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Autofusion With Magnetically Controlled Growing Rods: A Case Report.

Michael J Yang1,2, Alexander Rompala1, Solomon Praveen Samuel1

  • 1Orthopedic Surgery, Shriners Hospitals for Children, Philadelphia, USA.

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|May 8, 2023
PubMed
Summary

Magnetically controlled growing rods (MCGRs) offer effective early-onset scoliosis (EOS) treatment with fewer surgeries. This case report details a rare instance of autofusion with MCGRs, highlighting a potential complication in EOS management.

Keywords:
autofusioncerebralcontrolledgrowingmagneticallypalsypediatricrodsspinesurgery

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Area of Science:

  • Spinal surgery
  • Pediatric orthopedics
  • Biomedical engineering

Background:

  • Early-onset scoliosis (EOS) requires spinal instrumentation for correction.
  • Magnetically controlled growing rods (MCGRs) are an alternative to traditional growing rods (TGRs), offering remote lengthening.
  • MCGRs aim to reduce reoperation rates in EOS treatment.

Observation:

  • A unique case of spinal autofusion is presented in a pediatric patient with EOS, tetraplegic cerebral palsy, and thoracic myelomeningocele.
  • The patient underwent four years of serial lengthening procedures using dual MCGR instrumentation.
  • Intraoperative findings revealed dense heterotopic ossification (autofusion) around the MCGRs during explantation, impeding further correction.

Findings:

  • Autofusion around MCGR instrumentation can occur in EOS patients, potentially limiting spinal lengthening.
  • This phenomenon was observed in a complex pediatric case despite the theoretical low risk associated with MCGRs.
  • The autofusion presented a challenge to achieving maximal deformity correction during the final fusion procedure.

Implications:

  • While MCGRs are beneficial for EOS, the risk of autofusion warrants consideration in patient selection and monitoring.
  • Understanding and potentially mitigating autofusion may be crucial for optimizing MCGR outcomes in complex pediatric spinal deformities.
  • Further research into the mechanisms and prevalence of autofusion with MCGRs is needed to refine treatment strategies.