The Effect of Electrical Stimulation on Lumbar Spinal Fusion in Older Patients: A Randomized, Controlled, Multi-Center Trial

Abstract

The achievement of a good functional outcome was heavily dependent on the obtained walking distance. DC-stimulated patients tended to have better functional outcome as compared to controls. No negative effects of perioperative complications could be observed on the short-term functional outcome.

Degenerative Spondylolisthesis Is Associated with Low Spinal Bone Density: A Comparative Study between Spinal Stenosis and Degenerative Spondylolisthesis

“…The patient cohort in this study is taken from a multicenter randomized trial on the effect of direct current (DC) electrical stimulation in adjunct to uninstrumented spinal fusion [11, 12]. All patients underwent uninstrumented posterolateral spinal fusion using fresh frozen allograft and were braced postoperatively for 3-4 months.…”

Efficacy of Electrical Stimulation for Spinal Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Subgroup analyses investigating any differences in effect by type of stimulation, fusion level, and smoking status were preplanned. We were interested in exploring variations in effect between these population subgroups provided a higher rate of complications following spinal fusion are observed in patients who smoke or are elderly, which may influence the relative efficacy of electrical stimulation 15 . To explain any potential heterogeneity, we pre-specified a subgroup analysis of type of stimulation (pulsed electromagnetic fields, direct current electrical stimulation, and capacitive coupling).…”

“…Mean follow-up was 14.1 (SD 5.1) months for radiographic outcomes. Three trials reported the use of pulsed electromagnetic fields (PEMFs) 13,20,21 , 1 trial used capacitive coupling (CC) 19 , and 2 trials used direct current (DC) 15,16,36 . Furthermore, 1 trial had two intervention groups, of which one underwent PEMF and the other underwent DC 36 ( Table 1).…”

“…Following Dwyer's initial report on the clinical utility of electrical stimulation for spinal fusion in 1974 14 , a number of studies have since evaluated its efficacy on clinical and radiographic outcomes after spinal fusion 13,[15][16][17][18][19][20][21] . Within these trials, methodological flaws have led to inconclusive and conflicting findings 13,[15][16][17][18][19][20][21] . Current systematic reviews and meta-analyses evaluating spinal fusion are limited due to methodological flaws or limited inclusion criteria [22][23][24][25][26] .…”

“…Current systematic reviews and meta-analyses evaluating spinal fusion are limited due to methodological flaws or limited inclusion criteria [22][23][24][25][26] . The need to systematically evaluate the effect of electrical stimulation with respect to spinal fusion is required to provide clinicians with a current best estimate of efficacy 13,[15][16][17]21,22 . We therefore sought to determine the efficacy of postoperative electrical stimulation on radiographic fusion rates at a minimum 1-year follow-up in adult patients following spinal fusion.…”