P269. Lumbar spine fusion rates increased by utilizing pulsed electromagnetic field stimulation (PEMF) devices as an adjunct to surgery

• Published in: The spine journal 2024-09, Vol.24 (9), p.S196-S196
• Main Authors: Weinstein, Marc A., Hassanzadeh, Hamid, Patel, Vikas V., Vokshoor, Amir A, Wind, Joshua
• Format: Article
• Language: English
• ISSN: 1529-9430
• DOI: 10.1016/j.spinee.2024.06.392

A variety of risk factors may diminish the likelihood of a successful lumbar spine fusion. Existing research has indicated that the supplementary application of pulsed electromagnetic field (PEMF) stimulation devices can enhance spine fusion rates, especially in individuals predisposed to pseudarthrosis. This study aimed to assess the lumbar spine fusion rates in subjects with one or more risk factors for pseudarthrosis, comparing those who underwent PEMF treatment with those who did not. Multicenter prospective with retrospective control. Subjects with one or more risk factors for pseudarthrosis. Twelve-month fusion assessment. Data from a multicenter (11 sites) prospective study of subjects undergoing lumbar spine fusion and receiving PEMF treatment were compared to a retrospective cohort of subjects who underwent lumbar spine fusion but did not use PEMF bone stimulation. The applicability of seven known risk factors for pseudarthrosis were recorded for each subject: prior failed fusion, multi-level disease, advanced age, high BMI, diabetes, nicotine usage, and osteoporosis. Subjects treated with PEMF were required to wear the device for 4 hours per day for 6 months post-surgery. Fusion status was evaluated by each investigator at 12 months postoperatively using a combination of x-rays and/or CT scans. Successful fusion required all treated levels to be graded as fused. There were no statistically significant differences in gender, age, and BMI characteristics between cohorts (treated group: 55.6% female, 63.3yr, BMI 31.0 kg/m²; control: 70.2% female, 66.6yr, BMI 31.6 kg/m²). Subjects in the PEMF-treated group had a significantly higher average number of surgical levels treated (2.8 vs 2.6 for control, p < 0.0005) and a higher average number of risk factors for pseudarthrosis (2.7 vs 2.4 for control), although that difference was not statistically significant (p = 0.084) At 12 months postoperatively, the PEMF-treated group (n = 142) demonstrated an 88.0% fusion rate, which was superior compared to a 68.1% fusion rate for the control group (n = 47) (p = 0.0016). The use of PEMF stimulation yields statistically significant increases in lumbar spine fusion rates and can be especially helpful as an adjunctive therapy when patients are at risk for pseudarthrosis. PEMF-treated subjects in this study exhibited improved fusion outcomes compared to a similar group of control subjects. SpinalStim (Approved for this indication)