Combined magnetic field results in higher fusion rates than pulsed electromagnetic field bone stimulation after thoracolumbar fusion surgery. (April 2020)

• Record Type: Journal Article
• Authors: Cheaney, Barry; El Hashemi, Mahboub; Obayashi, James; Than, Khoi D.
• Is Part Of: Journal of clinical neuroscience. Volume 74(2020)
• Page Start: 115
• Page End: 119
• Publication Date: 2020-04
• Subjects: Pulsed electromagnetic field -- Combined magnetic field -- Thoracolumbar fusion; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.02.012
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Radiographic fusion outcomes were compared between PEMF, CMF, and NS groups. The PEMF group resulted in less successful fusions and more pseudarthrosis cases. The CMF group resulted in comparable fusion results to the NS group. Bone growth stimulation does not add any benefit to radiographic fusion outcomes. Abstract: Background: Bone growth stimulators have been used as an adjunct to spinal fusion surgery in efforts to increase fusion rates. Methods: The authors retrospectively reviewed the medical records of patients who underwent thoracolumbar fusion surgeries by a single surgeon. Patients were then separated into three groups; pulsed electromagnetic field stimulation (PEMF), combined magnetic field stimulation (CMF) or no stimulation (NS), and computed tomography radiographic results at least 1 year after surgery were compared (solid fusion, stable nonunion, and pseudarthrosis). Results: A total of 60 patients were included; 16 (26.7%) used PEMF, 24 (40.0%) used CMF, and 20 (33.3%) had NS. There were no significant differences in patient demographics. There was no difference in the mean fusion levels (p = 0. 477). Solid fusion was achieved in 11/16 (68.8%) PEMF, 21/24 (87.5%) CMF, and 20/20 (100.0%) NS patients. Stable nonunion was displayed in 2/24 (8.3%) CMF, and zero PEMF and NS patients. There were 5/16 (31.3%) PEMF, 1/24 (4.2%) CMF, and zero NS patients demonstrating radiologic pseudarthrosis. There was a statistically significant difference between PEMF and CMF (p = 0.017) and between PEMF and NS (p = 0.006) groups. No statistical difference was found between CMF and NS (p = 1.000). Conclusion: This is the first study to compare PEMF and CMF bone growth stimulators in patients with degenerative pathologies who underwent thoracolumbar spinal fusions. Overall, the addition of these bone growth stimulators does not improve fusion outcomes, although CMF appears superior to PEMF.