Prospective comparison of the effect of direct current electrical stimulation and pulsed electromagnetic fields on instrumented posterolateral lumbararthrodesis

The purpose of this prospective study was to compare the effect of adjuncti ve direct current (DC) electrical stimulation and pulsed electromagnetic fi eld therapy (PEMF) on augmentation of instrumented lumbar fusion. Sixty-one patients undergoing Lumbar spine fusion were enrolled in the study and ran domized to one of three treatment protocols: 1) adjunctive PEMF group (n = 22) fitted with Spinal-Stim model 8212(AME) within 30 days of surgery; 2) D C group (n = 17) had a SpF-2T stimulator(EBI) implanted at the time of surg ery; or 3) control group (n = 22). The fusion mass bone mineral density (BM D) assessment was performed on 3-month and 1-year radiographs for each pati ent. Lateral flexion-extension and anteroposterior radiographs were evaluat ed at 1 year to determine the presence of fusion. Clinical outcome patient analyses were performed at 1 year. At 1-year follow-up, radiographic fusion and fusion mass bone density were not significantly different among the gr oups. In the nonstimulated group, there were 43% excellent. 43% good, and 1 4% fair results. In the PEMF group, there were 35% excellent, 50% good, 10% fair, and 5% poor results. In the DC group, there were 32% excellent, 37% good and 31% fair results. The: results of the current study suggest that e lectrical stimulation does not significantly enhance fusion rate in instrum ented lumbar arthrodesis. although we observed a statistically insignifican t trend toward increased fusion mass BMD in the electrically stimulated gro ups. The significance of increased BMD remains unknown.