Effect of combined treatment with pulsed electromagnetic field stimulation and sclerostin monoclonal antibody on changes in bone metabolism and pedicle screw augmentation in rabbits with ovariectomy-induced osteoporosis

Abstract

Background: Both pulsed electromagnetic field (PEMF) stimulation and sclerostin monoclonal antibody are useful for treating osteoporosis, but whether the two therapies have synergistic effects on both screw fixation quality and bone metabolism of ovariectomy-induced osteoporosis has not been reported.Methods: We used ovariectomy to create a rabbit model of postmenopausal osteoporosis. Then, specimens were fixed with pedicle screws in the L4 vertebral body. Rabbits were randomly divided into an OVX control group, PEMF group, Scl-Ab group, and PEMF+Scl-Ab group. The PEMF group was given PEMF magnetic therapy, the Scl-Ab group was administered a subcutaneous Scl-Ab injection, and the PEMF+Scl-Ab group received both therapies. The OVX group was injected subcutaneously with the same dose of saline instead. After eight weeks of treatment, the bone metabolism index, bone mineral density (BMD), and bone microstructural, biological, and biomechanical parameters were evaluated.Results: BMD significantly decreased six months post-ovariectomy. Compared with that of the OVX group, the BMD of the PEMF, Scl-Ab, and PEMF+Scl-Ab groups increased by 20.3%, 19.9%, and 35.0%, respectively. The maximum pulling force of pedicle screws increased by 14.0%,15.0% and 19.1%, and the maximum failure power consumption of pedicle screws increased by 27.9%, 27.2% and 33.6%, respectively; these differences were statistically significant (P<0.05). The bone metabolism index and bone microstructure parameters of the PEMF+Scl-Ab group were more optimal than those in the single treatment group.Conclusions: Both Scl-Ab and PEMF therapy can enhance the BMD and the mechanical strength of pedicle screws in osteoporotic bones of rabbits with postmenopausal osteoporosis. However, combination of the two measures has achieved even better results, yielding potential clinical application value.

Pulsed electromagnetic fields as a promising therapy for glucocorticoid-induced osteoporosis

“…Waldorff et al (2017) also reported that PEMF increased the speed of bone healing when used as a treatment for fracture patients. Additionally, PEMFs have been proven to be beneficial in enhancing bone mechanical strength and improving bone microstructure by promoting bone formation and suppressing bone resorption in a study of a New Zealand white rabbit model of osteoporosis (Qian et al, 2021). Moreover, PEMF therapy attenuated bone resorption, enhanced BMD, and promoted osteogenesis in rats with disuse osteoporosis.…”

Pulsed Electromagnetic Field Stimulation in Osteogenesis and Chondrogenesis: Signaling Pathways and Therapeutic Implications

“…As Wnt pathway is negatively modulated by endogenous molecules such as sclerostin (SOST), molecules targeting SOST, such as SOST antibodies (Scl-Ab) and lithium chloride (LiCl) are currently in clinical trials [ 71 ]. On this basis, therapies combining PEMFs with Wnt modulatory molecules can be foreseen [ 74 ]. Indeed, combination therapies including treatment with local BMP and antibodies against Wnt signaling inhibitors are currently under investigation.…”

Magnesium–Magnetic Field Synergy Enhances Mouse Bone Marrow Mesenchymal Stem Cell Differentiation into Osteoblasts Via the MAGT1 Channel

“…Numerous studies have shown that BMSC proliferation and osteoinduction can be accelerated by medium-strength magnetic fields (1 mT-1 T) [11][12][13][14], which include both pulsed electromagnetic fields (PEMFs) [15][16][17] and static magnetic fields (SMFs) [18][19][20][21][22]. Since magnetic fields are noninvasive and safe, they have the potential for broad clinical applications [23][24][25][26][27]. Although PEMFs are currently extensively studied for the induction of bone formation, SMFs have unique advantages for the preparation of artificial bone materials.…”