IEEE Rev Biomed Eng. 2018;11:217-232. doi: 10.1109/RBME.2018.2799189. Epub 2018 Jan 30.
Pseudarthrosis is an exceedingly common, costly, and morbid complication in the treatment of long bone fractures and after spinal fusion surgery. Electrical bone growth stimulation (EBGS) presents a unique approach to accelerate healing and promote fusion success rates. Over the past three decades, increased experience and widespread use of EBGS devices has led to significant improvements in stimulation paradigms and clinical outcomes. In this paper, we comprehensively review the literature and examine the history, scientific evidence, available technology, and clinical applications for EBGS. We summarize indications, limitations, and provide an overview of cost-effectiveness and future directions of EBGS technology. Various models of electrical stimulation have been proposed and marketed as adjuncts for spinal fusions and long bone fractures. Clinical studies show variable safety and efficacy of EBGS under different conditions and clinical scenarios. While the results of clinical trials do not support indiscriminate EBGS utilization for any bone injury, the evidence does suggest that EBGS is desirable and cost efficient for certain orthopedic indications, especially when used in combination with standard, first-line treatments. This review should serve as a reference to inform practicing clinicians of available treatment options, facilitate evidence-based decision making, and provide a platform for further research.
假关节是长骨骨折和脊柱融合手术后一种非常常见、代价高昂且病态的并发症。电骨生长刺激 (EBGS) 提供了一种独特的方法来加速愈合并提高融合成功率。在过去的三十年中，EBGS 设备的使用经验增加和广泛应用导致刺激模式和临床结果有了显著改善。本文全面回顾了文献，检查了 EBGS 的历史、科学证据、可用技术和临床应用。我们总结了适应症、局限性，并概述了 EBGS 技术的成本效益和未来方向。已经提出并销售了各种电刺激模型，作为脊柱融合和长骨骨折的辅助治疗。临床研究表明，EBGS 在不同条件和临床情况下的安全性和有效性存在差异。虽然临床试验的结果并不支持在任何骨损伤的情况下不加选择地使用 EBGS，但有证据表明，EBGS 对于某些骨科适应症是可取且具有成本效益的，尤其是在与标准一线治疗联合使用时。这篇综述旨在为临床医生提供有关现有治疗选择的信息，促进基于证据的决策，并为进一步研究提供平台。
