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Locomotion and scratching are basic motor functions which are critically important for animal survival. Although the spinal circuits governing forward locomotion have been extensively investigated, the organization of spinal circuits and neural mechanisms regulating backward locomotion and scratching remain unclear. Here, we extend a model by Danner et al. to propose a spinal circuit model with asymmetrical cervical-lumbar layout to investigate these issues. In the model, the left-right alternation within the cervical and lumbar circuits is mediated by V 0D and V 0V commissural interneurons (CINs), respectively. With different control strategies, the model closely reproduces multiple experimental data of quadrupeds in different motor behaviors. Specifically, under the supraspinal drive, walk and trot are expressed in control condition, half-bound is expressed after deletion of V 0V CINs, and bound is expressed after deletion of V0 (V 0D and V 0V) CINs; in addition, unilateral hindlimb scratching occurs in control condition and synchronous bilateral hindlimb scratching appears after deletion of V 0V CINs. Under the combined drive of afferent feedback and perineal stimulation, different coordination patterns between hindlimbs during BBS (backward-biped-spinal) locomotion are generated. The results suggest that (1) the cervical and lumbar circuits in the spinal network are asymmetrically recruited during particular rhythmic limb movements. (2) Multiple motor behaviors share a single spinal network under the reconfiguration of the spinal network by supraspinal inputs or somatosensory feedback. Our model provides new insights into the organization of motor circuits and neural control of rhythmic limb movements.

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STUDY DESIGN: Observational Database Study. OBJECTIVES: Prospective clinical trials in spinal surgery are expensive to conduct, especially when randomized, appropriately powered, and/or multicentered. Industry collaborations generate symbiotic relationships promoting technological advancement; however, they also allow for bias. To the authors' knowledge, there is no known analysis of correlations between industry sponsorship and publication rates of spine-related clinical trials. This observational work evaluates such potential associations. METHODS: The ClinicalTrials.gov database was queried with terms spine, spinal, spondylosis, spondylolysis, cervical, lumbar, and compression fracture over an 11-year period. Design characteristics and outcomes were recorded from 822 spine surgery-related trials. Trials were stratified based on funding source and intervention class. Groups were compared via two-tailed chi-square test of independence or Fisher's exact test (α = .05), based on completion status and publication rates of positive vs negative results. RESULTS: Industry-sponsored spine-related clinical trials were more likely to be terminated than their non-industry-sponsored counterparts (P < .001). Of the trials achieving publication, industry-sponsored trials reported positive results at a higher rate than did trials without industry funding (P = .037). Clinical trials examining devices were more likely to be terminated than those studying other intervention classes (P = .001). CONCLUSIONS: High termination rates and positive result publication rates among industry-sponsored clinical trials in spinal surgery likely reflect industry's influence on the research community. Such partnership alleviates financial burden and provides accessibility to cutting-edge innovation. It is essential that all parties remain mindful of the significant bias that funding source may impart on study outcome.

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OBJECTIVE: Patients undergoing spine surgery generally have high expectations for improvement postoperatively. Little is known about how these expectations are affected by the diagnosis. The purpose of this study was to examine whether preoperative expectations differ based on diagnostic pathoanatomical patterns in elective spine surgery patients. METHODS: Patients with common degenerative cervical/lumbar pathology (lumbar/cervical stenosis, lumbar spondylolisthesis, and cervical/lumbar disc herniation) who had given their consent for surgery were analyzed using the Canadian Spine Outcomes and Research Network (CSORN). Patients reported the changes they expected to experience postoperatively in relation to 7 separate items using a modified version of the North American Spine Society spine questionnaire. Patients were also asked about the most important item that would make them consider the surgery a success. Sociodemographic, lifestyle, and clinical variables were also collected. RESULTS: There were 3868 eligible patients identified within the network for analysis. Patients with lumbar disc herniation had higher expectations for relief of leg pain compared with stenosis and lumbar degenerative spondylolisthesis cohorts within the univariate analysis. Cervical stenosis (myelopathy) patients were more likely to rank general physical capacity as their most important expectation from spine surgery. The multinomial regression analysis showed that cervical myelopathy patients have lower expectations for relief of arm or neck pain from surgery (OR 0.54, 0.34-0.88; p < 0.05). Patient factors, including age, symptoms (pain, disability, depression), work status, and lifestyle factors, were significantly associated with expectation, whereas the diagnoses were not. CONCLUSIONS: Patients with degenerative spinal conditions consenting for spine surgery have high expectations for improvement in all realms of their daily lives. With the exception of patients with cervical myelopathy, patient symptoms rather than diagnoses had a more substantial impact on the dimensions in which patients expected to improve or their most important expected change. Determination of patient expectation should be individualized and not biased by pathoanatomical diagnosis.