than in the modMOTLIF group; however, no difference was observed at 1 and 2 years. Radiological analysis showed nonunion in one and two patients in the OTLIF and modMOTLIF groups, respectively. The average blood loss was 63 mL in the mod-MOTLIF group and 254 mL in the OTLIF group. The mean hospital stay was 3 days for the modMOTLIF group and 5 days for the OTLIF group. CONCLUSIONS: modMOTLIF was associated with reduced blood loss and shorter hospital stay compared with OTLIF. No significant differences were observed in the clinical and radiological outcomes between the groups after 2 years despite reduced back pain in the immediate postoperative period in patients who underwent modMOTLIF.
Back Pain ; Cohort Studies ; Follow-Up Studies ; Humans ; Learning Curve ; Leg ; Length of Stay ; Pedicle Screws ; Postoperative Period ; Radiation Exposure ; Retrospective Studies ; Visual Analog Scale

STUDY DESIGN: Cross-sectional study. PURPOSE: To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. OVERVIEW OF LITERATURE: LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. METHODS: A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18–35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. RESULTS: Most subjects (90.6%) were aged 20–29 years (mean, 24.49; range, 18–35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems (p<0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. CONCLUSIONS: The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual's quality of life and increasing productivity.
Adolescent ; Alcoholism ; Body Mass Index ; Chronic Disease ; Coffee ; Cross-Sectional Studies* ; Diet ; Efficiency ; Heel ; Humans ; Incidence ; India ; Job Satisfaction ; Low Back Pain* ; Male ; Marital Status ; Obesity ; Posture ; Prevalence* ; Quality of Life ; Risk Factors* ; Smoke ; Smoking ; Spine ; Sports ; Young Adult*