Review: E-Stim Devices May Increase Spinal Fusion Rates
WEDNESDAY, Oct. 9, 2019 -- Electrical stimulation technologies (ESTs) appear to be effective for increasing spinal fusion, according to a review of preclinical and clinical literature published online Oct. 8 in the Journal of Neurosurgery: Spine.
Ethan Cottrill, from the Johns Hopkins School of Medicine in Baltimore, and colleagues conducted a systematic review of the literature to provide estimates of the effects of ESTs. All preclinical and clinical studies examining ESTs for spinal fusion were included (17 and 16 articles, respectively); 11 and 13 clinical studies with 257 animals and 2,144 patients, respectively, were included in the meta-analysis.
The researchers found that the mean fusion rates were higher among EST-treated animals in the preclinical studies (odds ratio, 4.79). ESTs were similarly shown to increase fusion rates in clinical studies (odds ratio, 2.26). Direct current stimulation was the only EST modality to improve fusion rates in both preclinical and clinical populations (odds ratios, 5.64 and 2.13); inductive coupling stimulation only improved fusion in clinical studies (odds ratio, 2.45). Although only one clinical study was identified, capacitive coupling stimulation was found not to be effective for increasing fusion. ESTs increased fusion rates in patients with difficult-to-fuse spines, smokers, and those who underwent multilevel fusions.
"Additional research is needed to analyze the cost-effectiveness of electrical stimulation devices to identify those patients in whom these devices are likely to be not only practically effective but also cost-effective," the authors write.
Several authors disclosed financial ties to the medical device industry.
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Posted: October 2019
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