scholarly journals Stacked PZT Discs Generate Necessary Power for Bone Healing through Electrical Stimulation in a Composite Spinal Fusion Implant

2018 ◽  
Vol 5 (4) ◽  
pp. 90
Author(s):  
Eileen Cadel ◽  
Ember Krech ◽  
Paul Arnold ◽  
Elizabeth Friis
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Bone Healing ◽  
Bone Growth ◽  
Fiber Composite ◽  
Piezoelectric Composite ◽  
Battery Packs ◽  
Electromechanical Performance ◽  
Piezoelectric Disc ◽  
Lumbar Spinal

Electrical stimulation devices can be used as adjunct therapy to lumbar spinal fusion to promote bone healing, but their adoption has been hindered by the large battery packs necessary to provide power. Piezoelectric composite materials within a spinal interbody cage to produce power in response to physiological lumbar loads have recently been investigated. A piezoelectric macro-fiber composite spinal interbody generated sufficient power to stimulate bone growth in a pilot ovine study, despite fabrication challenges. The objective of the present study was to electromechanically evaluate three new piezoelectric disc composites, 15-disc insert, seven-disc insert, and seven-disc Compliant Layer Adaptive Composite Stack (CLACS) insert, within a spinal interbody, and validate their use for electrical stimulation and promoting bone growth. All implants were electromechanically assessed under cyclic loads of 1000 N at 2 Hz, representing physiological lumbar loading. All three configurations produced at least as much power as the piezoelectric macro-fiber composites, validating the use of piezoelectric discs for this application. Future work is needed to characterize the electromechanical performance of commercially manufactured piezoelectric stacks under physiological lumbar loads, and mechanically assess the composite implants according to FDA guidelines for lumbar interbody fusion devices.

Electrical Stimulation in Lumbar Spinal Fusion

Orthopedics ◽  
2000 ◽  
Vol 23 (7) ◽  
pp. 737-743
Author(s):  
Jeffrey L Bush ◽  
Alexander R Vaccaro
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Lumbar Spinal Fusion ◽  
Lumbar Spinal

In Vivo Evaluation of Coralline Hydroxyapatite and Direct Current Electrical Stimulation in Lumbar Spinal Fusion

Spine ◽  
1999 ◽  
Vol 24 (20) ◽  
pp. 2127 ◽  
Author(s):  
Kevin J. Bozic ◽  
Paul A. Glazer ◽  
David Zurakowski ◽  
Bruce J. Simon ◽  
Stephen J. Lipson ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Direct Current ◽  
Lumbar Spinal Fusion ◽  
In Vivo Evaluation ◽  
Coralline Hydroxyapatite ◽  
Lumbar Spinal

The Effect of Electrical Stimulation on Lumbar Spinal Fusion in Older Patients: A Randomized, Controlled, Multi-Center Trial

Spine ◽  
2009 ◽  
Vol 34 (21) ◽  
pp. 2241-2247 ◽  
Author(s):  
Thomas Andersen ◽  
Finn B. Christensen ◽  
Carsten Ernst ◽  
Søren Fruensgaard ◽  
Jørgen Østergaard ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Older Patients ◽  
Lumbar Spinal Fusion ◽  
Randomized Controlled ◽  
Lumbar Spinal

ELECTRICAL STIMULATION AND LUMBAR SPINAL FUSION

Orthopedics ◽  
2001 ◽  
Vol 24 (2) ◽  
pp. 87-87
Author(s):  
Robert G Johnson ◽  
Jeffrey L Bush ◽  
Alexander R Vaccaro
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Lumbar Spinal Fusion ◽  
Lumbar Spinal

The Effect of Electrical Stimulation on Lumbar Spinal Fusion in Older Patients: A Randomized, Controlled, Multi-Center Trial

Spine ◽  
2009 ◽  
Vol 34 (21) ◽  
pp. 2248-2253 ◽  
Author(s):  
Thomas Andersen ◽  
Finn B. Christensen ◽  
Niels Egund ◽  
Carsten Ernst ◽  
Søren Fruensgaard ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Spinal Fusion ◽  
Older Patients ◽  
Lumbar Spinal Fusion ◽  
Randomized Controlled ◽  
Lumbar Spinal

Development of a Microfabricated Sensor System to Measure Lumbar Spinal Fusion

2016 ◽  
Author(s):  
Deborah S. Munro ◽  
Eric C. Tsai ◽  
Andrew R. Lingley ◽  
Michael T. Khbeis
Keyword(s):  
Spinal Fusion ◽  
Bone Growth ◽  
The United States ◽  
Capacitance Measurement ◽  
Lumbar Region ◽  
Peak Strain ◽  
Lumbar Spinal Fusion ◽  
Mechanical Stiffness ◽  
Free Standing ◽  
Lumbar Spinal

Lumbar spinal fusion surgery continues to experience major growth in the United States and worldwide. The surgery is performed by implanting spinal rods and screws within an incision on the lumbar region of the spine. This implanted hardware provides the initial mechanical stiffness until the morselized bone and bone growth factors generate new bone and can provide long term fixation. After surgery, development of the fusion is evaluated with radiographs, but determination of this fusion takes many months as the bone must first mineralize. The early stages are not visible on radiographs; however, this non-mineralized bone does provide substantial mechanical stiffness that could be measured with a sensor. As the spine moves and flexes, it creates a bending moment in the spinal rod, which could be measured as a strain. When initially implanted, this rod would experience its peak strain, but this would decrease as the bone shared some of the load. By periodically sampling the strain with a sensor, a curve could be generated that showed the overall progress of the fusion. To maximize the output signal, an interdigitated capacitor design was implemented as the most effective way to maximize the capacitance measurement. A design using 51 free-standing, interdigitated fingers resulted in 50 parallel plate capacitors. The interdigitated capacitor was connected to a Low-Z Amplifier circuit and attached to a spinal rod. The rod was then flexed to simulate spinal bending, and the capacitance changed as expected under physiological loads.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: Assessment of functional outcome following lumbar fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
Praveen V. Mummaneni ◽  
Andrew T. Dailey ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Functional Outcome ◽  
Spinal Fusion ◽  
Lumbar Fusion ◽  
Minimum Clinically Important Difference ◽  
Degenerative Disease ◽  
Psychological State ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Lumbar Spinal

Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

scholarly journals Are the Roland Morris Disability Questionnaire and Oswestry Disability Index interchangeable in patients after lumbar spinal fusion?

2021 ◽  
pp. 1-7
Author(s):  
R.F.M.R. Kersten ◽  
J. Fikkers ◽  
N. Wolterbeek ◽  
F.C. Öner ◽  
S.M. van Gaalen
Keyword(s):  
Back Pain ◽  
Spinal Fusion ◽  
Outcome Measures ◽  
Oswestry Disability Index ◽  
Roland Morris Disability Questionnaire ◽  
Leg Pain ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Disability Questionnaire ◽  
Lumbar Spinal

BACKGROUND: Low back pain is a common health problem for which there are several treatment options. For optimizing clinical decision making, evaluation of treatments and research purposes it is important that health care professionals are able to evaluate the functional status of patients. Patient reported outcome measures (PROMs) are widely accepted and recommended. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) are the two mainly used condition-specific patient reported outcomes. Concerns regarding the content and structural validity and also the different scoring systems of these outcome measures makes comparison of treatment results difficult. OBJECTIVE: Aim of this study was to determine if the RMDQ and ODI could be used exchangeable by assessing the correlation and comparing different measurement properties between the questionnaires. METHODS: Clinical data from patients who participated in a multicenter RCT with 2 year follow-up after lumbar spinal fusion were used. Outcome measures were the RMDQ, ODI, Short Form 36 – Health Survey (SF-36), leg pain and back pain measured on a 0–100 mm visual analogue scale (VAS). Cronbach’s alpha coefficients, Spearman correlation coefficients, multiple regression analysis and Bland-Altman plots were calculated. RESULTS: three hundred and seventy-six completed questionnaires filled out by 87 patients were used. The ODI and RMDQ had both a good level of internal consistency. There was a very strong correlation between the RMDQ and the ODI (r= 0.87; p< 0.001), and between the VAS and both the ODI and RMDQ. However, the Bland-Altman plot indicated bad agreement between the ODI and RMDQ. CONCLUSIONS: The RMDQ and ODI cannot be used interchangeably, nor is there a possibility of converting the score from one questionnaire to the other. However, leg pain and back pain seemed to be predictors for both the ODI and the RMDQ.

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