Pulsed Electromagnetic Field Stimulation of Intervertebral Disc Cells

Abstract

Pulsed electromagnetic field (PEMF) stimulation has been proposed for the noninvasive treatment of a variety of musculoskeletal disorders. PEMF is most commonly applied in the treatment of fracture nonunions or delayed fusion. PEMF stimulation devices are FDA approved as a complimentary therapy and there is clinical evidence of effectiveness for bone stimulation. More recently, potential therapeutic effects of PEMF on muscle and cartilage have been reported, with also an increasing interest in the application for the treatment of disc disorders. We have studied the influence of PEMFs in the mT range on isolated intervertebral disc cells in both 2D monolayer and 3D cell culture models, exploring the influence of parameters such as field strength, pulsing frequency, and daily exposure. Depending on the nature of the PEMF stimulation, we have demonstrated a mild anabolic effect, mostly of mitogenic nature, and also the potential to decrease the expression of catabolic enzymes, including matrix metalloproteinases and aggrecanases. A full and detailed understanding of the pathway(s) by which PEMFs influence cellular metabolism remains the topic of current investigations. Information on the optimal strategy for PEMF stimulation of the IVD is scarce. BMP-2 has been shown to mediate the response of disc cells to PEMF, suggesting a potential benefit of combined therapy. However, in vitro studies have also highlighted the highly variable nature of the response of disc cells to PEMF stimulation. Further work is required to elucidate the optimal parameters for PEMF therapy, to validate the process in vivo before translating the process to clinical practice. Disclosure of Interest None declared