Jenis L G, An H S, Stein R, Young B
New England Baptist Spine Center, Boston, Massachusetts 02120, USA.
J Spinal Disord. 2000 Aug;13(4):290-6. doi: 10.1097/00002517-200008000-00004.
The purpose of this prospective study was to compare the effect of adjunctive direct current (DC) electrical stimulation and pulsed electromagnetic field therapy (PEMF) on augmentation of instrumented lumbar fusion. Sixty-one patients undergoing lumbar spine fusion were enrolled in the study and randomized to one of three treatment protocols: 1) adjunctive PEMF group (n = 22) fitted with Spinal-Stim model 8212(AME) within 30 days of surgery; 2) DC group (n = 17) had a SpF-2T stimulator(EBI) implanted at the time of surgery; or 3) control group (n = 22). The fusion mass bone mineral density (BMD) assessment was performed on 3-month and 1-year radiographs for each patient. Lateral flexion-extension and anteroposterior radiographs were evaluated at 1 year to determine the presence of fusion. Clinical outcome patient analyses were performed at 1 year. At 1-year follow-up, radiographic fusion and fusion mass bone density were not significantly different among the groups. In the nonstimulated group, there were 43% excellent, 43% good, and 14% fair results. In the PEMF group, there were 35% excellent, 50% good, 10% fair, and 5% poor results. In the DC group, there were 32% excellent, 37% good, and 31% fair results. The results of the current study suggest that electrical stimulation does not significantly enhance fusion rate in instrumented lumbar arthrodesis, although we observed a statistically insignificant trend toward increased fusion mass BMD in the electrically stimulated groups. The significance of increased BMD remains unknown.
这项前瞻性研究的目的是比较辅助直流电(DC)电刺激和脉冲电磁场疗法(PEMF)对器械辅助腰椎融合术效果的影响。61例接受腰椎融合术的患者被纳入研究,并随机分为三种治疗方案之一:1)辅助PEMF组(n = 22),在术后30天内安装Spinal-Stim 8212型(AME);2)DC组(n = 17),在手术时植入SpF-2T刺激器(EBI);或3)对照组(n = 22)。对每位患者在术后3个月和1年的X光片上进行融合块骨密度(BMD)评估。在1年时评估腰椎侧屈-后伸位和前后位X光片以确定融合情况。在1年时进行临床结局患者分析。在1年随访时,各组之间的影像学融合和融合块骨密度无显著差异。在未刺激组中,结果为优的占43%,良的占43%,可的占14%。在PEMF组中,结果为优的占35%,良的占50%,可的占10%,差的占5%。在DC组中,结果为优的占32%,良的占37%,可的占31%。本研究结果表明,电刺激并不能显著提高器械辅助腰椎融合术的融合率,尽管我们观察到在电刺激组中融合块骨密度有增加的趋势,但在统计学上无显著意义。骨密度增加的意义尚不清楚。
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