Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuanxi Rd, Wenzhou, Zhejiang 325000, China.
Spine J. 2013 Oct;13(10):1238-43. doi: 10.1016/j.spinee.2013.06.056. Epub 2013 Aug 28.
Many clinical studies have demonstrated the effectiveness of electrical stimulation as an adjunct to spinal arthrodesis. However, there is a paucity of comparative data among different electrical stimulation techniques.
To compare the efficacy of three electrical stimulation methods for spinal fusion based on the literature review.
Twenty-one articles, meeting all the inclusion criteria, were selected. A total of 1,381 patients were evaluated.
Systematic literature review and meta-analysis.
Fusion rates were determined using radiography or computed tomography.
A systematic literature review was conducted on spinal fusion surgeries with the aid of electrical stimulation devices. Only studies applying radiography or computed tomography for fusion assessment were included. Study groups were divided based on electrical stimulation types and were further grouped by other patient characteristics. Pooled estimates and 95% confidence intervals (CIs) were calculated by random-effects meta-analysis.
The pooled fusion rate for all studies was 85% (95% CI, 79-90). There were 14 direct current, 1 capacitive coupling (CC), and 10 inductive coupling studies in our analysis, with combined fusion rate of 85% (95% CI, 76-91), 90% (95% CI, 83-95), and 85% (95% CI, 74-93), respectively. There were no statistically significant differences among the three electrical stimulation methods. Further subgroup analysis suggested that age, sex, smoking status, surgery type, fusion levels, fusion column, implant use, and graft type did not significantly influence the fusion rate.
The three types of electrical stimulation devices had similar clinical efficacy in promoting bone growth for spinal fusion. The results for CC stimulation should be applied with caution as only one relevant study was identified.
许多临床研究已经证明，电刺激作为脊柱融合术的辅助手段是有效的。然而，不同电刺激技术之间的比较数据很少。
通过文献回顾比较三种电刺激方法在脊柱融合中的疗效。
选择了符合所有纳入标准的 21 篇文章，共评估了 1381 例患者。
系统文献回顾和荟萃分析。
融合率通过放射学或计算机断层扫描确定。
对使用电刺激装置的脊柱融合手术进行了系统的文献回顾。仅纳入应用放射学或计算机断层扫描评估融合的研究。根据电刺激类型将研究组进行分组，并根据其他患者特征进一步分组。通过随机效应荟萃分析计算汇总估计值和 95%置信区间（CI）。
所有研究的总体融合率为 85%（95%CI，79-90）。我们的分析中包括 14 项直流电、1 项电容耦合（CC）和 10 项感应耦合研究，其综合融合率分别为 85%（95%CI，76-91）、90%（95%CI，83-95）和 85%（95%CI，74-93）。三种电刺激方法之间无统计学差异。进一步的亚组分析表明，年龄、性别、吸烟状况、手术类型、融合水平、融合柱、植入物使用和移植物类型对融合率无显著影响。
三种类型的电刺激装置在促进脊柱融合骨生长方面具有相似的临床疗效。由于仅确定了一项相关研究，因此 CC 刺激的结果应谨慎应用。
