Electrical stimulation as an adjunct to spinal fusion: A meta‐analysis of controlled clinical trials
- 10 September 2002
- journal article
- research article
- Published by Wiley in Bioelectromagnetics
- Vol. 23 (7), 496-504
- https://doi.org/10.1002/bem.10041
Abstract
This study was a meta‐analysis to examine whether electrical stimulation has a specific effect on spinal fusion. Little evidence exists on the efficacy of electrical stimulation for improving fusion rate of spinal fusion surgery. Using MEDLINE (1966–2000) and EMBASE (1985–1999), a search for articles was carried out using the Medical Subject Headings: (1) electric stimulation or electromagnetic fields, (2) spinal fusion, (3) controlled or clinical trial, and (4) human. Data were extracted from all the hit articles and additionally collected from appropriate journal lists. A total of five randomized controlled trials (RCT) on bones assessing healing of spinal fusion were identified and scored on methodological quality. All the identified studies reported positive findings, but the quality score of each trial showed wide flaws. Because of relatively homogenous subjects who had spine fusion and radiographic assessment from these studies, pooling of the data was able to be performed. Excluding one trial with the lowest score, the combined results of four trials, whose major endpoints were the success rate of the fusion, revealed a statistically significant effect of electrical stimulation with various techniques, but the selected trials still showed wide variation in view of stimulation modalities and treatment protocol. The pooled result of the studies in this review revealed the efficacy of electrical stimulation based on proved methodological quality. As problems on therapeutic modality and protocol remain, there is a further need for improvement in design to constitute acceptable proof and to establish treatment programs that better demonstrate electrical stimulation effects on spinal fusion. Bioelectromagnetics 23:496–504, 2002.Keywords
This publication has 35 references indexed in Scilit:
- Keynote addresses. Meta‐analysis: Reconciling the results of independent studiesStatistics in Medicine, 1995
- Physiotherapy exercises and back pain: a blinded review.BMJ, 1991
- Acupuncture and chronic pain: A criteria-based meta-analysisJournal of Clinical Epidemiology, 1990
- The Efficacy of Direct Current Electrical Stimulation to Enhance Canine Spinal FusionsClinical Orthopaedics and Related Research, 1990
- The Use of Pulsing Electromagnetic Fields in Posterolateral Lumbosacral Spinal FusionJournal of Bioelectricity, 1990
- Meta-Analyses of Randomized Controlled TrialsNew England Journal of Medicine, 1987
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986
- Treatment of Failed Posterior Lumbar Interbody Fusion (PLIF) of the Spine with Pulsing Electromagnetic FieldsPublished by Ovid Technologies (Wolters Kluwer Health) ,1985
- The Effect of Postoperative Electromagnetic Pulsing on Canine Posterior Spinal FusionsSpine, 1984
- A method for assessing the quality of a randomized control trialControlled Clinical Trials, 1981