Is rod diameter associated with the rate of rod fracture in patients treated with magnetically controlled growing rods?

Roye, Benjamin; Marciano, Gerard; Matsumoto, Hiroko; Fields, Mark; Campbell, Megan; White, Klane K.; Sawyer, Jeffrey R.; Smith, John T.; Luhmann, Scott J.; Sturm, Peter; Sponseller, Paul D.; Vitale, Michael G.

doi:10.1007/s43390-020-00161-x

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…One study focused on the correlation between rod diameter and fracture rate. 20 Accordingly, with our results, it concluded there is no clear association between rod fracture and rod diameter/size. It also analyzed other clinical and implant parameters and found no correlation between body mass index, lengthenings, and rod fracture rate.…”

Section: Discussionmentioning

confidence: 44%

“… 12 A fracture of the MCGR itself is estimated to occur in 10.6% of the total number of complications, 13 however, the risk factors for this are poorly understood. 14 …”

mentioning

confidence: 99%

“…12 A fracture of the MCGR itself is estimated to occur in 10.6% of the total number of complications, 13 however, the risk factors for this are poorly understood. 14 The aim of this study was to identify the mechanisms of fracture of explanted fracture MCGRs and assess the risk factors for this by (1) assessing the implant's state at retrieval (by means of retrieval analysis) (2) analyzing the fracture surface (fractographic analysis), and (3) using imaging analysis to evaluate an eventual patient or surgical risk factors for rod fracture, through comparison with a control group of intact rods.…”

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confidence: 99%

“…MCGRs have been shown to experience implant failure in several ways, including an inability to distract due to corrosion or internal pin fracture issues 12. A fracture of the MCGR itself is estimated to occur in 10.6% of the total number of complications,13 however, the risk factors for this are poorly understood 14…”

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confidence: 99%

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Rod Fracture in Magnetically Controlled Growing Spine Rods

Tognini

Hothi

Bergiers

et al. 2023

Journal of Pediatric Orthopaedics

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Background: The mechanisms of fracture in magnetically controlled growing rods (MCGRs) and the risk factors associated with this are poorly understood. This retrospective analysis of explanted MCGRs aimed to add understanding to this subject. Methods: From our cohort of over 120 retrieved MCGRs, we identified 7 rods that had fractured; all were single-rod constructs, retrieved from 6 patients. These were examined and compared with 15 intact single-rod constructs. Retrieval and fractographic analyses were used to determine the failure mode at the fracture site and the implant's functionality. Cobb angle, degree of rod contouring, and the distance between anchoring points were computed on anteroposterior and lateral radiographs. Results: 5/7 versus 3/15 rods had been inserted after the removal of a previously inserted rod, in the fractured versus control groups. All fractured rods failed due to bending fatigue. Fractured rods had greater rod contouring angles in the frontal plane ( P = 0.0407) and lateral plane ( P = 0.0306), and greater distances between anchoring points in both anteroposterior and lateral planes ( P = 0.0061 and P = 0.0074, respectively). Conclusions: We found all failed due to a fatigue fracture and were virtually all single rod configurations. Fracture initiation points corresponded with mechanical indentation marks induced by the intraoperative rod contouring tool. Fractured rods had undergone greater rod contouring and had greater distances between anchoring points, suggesting that it is preferable to implant double rod constructs in patients with sufficient spinal maturity to avoid this complication. Clinical Relevance: Level III.

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Section: Discussionmentioning

confidence: 44%

“… 12 A fracture of the MCGR itself is estimated to occur in 10.6% of the total number of complications, 13 however, the risk factors for this are poorly understood. 14 …”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Rod Fracture in Magnetically Controlled Growing Spine Rods

Tognini

Hothi

Bergiers

et al. 2023

Journal of Pediatric Orthopaedics

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“…In the past decade, magnetically controlled growing rods (MCGR) have replaced TGR with equal clinical results, and less radiation and surgical risks during their course of treatment [2][3][4][5][6][7][8][9][10][11]. However, with reports of unique complications such as distraction failure and metallosis, the actual benefits of long-term MCGR use have been questioned [12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal comparison of direct medical cost, radiological and health-related quality of life treatment outcomes between traditional growing rods and magnetically controlled growing rods from preoperative to maturity

Cheung

Wong

Sadiang-abay

et al. 2022

BMC Musculoskelet Disord

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Background Magnetically controlled growing rods (MCGR) have replaced traditional growing rods (TGR) in the past decade, however, a comparison of their direct costs and treatment outcomes based on real longitudinal data is lacking. This study aims to compare the direct cost and treatment outcomes between TGR and MCGR, whilst incorporating complications, reoperations and changes in health-related quality of life (HRQoL) throughout the entire treatment course. Methods Patients with early onset scoliosis (EOS) who underwent initial growing rod surgery between 2003 and 2016 at a tertiary scoliosis clinic were studied with longitudinal data. Accumulated direct medical costs were calculated based on the unit cost of surgeries of each TGR and MCGR, costs incurred for any rod exchange or remedial surgery for post-operative complication. Treatment outcomes were evaluated via: Patient’s HRQoL using SRS-22r questionnaire, and radiological parameters (including major curve correction, spine length gains, spinal balance) throughout the treatment until maturity. Results A total of 27 EOS patients (16 MCGR, 11 TGR) were studied. Total direct cost of index surgery for MCGR was HKD$223,108 versus lower cost of HKD$135,184 for TGR (p < 0.001). At 2–3 years post-index surgery, accumulative total direct medical cost of MCGR and TGR became most comparable (TGR:MCGR ratio = 1.010) and had reached neutrality between the two groups since. Radiological parameters had no intergroup differences at maturity. For HRQoL, TGR group had shown the trend of less pain (domain score mean difference: 0.53, p = 0.024) post-index surgery and better self-appearance (domain score mean difference: 1.08, p = 0.017) before fusion. Higher satisfaction with treatment (domain score mean difference: 0.76, p = 0.029) was demonstrated by TGR patients at fusion/maturity. MCGR had negative (rs = -0.693) versus TGR’s positive (rs = 0.989) correlations (p < 0.05) of cost and SRS-22r total scores at 2–3 years post-index surgery. Conclusions From index surgery to maturity, TGR demonstrated better satisfaction with treatment by patients and comparable overall HRQoL with MCGR during the treatment course, as MCGR did not show apparent benefit despite less surgeries and cost neutrality between the two groups at 2–3 years post-index surgery.

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Use of Magnetically Controlled Growing Rod Implants for the Spine

Gagner

2021

Magnetic Surgery

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Is rod diameter associated with the rate of rod fracture in patients treated with magnetically controlled growing rods?

Cited by 5 publications

References 23 publications

Rod Fracture in Magnetically Controlled Growing Spine Rods

Rod Fracture in Magnetically Controlled Growing Spine Rods

Longitudinal comparison of direct medical cost, radiological and health-related quality of life treatment outcomes between traditional growing rods and magnetically controlled growing rods from preoperative to maturity

Use of Magnetically Controlled Growing Rod Implants for the Spine

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