Pulsed Electromagnetic Fields for Cervical Spine Fusion in Patients with Risk Factors for Pseudarthrosis

Area of Science:

• Spinal Surgery
• Biomedical Engineering
• Orthopedics

Background:

• Cervical spinal surgery complications like pseudarthrosis and reduced quality of life (QoL) are linked to specific demographics and risk factors.
• Pulsed electromagnetic field (PEMF) stimulation offers a non-invasive therapeutic approach to potentially improve fusion success in high-risk surgical patients.

Purpose of the Study:

• To assess the safety and efficacy of using pulsed electromagnetic field (PEMF) therapy as an additional treatment after cervical spinal surgery.
• To determine if PEMF therapy can enhance fusion success in patients identified as being at risk for pseudarthrosis.

Main Methods:

• A prospective, multicenter study involved subjects undergoing cervical spinal fusion with at least one risk factor for pseudarthrosis (e.g., prior failed fusion, multi-level fusion, nicotine use, osteoporosis, diabetes).
• Pulsed electromagnetic field (PEMF) was administered as an adjunctive therapy post-operatively.
• Radiographic fusion status and patient-reported outcomes, including SF-36, EQ5D, Neck Disability Index (NDI), and Visual Analog Scale (VAS) for arm and neck pain, were evaluated.

Main Results:

• Out of 160 subjects assessed at 12 months post-surgery, 144 achieved successful fusion, resulting in a 90.0% fusion rate.
• Fusion success rates were high across different numbers of risk factors: 91.7% for one, 89.0% for two or more, and 90.9% for three or more.
• Statistically significant improvements were observed in NDI, VAS-arm pain, and VAS-neck pain compared to baseline (p < 0.001), alongside enhancements in SF-36 and EQ5D scores (p < 0.001).

Conclusions:

• Adjunctive pulsed electromagnetic field (PEMF) therapy demonstrates a high success rate for cervical spinal fusion.
• PEMF therapy significantly improves patient-reported outcomes, including pain reduction and enhanced quality of life, even in individuals with pre-existing risk factors for pseudarthrosis.