Minimum 2-Year Experience with Magnetically Controlled Growing Rods for the Treatment of Early-Onset Scoliosis: A Systematic Review

Abstract

Magnetically controlled growing rods have been used to treat early-onset scoliosis for the last 9 years; however, few studies have been published, with only short-term follow-up. The aim of the present study is to systematically review the outcomes of magnetically controlled growing rods in the treatment of early-onset scoliosis with a minimum of 2-year follow-up. Studies were included if patients with early-onset scoliosis (scoliosis diagnosed before 10 years of age) underwent implantation of magnetically controlled growing rods with a minimum of 2-year follow-up. The literature review and data extraction followed the established preferred reporting items for systematic review and meta-analysis guidelines. Data of distraction frequency, number of distractions, distracted length, Cobb angle, kyphosis, T1–T12 length, and T1–S1 length preoperatively, postoperatively, and at final follow-up were collected. Data regarding complications and unplanned reoperations were also extracted. The mean values of these parameters were calculated, or pooled meta-analysis was performed if available. Ten articles were included in this systematic review, with a total of 116 patients and a follow-up period between 23 and 61 months. The mean preoperative Cobb angle and kyphosis angle were 60.1° and 38.0°, respectively, and improved to 35.4° and 26.1° postoperatively. At final follow-up, the Cobb and kyphosis angles were maintained at 36.9° and 36.0°, respectively. The average preoperative T1–T12 and T1–S1 lengths were 180.6 mm and 293.6 mm, respectively, and increased to 198.3 mm and 320.3 mm postoperatively. T1–T12 and T1–S1 lengths were 212.3 mm and 339.3 mm at final follow-up, respectively. The overall rate of patients with complications was 48% (95% confidence interval [CI], 0.38–0.58) and unplanned reoperation 44% (95% CI, 0.33–0.55) after sensitivity analysis. The current evidence from different countries with a minimum of a 2-year follow-up suggests that magnetically controlled growing rods are an effective technique to treat pediatric scoliosis and promote spine growth. However, nearly half of patients still developed complications or required unplanned reoperations.

Incidence and Surgery Rate of Idiopathic Scoliosis: A Nationwide Database Study

“…Thirdly, the data used in this study included only those claimed by the HIRA, which review the insurance claims, and the incidence and outcomes of uninsured procedures, such as bracing treatments, could not be investigated. In addition, growthsparing techniques, such as growing rods or vertical expandable prosthetic titanium ribs, do not have individual procedural codes and instead are included in the procedural code for posterior surgeries [31,32]. Therefore, if such procedures were performed, there could be an overestimation of the surgery rates, particularly in infants or juvenile patients.…”

Is there an indication for surgery in patients with spinal deformities? – A critical appraisal

“…For seach (4), 116 items were found, and 26 items were identified as relevant (Aghdasi et al 2020 ; Bettany-Saltikov et al 2015 , 2016 ; Cho et al 2014 ; Drazin et al 2011 ; Evaniew et al 2015 ; Figueiredo et al 2016 ; Guan et al 2020 ; Hawes & O’Brien 2008 ; Kim et al 2012 ; Larson et al 2013 ; Lau et al 2014 ; Ledonio, Polly & Crawford 2013 ; Legg et al 2014 ; Liang et al 2012 ; Sharma et al 2013 ; Theis, Gerdhem & Abbott 2015 ; Toovey et al 2017 ; Weiss 2008 ; Weiss & Goodall 2008a , 2009 ; Wu et al 2019 ; Yadla et al 2010 ; Yang et al 2016 ; Yoshihara 2019 ; Zanirato et al 2018 ).…”

Crecimiento guiado con barras magnéticas en pacientes con escoliosis de inicio temprano. Reporte preliminar

“…9 En una revisión bibliográfica sistemática, se halló una tasa global de complicaciones del 46% en pacientes tratados con BM y un seguimiento mínimo de dos años. 17 En un estudio comparativo entre el sistema de BM (10 pacientes) y barras tradicionales (10 pacientes), se observó una importante reducción en el número de cirugías con el sistema de BM. 18 Cualquier cirugía de revisión implica un aumento de la morbilidad para el niño, como así también un perjuicio financiero significativo tanto para la familia como para el sistema de salud.…”

“…19,20 No hay consenso en cuanto a los tiempos y la cantidad de milímetros por distraer en cada procedimiento. Nuestro protocolo consistió en distracciones cada tres meses, con una elongación promedio de 3 a 5 mm en cada sesión; 17,21 esto implicaría a cuatro distracciones anuales y un promedio de elongación anual del sistema de 12-20 mm.…”