The Spine Journal
Volume 6, Issue 1 , Pages 7-13, January 2006

Direct current stimulation for spine fusion in a nicotine exposure model

  • John C. France, MD

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Timothy L. Norman, PhD

      Affiliations

    • Department of Engineering, Cedarville University, 251 North Main Street, Cedarville, OH 45314, USA
    • Corresponding Author InformationCorresponding author. Department of Engineering, Cedarville University, 251 North Main Street, Cedarville, OH 45314. Tel.: (937) 766-3761; fax: (937) 766-7689.
    • ,
  • Matthew M. Buchanan, MD

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Michael Scheel, MD

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Michael Veale, MD

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Elizabeth S. Ackerman, MD

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Nina B. Clovis

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Vincent L. Kish, ASEE

      Affiliations

    • Department of Orthopaedics, Musculoskeletal Research Center, West Virginia University, 1 Medical Center Drive, Morgantown, WV 26506-9196, USA
    • ,
  • Bruce Simon, PhD

      Affiliations

    • EBI Medical Systems, 100 Interpace Parkway, Parsippany, NJ 07054, USA

Received 20 October 2004; accepted 2 May 2005.

Abstract 

Background context

Decreased effectiveness in spinal fusion procedures in patients who smoke before, during, or after the operation has been noted in several clinical studies. In previous work, direct current (DC) electrical stimulation has been shown to enhance intertransverse process fusion in a rabbit model.

Purpose

To test the efficacy of DC stimulation on bone healing in spinal fusion in rabbits exposed to nicotine.

Study design/setting

A randomized and controlled interventional study.

Methods

Thirty male New Zealand white rabbits received a single level posterolateral, intertransverse process fusion with autologous iliac crest bone. One group (control) acted as a control without nicotine or electrical stimulation. A second group (Nic) received a continuous dose of nicotine via a transdermal patch to simulate a heavy smoker, and a third group, nicotine/stimulator group (Nic/Stim), additionally received a 100-microamp DC stimulator. The fusion masses (L5-L6) and the adjacent unfused control segment (L4-L5) were evaluated radiographically, manually, and biomechanically.

Results

The Nic group showed significantly higher fusion rate compared with the control group. The Nic/Stim group also demonstrated significantly higher fusion rate and X-ray trabeculation compared with the control group. However, the Nic/Stim group was not significantly higher than the Nic group in fusion rate or X-ray trabeculation.

Conclusions

Nicotine significantly improved fusion rate compared with controls, and DC stimulation significantly increased X-ray trabeculation of nicotine treated rabbits compared with controls.

Keywords: Spine fusion, Smoking, Nicotine, Bone healing, Spine

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 FDA device/drug status: not applicable.Support in whole or in part was received from the North American Spine Society (NASS), a non-profit organization. Author BS acknowledges a financial relationship (Director of Research, EBI Medical Systems), which may indirectly relate to the subject of this manuscript.

PII: S1529-9430(05)00695-9

doi:10.1016/j.spinee.2005.05.380

The Spine Journal
Volume 6, Issue 1 , Pages 7-13, January 2006

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