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Research ArticleLumbar Spine

Pulsed Electromagnetic Field Stimulation in Lumbar Spine Fusion for Patients With Risk Factors for Pseudarthrosis

Marc A. Weinstein, Andrew Beaumont, Peter Campbell, Hamid Hassanzadeh, Vikas Patel, Amir Vokshoor, Joshua Wind, Kristen Radcliff, Ilyas Aleem and Domagoj Coric
International Journal of Spine Surgery October 2023, 8549; DOI: https://doi.org/10.14444/8549
Marc A. Weinstein
1 Florida Orthopedic Institute, Tampa, FL, USA
MD
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  • For correspondence: mweinstein@floridaortho.com
Andrew Beaumont
2 Aspirus Spine and Neurosciences Institute, Wausau, WI, USA
MD
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Peter Campbell
3 Spine Institute of Louisiana, Shreveport, LA, USA
MD
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Hamid Hassanzadeh
4 Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
MD
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Vikas Patel
5 Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA
MD
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Amir Vokshoor
6 Institute of Neuro Innovation, Santa Monica, CA, USA
MD
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Joshua Wind
7 Washington Neurological Associates, Sibley Memorial Hospital, Washington, DC, USA
MD
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Kristen Radcliff
8 Spinal DISC Center, Cherry Hill, NJ, USA
MD
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Ilyas Aleem
9 Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
MD
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Domagoj Coric
10 Carolina Neurosurgery and Spine Associates, Charlotte, NC, USA
MD
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  • Article
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  • Figure 1
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    Figure 1

    Fusion success at 12 months following pulsed electromagnetic field stimulation. (A) An overall successful fusion rate of 88.0% (n = 125/142) was observed following lumbar spinal fusion with adjunct pulsed electromagnetic field stimulation treatment. (B) A high rate of successful fusion was observed in patients presenting with single or multiple risk factors for pseudarthrosis.

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    Figure 2

    Impact of pulsed electromagnetic field stimulation on short form-36 mental and physical component scores. Significant improvements in short form-36 mental (P = 0.005) and physical (P < 0.001) component scores were observed at the 12-month time point.

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    Figure 3

    Impact of pulsed electromagnetic field stimulation on overall quality of life and disability index (EQ-5D). (A) A significant improvement in EQ-5D scores was observed at the 12-month time point (P < 0.0001). (B) A significant improvement in Oswestry Disability Index (ODI) scores was observed at the 12-month time point (P < 0.0001).

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    Figure 4

    Impact of pulsed electromagnetic field stimulation on overall visual analog scale (VAS)-back and VAS-leg pain scores. A significant improvement in VAS-back and VAS-leg pain scores was observed at the 12-month time point (P < 0.0001).

Tables

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    Table 1

    Demographics and baseline characteristics of study participants (N = 142).

    Variable n (%)
    Sex
     Female79 (55.6%)
     Male63 (44.4%)
    Ethnicity
     Hispanic/Latino5 (3.5%)
     Not Hispanic/Latino137 (96.5%)
    Race
     Caucasian or White130 (91.5%)
     Black or African American8 (5.6%)
     Other4 (2.8%)
    BMI
     Mean (SD)31.03 (5.94)
     Min–Max17.16–44.19
     BMI ≥3079 (55.6%)
     BMI <3063 (44.4%)
    Age, y
     Mean (SD)63.27 (10.34)
     Min–Max30–81
     Age 65+76 (53.5%)
     Age <6566 (46.5%)
    • Abbreviation: BMI, body mass index.

    • Note: Data presented as n (%) unless otherwise noted.

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    Table 2

    Number of risk factors or fusion levels (N = 142).

    Variable n (%)
    Number of risk factors
     178 (54.9)
     ≥264 (45.1)
     ≥317 (12.0)
     ≥42 (1.4)
    Number of levels
     110 (7.0)
     271 (50.0)
     339 (27.5)
     411 (7.8)
     55 (3.5)
     71 (0.7)
     82 (1.4)
     92 (1.4)
     151 (0.7)
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    Table 3

    Impact of patient risk factors on fusion success.

    VariableFusion Success
    n/N (%)
    P
    BMI risk factor
     ≥3072/79 (91.1%)0.2
     <3053/63 (84.1%)
    Nicotine risk factor
     Smoker22/27 (81.5%)0.2
     Nonsmoker103/113 (92.9%)
    Age risk factor
     65+ y70/76 (92.1%)0.1
     <65 y55/66 (83.3%)
    Diabetes risk factor
     Diabetes27/32 (84.4%)0.5
     No diabetes98/110 (89.1%)
    Osteoporosis risk factor
     Yes11/14 (78.6%)0.4
     No114/128 (89.1%)
    Prior fusion
     Yes20/22 (90.9%)1.0
     No105/120 (87.5%)
    Multiple levels
     Multiple114/128 (89.1%)0.4
     Single11/14 (78.6%)
    • Abbreviation: BMI, body mass index.

    • View popup
    Table 4

    Safety outcomes.

    AE ParameterEvents, n (%)
    Total AEs553
    Total No. of patients with ≥1 AE119 (53.1)
    AE severity 
     Mild312 (56.3)
     Moderate170 (30.7)
     Severe71 (12.8)
    AE relatedness 
     Related6 (1.1)
     Unrelated547 (98.7)
    Description of AESeverityAction Taken
    Pain from screwsModerateNo action taken
    Increase in diarrheaModerateTemporarily discontinued use of device
    Postoperative ankle dorsiflexion weaknessModerateOngoing
    Increased pain when wearing deviceMildOngoing
    Mild low back pain with device useMildResolved
    Increased back pain with some radicular pain through hips and groinSevereResolved
    • Abbreviation: AE, adverse event.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Pulsed Electromagnetic Field Stimulation in Lumbar Spine Fusion for Patients With Risk Factors for Pseudarthrosis
Marc A. Weinstein, Andrew Beaumont, Peter Campbell, Hamid Hassanzadeh, Vikas Patel, Amir Vokshoor, Joshua Wind, Kristen Radcliff, Ilyas Aleem, Domagoj Coric
International Journal of Spine Surgery Oct 2023, 8549; DOI: 10.14444/8549

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Pulsed Electromagnetic Field Stimulation in Lumbar Spine Fusion for Patients With Risk Factors for Pseudarthrosis
Marc A. Weinstein, Andrew Beaumont, Peter Campbell, Hamid Hassanzadeh, Vikas Patel, Amir Vokshoor, Joshua Wind, Kristen Radcliff, Ilyas Aleem, Domagoj Coric
International Journal of Spine Surgery Oct 2023, 8549; DOI: 10.14444/8549
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  • Recovery Trajectories After Lumbar Fusion Stratified by Baseline Patient-Reported Outcomes Measurement Information System Physical Function Disability Levels
  • Safety and Viability of Anterior Lumbar Interbody Fusion in Complex Revision Lumbar Spine Surgeries: Insights From a Case Series of 135 Patients on Transforaminal Lumbar Interbody Fusion/Posterior Lumbar Interbody Fusion Cage Removal
  • Effects of Body Mass Index on Spondylolisthesis Surgery and Associated Patient-Reported Outcomes: A Retrospective Review
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Keywords

  • pulsed electromagnetic fields
  • lumbar spinal fusion
  • PEMF
  • adjunctive therapy
  • bone stimulation
  • pseudarthrosis
  • failed fusion

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