DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20201062

Effectiveness of combined magnetic field bone growth stimulation on lumbar spinal fusion outcomes: a single center retrospective analysis comparing combined magnetic field to no-stimulation

Ramin Raiszadeh, Kamshad Raiszadeh, Laura Eaton, Paul Kim, Choll Kim

Abstract


Background: The objective of this retrospective study was to assess the effect of combined magnetic field (CMF) bone growth stimulation on lumbar fusion outcomes, as compared to no-stimulation.

Methods: This study reviewed fusion efficacy of a consecutive cohort of 652 patients who underwent lumbar fusion surgery at our institution between 2001 and 2018.  Fusion status was determined via radiographic analysis, with four surgeons contributing data to this study. The minimum patient follow-up time was 6 months. Previously identified risk factors (i.e. smoking status) were also collected. Statistical analysis was performed using cross-tabulation tests with chi-square analyses, one-way ANOVA’s, and Tukey’s range tests. 53% (343/652) of patients had undergone adjuvant treatment with CMF stimulation.

Results: Patients treated with CMF stimulation had significantly greater fusion success of 97% compared to no stimulation at 62% (p<0.00001). Further, it was observed that smokers had a significantly higher fusion rate with CMF treatment than without electrical stimulation (94% vs 61%, p=0.000032).

Conclusions: Additional studies to evaluate the effectiveness of CMF treatment in patients with risk factors are warranted.


Keywords


Lumbar, Spine, Spinal fusion, Combined magnetic field, Electrical bone growth stimulation

Full Text:

PDF

References


Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, Brodke DS. Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015. Spine. 2019;44(5):369-76.

Gruskay JA, Webb ML, Garauer JN. Methods of evaluating lumbar and cervical fusion. Spine J. 2014;14(3):531-9.

Miyazaki M, Tsumura H, Wang JC, Alanay A. An update on bone substitutes for spinal fusion. Europ Spine J. 2009;18(6):783-99.

Chun DS, Baker KC, Hsu WK. Lumbar pseudarthrosis: a review of current diagnosis and treatment. Neuroserg FOCUS. 2015;39(4):10.

Jenkins LT, Jones AL, Harms JJ. Prognostic factors in lumbar spinal fusion. Contemp Orthop. 1994;29(3):173-80.

Gan JC, Glazer PA. Electrical stimulation therapies for spinal fusions: current concepts. Europ spine J. 2006;15(9):1301-11.

Berman D, Oren JH, Bendo J, Spivak J. The Effect of Smoking on Spinal Fusion. Int J Spine Surg. 2017;11:29.

Miyazaki M, Tsumura H, Wang J, Alanay A. An update on bone substitutes for spinal fusion. Europ Spine J. 2009;18(6):783-99.

Stippick TW, Sheller MR. Combined magnetic fields provide robust coverage for interbody and posterolateral lumbar spinal fusion sites. Med Biolog Engin Comput. 2016;54(1):113-22.

Khalifeh JM, Zohny Z, Ewan M. Electrical Stimulation and Bone Healing: A Review of Current Technology and Clinical Applications. IEEE Rev Biomed Eng. 2018;11:217-32.

Victoria G, Petrisor BA, Drew B, Dick D. Bone stimulation for fracture healing: What's all the fuss. Indian J Orthop. 2009;43(2):117-20.

Hannouche D, Petite H, Sedel L. Current trends in the enhancement of fracturre healing. J Bone Joint Surg Br. 2001;83(2):157-64.

Ciombor D, Aaron RK. The role of electrical stimulation in bone repair. Foot Ankle Clin. 2005;10(4):579-93.

Zayzafoon M. Calcium/calmodulin signaling controls osteoblast growth and differentiation. J Cell Biochem. 2006;97(1):56-70.

Cottrill E, Pennington Z, Ahmed AK. The effect of electrical stimulation therapies on spinal fusion: a cross-disciplinary systematic review and meta-analysis of the preclinical and clinical data. J Neurospine Surg. 2019;8:1-21.

Fitzsimmons RJ, Fyaby JT, Mohan S, Magee FP, Baylink DJ. Combined magnetic fields increase insulin-like growth factor-II in TE-8 human osteosarcoma bone cell cultures. Endocrinology. 1995;136(7):3100-6.

Ryaby JT, Fitzsimmons RJ, Khin NA. The role of insulin-like growth factor II in magnetic field regulation of bone formation. Bioelectrochem Bioenerg. 1994;35(1-2):87-91.

Mooney V. A randomized double-blind prospective study of the efficacy of pulsed electromagnetic fields for interbody lumbar fusions. Spine. 1990;15(7):708-12.

Linovitz RJ, Pathria M, Bernhardt M. Combined magnetic fields accelerate and increase spine fusion: a double-blind, randomized, placebo controlled study. Spine. 2002;27(13):1383-9.

Oro A, Buser Z, Brodke DS. Trends and costs of external electric bone stimulators and grafting materials in anterior lumbar interbody fusion. Asian Spine J. 2018;12(6):973-80.

Goodwin CB, Brighton CT, Guyer RD, Johnson JR, Light KI, Yuan HA. A double-blind study of capacitively coupled electrical stimulation as an adjunct to lumbar spinal fusions. Spine. 1999;24(13):1349-56.

Phillips M, Drew B, Sprague S, Aleem I. Efficacy of Combined Magnetic Field Treatment on Spinal Fusion: A Review of the Literature. J Long Term Eff Med Implants. 2016;26(3):271-6.

Zhang L, Li EN. Risk factors for surgical site infection following lumbar spinal surgery: a meta-analysis. Ther Clin Risk Manag. 2018;14:2161-9.

Schoenfeld AJ, Ochoa LM, Bader JO, Belmont PJ. Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program. J Bone Joint Surg. 2011;93(17):1577-82.

Park P, Lau D, Brodt ED, Dettori JR. Electrical stimulation to enhance spinal fusion: a systematic review. Evi Based Spine Care J. 2014;5(2):87-94.