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Supercharged Results after Failed Lumbar Fusion
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Posted on: 03/15/2004
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Spinal fusion has become increasingly popular as a treatment for chronic low back pain. Two or more vertebrae are fused together using bone grafts. Some procedures include metal spacers, plates, and screws. The success of the fusion varies from patient to patient. A fusion holds the spinal level stable and keeps it from moving. Sometimes the bones do not fuse as planned. This is called a nonunion, or pseudarthrosis.
Many factors can make a failed fusion more likely. Research shows smoking reduces the chances of a good fusion. So does the number of spinal levels involved. (The more levels that are fused, the less likely a patient will have a solid fusion.) Using bone graft from another person (an allograft) instead of the patient's own bone can also slow down or stop the fusion process.
Doctors are looking for ways to improve the fusion rate. They are also studying ways to treat a nonunion. In this study, doctors used pulsed electromagnetic field(PEMF) stimulation to save the fusion site without doing more surgery.
Past studies have shown PEMF works well to increase bone formation after spinal fusion. This study shows it can also enhance bone formation in a patient with a failed fusion and nonunion. One hundred patients took part in the research. All had nonunion within the first nine months after fusion. Patients used a PEMF device at least two hours every day for 90 days or more. X-rays were taken to look at the fusion after PEMF. Doctors also used patients' pain levels, medications taken, and return to work and activity as measures of success.
The authors found an overall fusion success rate of 67 percent. This means two-thirds of the failed fusions became solid fusions using PEMF. The PEMF turned a failure into a success. It saved these patients from having a second operation. The authors say this is good news for patients who can't have any more surgery because of poor health. PEMF is also a big cost savings compared to another surgery.
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References:
James W. Simmons, Jr, MD, et al. Pseudoarthrosis after Lumbar Spine Fusion: Nonoperative Salvage with Pulsed Electromagnetic Fields. In The American Journal of Orthopedics. January 2004. Vol. 33. No. 1. Pp. 27-30.
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