Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis

Abstract

Purpose Magnetically controlled growing rod systems have been introduced over recent years as an alternative to traditional growing rods for management of early onset scoliosis. The purpose of this paper is to report our early experience of a magnetically controlled growing rod system (MAGEC, Ellipse). Methods Review of pre-operative, postoperative and follow-up Cobb angles and spinal growth in case series of eight patients with a minimum 23 months' follow-up (23-36 months). Results A total of six patients had dual rod constructs implanted and two patients received single-rod constructs. Four patients had MAGEC rods as a primary procedure. Four were revisions from other systems. Mean age at surgery in the primary group was 4.5 years (range 3.9-6.9). In patients who had MAGEC as a primary procedure, mean pre-operative Cobb angle was 74°(63-94), with postoperative Cobb angle of 42°(32-56) p B 0.001 (43 % correction). Mean Cobb angle at follow-up was 42°(35-50). Spinal growth rate was 6 mm/year. One sustained proximal screw pull out. A final patient sustained a rod fracture. Mean age at surgery in the revision group was 10.9 years (range 9-12.6). Mean pre-operative Cobb angle was 45°( 34-69). Postoperative Cobb angle was 42°(33-63) (2 % correction). Mean Cobb angle at follow-up was 44°( 28-67). Mean spinal growth rate was 12 mm/year. Two patients developed loss of distraction.Conclusion MAGEC growing rod system effectively controls early onset scoliosis when used as either a primary or revision procedure. Although implant-related complications are not uncommon, the avoidance of multiple surgeries following implantation is beneficial compared with traditional growing rod systems.

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

“…Preliminary studies of MCGRs have been met with optimism with respect to achieving the same results of TGRs. [34][35][36] Dannawi et al 34 demonstrated that the mean coronal Cobb angle improved from 69° to 41° after MCGRs with a mean of 4.8 distractions per patient were used over 15 months. The T1 to S1 length increased a mean of 3.5 cm during this time period.…”

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

“…MCGRs are gaining in popularity among patients and surgeons as they are the least invasive technique for patients with a high degree scoliosis [6][7][8][9][10][11], both for primary operations and conversion cases from the traditional growing rods [12]. Once implanted (see Fig.…”

“…1), MCGRs are elongated non-invasively every 3 months using an external remote controller (the external magnet) in an outpatients' clinic, while the patient is conscious. The lengthening procedure lasts approximately 40 s per rod and the total length is measured using a plain radiograph [8]. Recent studies have also investigated the reliability of other imaging modalities, including ultrasound [13][14][15].…”

Innovative Method of Gradual Temporary Distraction Using Magnetic Growing Rods (MCGR) for Surgical Treatment of Severe Kyphoscoliosis: Mini-case Series

“…These new rods seem to provide distraction of the spine with no need for repeated lengthening surgeries before definitive fusion [5][6][7]. Therefore, we have applied this distraction technique in adult patients to obtain gradual lengthening of the spine by posterior access alone, thus avoiding the anterior access and vertebrectomy related risks, as well as halo-traction discomfort.…”