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Magnetically Controlled Growing Rods for the Management of Early-onset Scoliosis: A Preliminary Report.
Journal of Pediatric Orthopedics 2017 March
BACKGROUND: A new method for the management of early-onset scoliosis (EOS) has been recently introduced: it consists of a magnetically controlled growing rod (MCGR) that allows gradual outpatient distractions under control of an external remote device. The aim of the present study is to present a series of 10 patients with EOS managed with MCGR (Ellipse TM MAGEC System, Irvine, CA).
METHODS: We implanted MCGR in 10 patients affected by EOS. Scoliosis and kyphosis angles, T1-T12 and T1-S1 length were evaluated preoperatively, postoperatively, and at the last follow-up. A visual analogue scale score was used to evaluate pain during outpatient rod distraction procedures. The mean follow-up is 27 months. All patients attended distractions of the magnetic rod through an external remote control every 3 months. The mean predicted distraction was 3 mm at each lengthening session.
RESULTS: The mean Cobb angle value was 64.7±17.4 degrees (range, 45 to 100 degrees) preoperatively and 28.5±13.9 degrees (range, 15 to 59 degrees) at the latest follow-up. The mean T1-S1 length value was 27.1±5.4 cm (range, 16 to 34.8 cm) preoperatively and 32.8±4 cm (range, 26.5 to 39 cm) at the latest follow-up. The mean T1-T12 length value was 16.2±2.7 cm (range, 10 to 19 cm) preoperatively and 20.6±2.9 cm (range, 15.5 to 23.5 cm) at the latest follow-up.The average monthly T1-T12 height increase was 0.8 mm, whereas the average monthly T1-S1 increase was 0.9 mm.Two patients experienced a rod breakage and 1 patient had a pull-out of the apical hooks.
CONCLUSIONS: Although implant-related complications could occur, as in all EOS growing rods procedures, MCGR can be effectively used in patients with EOS. This spinal instrumentation can overcome many of the complications related with the traditional growing rods implants. This procedure can be effectively used in outpatient settings, minimizing surgical scarring, surgical site infection, and psychological distress due to multiple surgeries needed in the traditional growing rods system, improving quality of life, and saving health care costs.
LEVEL OF EVIDENCE: Level IV.
METHODS: We implanted MCGR in 10 patients affected by EOS. Scoliosis and kyphosis angles, T1-T12 and T1-S1 length were evaluated preoperatively, postoperatively, and at the last follow-up. A visual analogue scale score was used to evaluate pain during outpatient rod distraction procedures. The mean follow-up is 27 months. All patients attended distractions of the magnetic rod through an external remote control every 3 months. The mean predicted distraction was 3 mm at each lengthening session.
RESULTS: The mean Cobb angle value was 64.7±17.4 degrees (range, 45 to 100 degrees) preoperatively and 28.5±13.9 degrees (range, 15 to 59 degrees) at the latest follow-up. The mean T1-S1 length value was 27.1±5.4 cm (range, 16 to 34.8 cm) preoperatively and 32.8±4 cm (range, 26.5 to 39 cm) at the latest follow-up. The mean T1-T12 length value was 16.2±2.7 cm (range, 10 to 19 cm) preoperatively and 20.6±2.9 cm (range, 15.5 to 23.5 cm) at the latest follow-up.The average monthly T1-T12 height increase was 0.8 mm, whereas the average monthly T1-S1 increase was 0.9 mm.Two patients experienced a rod breakage and 1 patient had a pull-out of the apical hooks.
CONCLUSIONS: Although implant-related complications could occur, as in all EOS growing rods procedures, MCGR can be effectively used in patients with EOS. This spinal instrumentation can overcome many of the complications related with the traditional growing rods implants. This procedure can be effectively used in outpatient settings, minimizing surgical scarring, surgical site infection, and psychological distress due to multiple surgeries needed in the traditional growing rods system, improving quality of life, and saving health care costs.
LEVEL OF EVIDENCE: Level IV.
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