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Magnetically controlled growing rod in early onset scoliosis: a 30-case multicenter study
Julie Lebon1,2,3, Cécile Batailler4, Matthieu Wargny5
1Centre Hospitalier Universitaire de Toulouse, Toulouse, France. julie-lebon@hotmail.fr.
Purpose:
Preliminary results of magnetically controlled growing rods (MCGR) are encouraging. However, only short case series of MCGR for the treatment of early onset scoliosis (EOS) have been reported. Our aim was to evaluate its effectiveness and complications.
Methods:
We report a 30-case retrospective, consecutive, multicenter series of MCGR. Effectiveness was judged upon: deformity correction and difficulties to achieve desired distraction. Secondary endpoints included complications and revision surgeries.
Results:
Median age at surgery was 9.1 years (5-13). Mean follow-up was 18.4 months (12-33.9). Mean Cobb angle was 66° preoperatively and 44° at latest follow-up. MCGR has avoided an average of 2.03 scheduled surgical procedures per patient compared to traditional growing rod (GR). The intended total length gain was 40.1 mm per patient (5-140) and the total measured length gain was 21.9 mm (45.5% discrepancy). There were 24 complications: 7 proximal pull-outs of the hooks, 3 rod breakages, 6 failures of the lengthening of which 4 complete blockages and 2 complete blockages followed by backtracking, 1 proximal junctional kyphosis, 1 wound dehiscence, 1 superficial infection, 1 deep infection requiring implant removal, 1 pulmonary embolism, 1 pulmonary insufficiency, 1 secondary lumbar scoliosis, and 1 painful outpatient distraction. Eight patients had a gradual loss of effectiveness of distractions. There were 13 revision surgeries in 9 patients.
Conclusions:
MCGR provides satisfactory deformity correction and avoids repeated surgical procedures for lengthening. However, it has substantial complication rate. Although less frequent than in GR, the law of diminishing returns also applies to MCGR.
Insights
Magnetically controlled growing rods (MCGR) offer good scoliosis correction and reduce surgeries. However, they have a high complication rate and may lose effectiveness over time.
Area of Science:
- Spinal surgery
- Orthopedic technology
- Pediatric orthopedics
Background:
- Early onset scoliosis (EOS) requires spinal growth management.
- Magnetically controlled growing rods (MCGR) are a newer option for EOS treatment.
- Limited data exists on MCGR effectiveness and complications.
Purpose of the Study:
- To evaluate the effectiveness of MCGR in treating early onset scoliosis.
- To assess the complication rate associated with MCGR.
- To compare MCGR outcomes with traditional growing rods (GR).
Main Methods:
- Retrospective, consecutive, multicenter case series of 30 patients.
- Effectiveness assessed by deformity correction and distraction achievement.
- Complications and revision surgeries were secondary endpoints.
Main Results:
- Mean Cobb angle improved from 66° to 44°.
- MCGR avoided an average of 2.03 surgeries per patient compared to GR.
- A significant complication rate (24 events) was observed, including hook pull-outs, rod breakages, and lengthening failures.
Conclusions:
- MCGR achieves satisfactory deformity correction and reduces surgical frequency for lengthening.
- MCGR is associated with a substantial complication rate.
- The law of diminishing returns applies to MCGR, similar to traditional GR.
