Journal of Korean Neurosurgical Society

  • 제64권4호
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  • Pages.486-494
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  • 2021
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Pulsed Electromagnetic Field Stimulators Efficacy for Noninvasive Bone Growth in Spine Surgery

  • 투고 : 2020.09.11
  • 심사 : 2020.10.29
  • 발행 : 2021.07.01
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초록

The growth of pulsed electromagnetic field (PEMF) therapy and its progress over the years for use in post-operative bone growth has been revolutionary in its effect on bone tissue proliferation and vascular flow. However, further progress in PEMF therapy has been difficult due to lack of more evidence-based understanding of its mechanism of action. Our objective was to review the current understanding of bone growth physiology, the mechanism of PEMF therapy action along with its application in spinal surgery and associated outcomes. The authors of this review examined multiple controlled, comparative, and cohort studies to compare fusion rates of patients undergoing PEMF stimulation. Examining spinal fusion rates, a rounded comparison of post-fusion outcomes with and without bone stimulator was performed. Results showed that postoperative spinal surgery PEMF stimulation had higher rates of fusion than control groups. Though PEMF therapy was proven more effective, multiple factors contributed to difficulty in patient compliance for use. Extended timeframe of treatment and cost of treatment were the main obstacles to full compliance. This review showed that PEMF therapy presented an increased rate of recovery in patients, supporting the use of these devices as an effective post-surgical aid. Given the recent advances in the development of PEMF devices, affordability and access will be much easier suited to the patient population, allowing for more readily available treatment options.

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참고문헌

  1. Aaron RK, Ciombor DM, Simon BJ : Treatment of nonunions with electric and electromagnetic fields. Clin Orthop Relat Res (419) : 21-29, 2004
  2. Aetna Inc. : High-frequency pulsed electromagnetic stimulation. Available at : http://www.aetna.com/cpb/medical/data/100_199/0175.html
  3. Akhter S, Qureshi AR, Aleem I, El-Khechen HA, Khan S, Sikder O, et al. : Efficacy of electrical stimulation for spinal fusion: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 10 : 4568, 2020 https://doi.org/10.1038/s41598-020-61266-x
  4. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. : Grading quality of evidence and strength of recommendations. BMJ 328 : 1490, 2004 https://doi.org/10.1136/bmj.328.7454.1490
  5. Baumgart M, Wisniewski M, Grzonkowska M, Malkowski B, Badura M, Dabrowska M, et al. : Digital image analysis of ossification centers in the axial dens and body in the human fetus. Surg Radiol Anat 38 : 1195-1203, 2016 https://doi.org/10.1007/s00276-016-1679-9
  6. Blue Cross Blue Shield of Massachusetts : Electrical Bone Growth Stimulation of the Appendicular Skeleton. Available at : https://www.bluecrossma.org/medical-policies/sites/g/files/csphws2091/files/acquiadam-assets/499%20Electrical%20Bone%20Growth%20Stimulation%20of%20the%20Appendicular%20Skeleton%20prn.pdf
  7. Bose B : Outcomes after posterolateral lumbar fusion with instrumentation in patients treated with adjunctive pulsed electromagnetic field stimulation. Adv Ther 18 : 12-20, 2001 https://doi.org/10.1007/BF02850247
  8. Clarke B : Normal bone anatomy and physiology. Clin J Am Soc Nephrol 3 Suppl 3(Suppl 3) : S131-S139, 2008 https://doi.org/10.2215/CJN.04151206
  9. Coric D, Bullard DE, Patel VV, Ryaby JT, Atkinson BL, He D, et al. : Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations. Bone Joint Res 7 : 124-130, 2018 https://doi.org/10.1302/2046-3758.72.BJR-2017-0221.R1
  10. Cottrill E, Pennington Z, Ahmed AK, Lubelski D, Goodwin ML, PerdomoPantoja A, et al. : The effect of electrical stimulation therapies on spinal fusion: a cross-disciplinary systematic review and meta-analysis of the preclinical and clinical data. J Neurosurg Spine 32 : 106-126, 2020 https://doi.org/10.3171/2019.5.SPINE19465
  11. CPT Only - American Medical Association : Noninvasive electrical bone growth stimulation of the appendicular skeleton. Available at : https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_d055254.html
  12. Di Silvestre M, Savini R : Pulsing electromagnetic fields (PEMFs) in spinal fusion: preliminary clinical results. Chir Organi Mov 77 : 289-294, 1992
  13. Dimitriou R, Jones E, McGonagle D, Giannoudis PV : Bone regeneration: current concepts and future directions. BMC Med 9 : 66, 2011 https://doi.org/10.1186/1741-7015-9-66
  14. Doskocil M, Valouch P, Pazderka V : On vertebral body growth. Funct Dev Morphol 3 : 149-155, 1993
  15. Foley KT, Mroz TE, Arnold PM, Chandler HC Jr, Dixon RA, Girasole GJ, et al. : Randomized, prospective, and controlled clinical trial of pulsed electromagnetic field stimulation for cervical fusion. Spine J 8 : 436-442, 2008 https://doi.org/10.1016/j.spinee.2007.06.006
  16. Frykman GK, Taleisnik J, Peters G, Kaufman R, Helal B, Wood VE, et al. : Treatment of nonunited scaphoid fractures by pulsed electromagnetic field and cast. J Hand Surg Am 11 : 344-349, 1986 https://doi.org/10.1016/S0363-5023(86)80140-X
  17. Garland DE, Moses B, Salyer W : Long-term follow-up of fracture nonunions treated with PEMFs. Contemp Orthop 22 : 295-302, 1991
  18. Gilbert SF : Developmental Biology, ed 6. Sunderland : Sinauer Associates, 2000
  19. Goodwin CB, Brighton CT, Guyer RD, Johnson JR, Light KI, Yuan HA : A double-blind study of capacitively coupled electrical stimulation as an adjunct to lumbar spinal fusions. Spine (Phila Pa 1976) 24 : 1349-1356; discussion 1357, 1999 https://doi.org/10.1097/00007632-199907010-00013
  20. Griffin M, Bayat A : Electrical stimulation in bone healing: critical analysis by evaluating levels of evidence. Eplasty 11 : e34, 2011
  21. Gupta A, Kukkar N, Sharif K, Main BJ, Albers CE, El-Amin Iii SF : Bone graft substitutes for spine fusion: a brief review. World J Orthop 6 : 449-456, 2015 https://doi.org/10.5312/wjo.v6.i6.449
  22. Hannemann PF, Essers BA, Schots JP, Dullaert K, Poeze M, Brink PR : Functional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis. BMC Musculoskelet Disord 16 : 84, 2015 https://doi.org/10.1186/s12891-015-0541-2
  23. Huang AJ, Gemperli MP, Bergthold L, Singer SS, Garber A : Health plans' coverage determinations for technology-based interventions: the case of electrical bone growth stimulation. Am J Manag Care 10 : 957-962, 2004
  24. Huegel J, Choi DS, Nuss CA, Minnig MCC, Tucker JJ, Kuntz AF, et al. : Effects of pulsed electromagnetic field therapy at different frequencies and durations on rotator cuff tendon-to-bone healing in a rat model. J Shoulder Elbow Surg 27 : 553-560, 2018 https://doi.org/10.1016/j.jse.2017.09.024
  25. Jenis LG, An HS, Stein R, Young B : Prospective comparison of the effect of direct current electrical stimulation and pulsed electromagnetic fields on instrumented posterolateral lumbar arthrodesis. J Spinal Disord 13 : 290-296, 2000 https://doi.org/10.1097/00002517-200008000-00004
  26. Kahanovitz N : Electrical stimulation of spinal fusion: a scientific and clinical update. Spine J 2 : 145-150, 2002 https://doi.org/10.1016/S1529-9430(02)00177-8
  27. Khalifeh JM, Zohny Z, MacEwan M, Stephen M, Johnston W, Gamble P, et al. : Electrical stimulation and bone healing: a review of current technology and clinical applications. IEEE Rev Biomed Eng 11 : 217-232, 2018 https://doi.org/10.1109/RBME.2018.2799189
  28. Linovitz RJ, Pathria M, Bernhardt M, Green D, Law MD, McGuire RA, et al. : Combined magnetic fields accelerate and increase spine fusion: a double-blind, randomized, placebo controlled study. Spine (Phila Pa 1976) 27 : 1383-1389; discussion 1389, 2002 https://doi.org/10.1097/00007632-200207010-00002
  29. Makino T, Tsukazaki H, Ukon Y, Tateiwa D, Yoshikawa H, Kaito T : The biological enhancement of spinal fusion for spinal degenerative disease. Int J Mol Sci 19 : 2430, 2018 https://doi.org/10.3390/ijms19082430
  30. Markov MS : Expanding use of pulsed electromagnetic field therapies. Electromagn Biol Med 26 : 257-274, 2007 https://doi.org/10.1080/15368370701580806
  31. Markov MS : Pulsed electromagnetic field therapy history, state of the art and future. Environmentalist 27 : 465-475, 2007 https://doi.org/10.1007/s10669-007-9128-2
  32. Marks RA : Spine fusion for discogenic low back pain: outcomes in patients treated with or without pulsed electromagnetic field stimulation. Adv Ther 17 : 57-67, 2000 https://doi.org/10.1007/BF02854838
  33. Mooney V : A randomized double-blind prospective study of the efficacy of pulsed electromagnetic fields for interbody lumbar fusions. Spine (Phila Pa 1976) 15 : 708-712, 1990 https://doi.org/10.1097/00007632-199007000-00016
  34. Morone MA, Feuer H : The use of electrical stimulation to enhance spinal fusion. Neurosurg Focus 13 : e5, 2002
  35. Oishi M, Onesti ST : Electrical bone graft stimulation for spinal fusion: a review. Neurosurgery 47 : 1041-1055; discussion 1055-1056, 2000 https://doi.org/10.1097/00006123-200011000-00005
  36. Orthofix Medical Inc. : CervicalStim spinal fusion therapy. Available at : https://www.orthofix.com/ifus/cervical-stim/
  37. Orthofix Medical Inc. : PhysioStim bone healing therapy. Available at : https://www.orthofix.com/ifus/physio-stim/
  38. Park SB, Chung CK : Strategies of spinal fusion on osteoporotic spine. J Korean Neurosurg Soc 49 : 317-322, 2011 https://doi.org/10.3340/jkns.2011.49.6.317
  39. Rikk J, Finn KJ, Liziczai I, Radak Z, Bori Z, Ihasz F : Influence of pulsing electromagnetic field therapy on resting blood pressure in aging adults. Electromagn Biol Med 32 : 165-172, 2013 https://doi.org/10.3109/15368378.2013.776420
  40. Shupak NM, Prato FS, Thomas AW : Therapeutic uses of pulsed magnetic-field exposure: a review. URSI Radio Science Bulletin 2003 : 9-32, 2003
  41. Simmons JW Jr, Mooney V, Thacker I : Pseudarthrosis after lumbar spine fusion: nonoperative salvage with pulsed electromagnetic fields. Am J Orthop (Belle Mead NJ) 33 : 27-30, 2004
  42. Strauch B, Herman C, Dabb R, Ignarro LJ, Pilla AA : Evidence-based use of pulsed electromagnetic field therapy in clinical plastic surgery. Aesthet Surg J 29 : 135-143, 2009 https://doi.org/10.1016/j.asj.2009.02.001
  43. Tian NF, Wu YS, Zhang XL, Mao FM, Xu HZ, Chi YL : Efficacy of electrical stimulation for spinal fusion: a meta-analysis of fusion rate. Spine J 13 : 1238-1243, 2013 https://doi.org/10.1016/j.spinee.2013.06.056
  44. Victoria G, Petrisor B, Drew B, Dick D : Bone stimulation for fracture healing: what's all the fuss? Indian J Orthop 43 : 117-120, 2009 https://doi.org/10.4103/0019-5413.50844
  45. Wade B : A review of pulsed electromagnetic field (PEMF) mechanisms at a cellular level: a rationale for clinical use. Am J Health Res 1 : 51-55, 2013 https://doi.org/10.11648/j.ajhr.20130103.13
  46. Waldorff EI, Zhang N, Ryaby JT : Pulsed electromagnetic field applications: a corporate perspective. J Orthop Translat 9 : 60-68, 2017 https://doi.org/10.1016/j.jot.2017.02.006
  47. Wang C, Liu Y, Wang Y, Wei Z, Suo D, Ning G, et al. : Low-frequency pulsed electromagnetic field promotes functional recovery, reduces inflammation and oxidative stress, and enhances HSP70 expression following spinal cord injury. Mol Med Rep 19 : 1687-1693, 2019
  48. Wu N, Lee YC, Segina D, Murray H, Wilcox T, Boulanger L : Economic burden of illness among US patients experiencing fracture nonunion. Orthop Res Rev 5 : 21-33, 2013 https://doi.org/10.4081/or.2013.e21
  49. Zborowski M, Androjna C, Waldorff EI, Midura RJ : Comparison of therapeutic magnetic stimulation with electric stimulation of spinal column vertebrae. IEEE Trans Magn 51 : 1-9, 2015
  50. Zimmer Biomet : Biomet® EBI bone healing system. Available at : https://www.zimmerbiomet.com/medical-professionals/trauma/product/biomet-ebi-bone-healing-system.html