Spinal fusionDoes electromagnetic stimulation accelerate fusion after fixation?
30 December 2009 (online)
There is insufficient evidence from three randomized controlled trials to suggest that pulsed electromagnetic field (PEMF) treatment after spinal fusion procedures improves outcomes compared with sham or no additional treatment. One study focused on the cervical spine and two on the lumbar spine. There is conflicting evidence regarding fusion rates. In the one cervical trial, fusion rates were slightly higher in the PEMF group 6 months following surgery but this difference was not present at the 1 year follow-up. In the two lumbar trials, one reported higher fusion rates in those receiving PEMF while the other trial did not. The definition of a successful fusion varied across studies. No other significant differences were found between the treatment groups with respect to fusion bone density, physical impairment, functional status, pain, clinical outcome evaluation, or treatment complications. Two studies did not use a sham device in the control group, one study was limited by a small sample size, and one study measured only one outcome. Additional randomized trials with standardized outcome measures, adequate sample size, and a sham device for patients in the control group are necessary to establish the efficacy of PEMF treatment for spinal fusion patients.