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Effects of Low‐Intensity Pulsed Ultrasound on Spinal Pseudarthrosis Created by Nicotine Administration
Author(s) -
Liao Jen-Chung,
Chen Wen-Jer,
Niu Chi-Chien,
Chen Lih-Hui
Publication year - 2015
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.34.6.1043
Subject(s) - medicine , pseudarthrosis , palpation , spinal fusion , nuclear medicine , low intensity pulsed ultrasound , radiography , intensity (physics) , ultrasound , surgery , radiology , physics , therapeutic ultrasound , quantum mechanics
Objectives Low‐intensity pulsed ultrasound (US) can enhance spinal fusion and fracture healing; however, its effect on spinal pseudarthrosis has not been reported in the literature. We hypothesized that low‐intensity pulsed US could overcome spinal pseudarthrosis created by nicotine administration. Methods Thirty‐two rabbits underwent posterolateral fusion with an iliac bone graft and nicotine administration. At 5 weeks, the spines were examined by computed tomography (CT) to determine the presence of pseudarthrosis. All rabbits with pseudarthrosis were randomly divided into groups A, B, C, and D according to treatment: no second graft, iliac autograft only, low‐intensity pulsed US only, and iliac autograft and low‐intensity pulsed US, respectively. At 10 weeks, the rabbits were euthanized, and the specimens were assessed with radiography, CT, manual palpation, and histologic analysis. Results One rabbit was lost because of severe infection. Twenty‐seven (87%) had pseudarthrosis on CT at 5 weeks. On manual palpation at 10 weeks, the fusion rates were 0%, 29%, 0%, and 57% in groups A, B, C, and D, respectively. Group D had highest radiographic scores (mean ± SD, 2.87 ± 0.92), and the difference was statistically significant compared to the other groups ( P < .001). Computed tomography confirmed that group D had the most fused segments at 10 weeks. Histologic specimens from group D also showed the most mature bone formation inside the fusion mass. Conclusions Low‐intensity pulsed US can enhance spinal fusion but cannot overcome spinal pseudarthrosis created by nicotine administration. Stopping nicotine consumption or administering a more powerful bone substitute might be an alternative method for overcoming spinal pseudarthrosis.