Pulsed Electromagnetic Fields for Cervical Spine Fusion in Patients with Risk Factors for Pseudarthrosis.

IF 1.4 Q3 ORTHOPEDICS Orthopedic Reviews Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI:10.52965/001c.122534
Todd Lansford, Peter Campbell, Hamid Hassanzadeh, Marc Weinstein, Joshua Wind, Andrew Beaumont, Amir Vokshoor, Kristen Radcliff, Ilyas Aleem, Domagoj Coric
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Abstract

Background: Certain demographics and/or risk factors contribute to complications following cervical spinal surgery including pseudarthrosis, prolonged pain, and reduced quality of life (QoL). Pulsed electromagnetic field (PEMF) stimulation is a non-invasive therapy that may enhance fusion success in at-risk patients.

Objective: To evaluate the safety and efficacy of post-operative adjunctive PEMF therapy following cervical spinal surgery in subjects at risk for pseudarthrosis.

Methods: This prospective, multicenter study investigated PEMF as an adjunctive therapy to cervical spinal fusion procedures in subjects at risk for pseudarthrosis based on having at least one of the following: prior failed fusion, multi-level fusion, nicotine use, osteoporosis, or diabetes. Radiographic fusion status and patient-reported outcomes (SF-36, EQ5D, NDI, and VAS-arm pain and VAS-neck pain) were assessed.

Results: A total of 160 subjects were assessed for fusion 12-months postoperative, and 144 subjects were successfully fused (90.0%). Fusion success for subjects with 1, 2+, or 3+ risk factors was 91.7%, 89.0%%, and 90.9%, respectively. Significant improvements in NDI, VAS-arm and VAS-neck were observed compared to baseline scores (p < 0.001) along with improvements in SF-36 and EQ5D (p < 0.001).

Conclusions: Adjunctive treatment with PEMF provides a high rate of successful fusion and significant improvements in pain, function, and quality of life despite having risk factors for pseudarthrosis.

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脉冲电磁场在假关节危险因素患者颈椎融合中的应用。
背景:某些人口统计学和/或危险因素会导致颈椎手术后的并发症,包括假关节、疼痛延长和生活质量(QoL)降低。脉冲电磁场(PEMF)刺激是一种非侵入性治疗,可以提高高危患者的融合成功率。目的:评价有假关节风险的颈椎手术后辅助脉冲电场治疗的安全性和有效性。方法:这项前瞻性、多中心研究调查了PEMF作为假关节风险患者颈椎融合手术的辅助治疗,这些患者至少有以下一种情况:先前融合失败、多级融合、尼古丁使用、骨质疏松或糖尿病。评估影像学融合状态和患者报告的预后(SF-36、EQ5D、NDI、vas -臂痛和vas -颈痛)。结果:术后12个月共评估160例患者融合情况,144例患者成功融合(90.0%)。具有1、2、3+危险因素的受试者融合成功率分别为91.7%、89.0%和90.9%。与基线评分相比,NDI、vas -臂和vas -颈评分有显著改善(p < 0.001), SF-36和EQ5D评分也有显著改善(p < 0.001)。结论:尽管存在假关节的危险因素,但使用PEMF辅助治疗可以提供高的融合成功率,并显著改善疼痛、功能和生活质量。
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来源期刊
Orthopedic Reviews
Orthopedic Reviews ORTHOPEDICS-
CiteScore
2.70
自引率
4.80%
发文量
122
审稿时长
10 weeks
期刊介绍: Orthopedic Reviews is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome. The journal publishes original articles, brief reports, reviews and case reports of general interest.
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