Stimulating Talk About Spinal Fusion
November 13, 2019
More than 400,000 spinal fusions are performed in the United States each year.
These procedures are designed to help ease back pain and prevent damage to vertebrae in the spine and to treat conditions such as degenerative disk disease, spinal stenosis and isthmic spondylolisthesis, a lumbar spinal condition that occurs when the isthmus, a small, thin segment of vertebral bone, slips forward on top of the vertebrae below it.
Spinal fusion is also used to treat fractures of the vertebrae and tumors of the spine.
Researchers report that while these surgeries are frequent, around 30 percent of these procedures fail to completely fuse the vertebrae they are treating into a single, stronger bone.
When spinal fusion fails, patients often experience the return of back pain, difficulty moving and numbness.
But that may soon change.
Researchers from Johns Hopkins University have found that electrical stimulation may help reduce failure rates for spinal fusion patients.
Scientists from the school reviewed 16 studies in humans and 17 in animals that tested three different types of electrical stimulation, including one implanted device and two devices worn by patients.
These devices were used for six to nine months after surgery and then removed.
After analysis, the Johns Hopkins team found that humans who received these devices after their spinal fusion procedure were twice as likely to have successful vertebrae fusion.
While the implanted device could be helpful for surgeons and patients, it does carry some risks and complications. These devices may interfere with diagnostic imaging tests such as MRIs or be rejected by the immune system.
Spinal fusion has its own risks - implanted electrical stimulation or not.
In addition to failure, many patients also experience lower back pain and discomfort after their procedure.
If pedicle screws are used during the surgery to connect vertebrae, there is also a risk that the screws could break or loosen, which requires more surgery to correct. If rods or grafts are used, these devices can migrate, which may also necessitate another procedure.
But, some spinal surgeons are taking extra precautions in the operating room to help reduce post-surgical complications; they are using intraoperative neuromonitoring to help reduce nerve damage and its subsequent side effects.
Nerve and spinal cord damage is a potential complication of spinal fusion surgery and other spinal procedures.
"Nervous tissue is at risk of direct or indirect injury during spinal procedures, which may result in nerve damage, loss of sensation in the legs, muscle weakness or loss of strength in limbs, and changes to the ability to control the bladder or bowels," said Dr. Faisal Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
The findings were published Oct. 8 in the Journal of Neurosurgery: Spine.
Source: SciTechDaily. Johns Hopkins Analyzes the Effectiveness of Electrical Stimulation Therapies on Spinal Fusion. 7 October 2019.
