Direct current stimulation of allograft in anterior and posterior lumbar interbody fusions.

Abstract

Interbody spinal fusion rates were compared in patients with and without direct current stimulation. To determine whether direct current improves interbody fusion rates. High pseudarthrosis rates have been reported for anterior lumbar interbody fusions and failure of posterior lumbar interbody fusions pose difficult problems for the surgeon. Use of direct current to enhance interbody fusions is based on prior reports of electrically stimulated posterolateral lumbar fusions. A modified Crock surgical technique with allograft was performed and stimulator cathodes, when used, were wrapped around the graft. Fusion was assessed using multiplanar computed tomographic reconstructions, radiographs, and tomograms. Overall fusion rates were significantly higher in stimulated patients (93% vs. 75%). Particularly striking were high risk groups such as smokers (92% vs. 71%), and those with no internal fixation (91% vs. 65%) and L4-L5 fusions (91% vs. 59%). Lumbar interbody fusion rates are improved by direct current treatment.