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Magnetically Controlled Growing Rods: Influence on Intraoperative Fluoroscopic Imaging: A Case Report
Brenton Sio1, Woei Jack Pan1, Kevin Boon Leong Lim1,2
1Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore.
Case:
A 7-year-old boy with severe congenital scoliosis and impending thoracic insufficiency syndrome underwent uneventful single magnetically controlled growing rod (MCGR) insertion and removal of his ipsilateral rib-based distraction implants at our institution. Intraoperative fluoroscopy imaging revealed an artifactual bend (S-distortion) of the rod actuator after placement. This artifact was eliminated by moving the image intensifier further from the patient.
Conclusion:
We attributed the S-distortion to influences of magnetic fields within the MCGR actuator onto the image intensifier. Surgeons should be aware of such implications which can lead to misleading imaging artifacts. This is a first reported case of such incident with MCGR.
Insights
A magnetically controlled growing rod (MCGR) can cause imaging artifacts during surgery. Moving the image intensifier resolved an S-distortion, a finding important for surgeons using this device.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Spinal Surgery
Background:
- Congenital scoliosis requires innovative surgical solutions.
- Thoracic insufficiency syndrome poses significant risks.
- Magnetically controlled growing rods (MCGR) offer a less invasive approach for spinal deformities.
Observation:
- During MCGR placement, an artifactual S-distortion was noted in the rod actuator on intraoperative fluoroscopy.
- This imaging artifact was observed in a 7-year-old boy with severe congenital scoliosis.
Findings:
- The S-distortion artifact was attributed to the magnetic fields generated by the MCGR actuator interacting with the image intensifier.
- Moving the image intensifier away from the patient successfully eliminated the observed artifact.
Implications:
- Surgeons utilizing MCGR technology must be aware of potential magnetic field interference with imaging equipment.
- This awareness can prevent misinterpretation of imaging results and ensure accurate surgical assessment.
- This represents the first reported instance of MCGR-induced imaging artifacts, highlighting a novel consideration in spinal instrumentation procedures.
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