Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis

Thakar, Chrishan; Kieser, David; Mardare, Mihai; Haleem, Shahnawaz; Fairbank, Jeremy; Nnadi, Colin

doi:10.1007/s00586-018-5590-4

Cited by 118 publications

(99 citation statements)

References 34 publications

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“…After MCGR became available, the dual MCGR rod construct has become a popular treatment in many centers despite the high initial implant cost [5]. The advantages of a dual MCGR over a single MCGR construct has been advocated by a recent systematic review which found fewer implant-related failures including a lower frequency of rod breakage [7]. The bilateral support of our proposed hybrid construct follows a dual-rod principle with added apical support and could reduce complications including rod breakage.…”

Section: Introductionmentioning

confidence: 97%

“…An anchor site was added at the apex to increase the stability and aid for axial deformity correction [6]. Dual rods instead of single rods have been advised in the traditional growing-rod treatment because of better correction, spinal growth, and lower implant-related complications [7,8]. After MCGR became available, the dual MCGR rod construct has become a popular treatment in many centers despite the high initial implant cost [5].…”

Section: Introductionmentioning

confidence: 99%

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3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis

Wijdicks

Skov

et al. 2020

Spine Deform

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Study design Two-center retrospective cohort study. Objective The aim of this study is to investigate the clinical effectiveness and safety of the MCGR hybrid in terms of spinal growth, 3D correction, balance, and complications. Summary of background data The magnetic-controlled growing-rod (MCGR) growth instrumentation method has gained popularity for early onset scoliosis (EOS) treatment in the past years due to the non-invasiveness of the subsequent interval elongation procedures. To improve 3D correction and reduce the costs, we combined a single concave MCGR with a sliding rod on the convex side to control the apex. Methods A retrospective cohort study of 18 EOS children with an average 3-year follow-up (range 2.0-3.7) from two European spine centers treated with the single MCGR hybrid concept; 14 primary and 4 conversion cases. The primary and conversion cases were both evaluated preoperatively, postoperatively, 1 year, 2 years, and last follow-up. Results Mean age was 9.9 (SD ± 2.9 years). The average frontal Cobb angle was reduced from mean 65° to 30° postoperatively, and had increased to 37° at latest follow-up. Rotation of the apical vertebra improved from mean 27° to 20° postoperatively which was partially lost to 23°. Kyphosis and lordosis both increased by an average of 5° during the time of follow-up. Spinal balance was improved. The post-implantation T1-S1 spine growth rate averaged 10 mm/year at last follow-up. There were 13 implant-related complications in 6 out of 18 patients. No screw pull-outs and nor surgical site infections were registered. Conclusions This is the first medium-term results of a single MCGR hybrid construct. Maintenance of correction and growth are reasonable, and the complication rate is relatively low as compared to bilateral MCGR application. Level of evidence III.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis

Wijdicks

Skov

et al. 2020

Spine Deform

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“…A systematic review of the radiological outcomes and clinical complications associated with MAGEC rods was performed by Thakar et al 39 comprising 15 studies with 196 patients treated with MAGEC as a primary procedure and 66 patients treated with MAGEC at revision surgery for EOS; mean follow-up was 29.7 months. Improvements were reported between mean preoperative and final follow-up measurements for Cobb angle (64.8°versus 34.9°), thoracic kyphosis (38°versus 29.6°), pre-op T1-T12 height (174 mm versus 209.4 mm) and T1-S1 height (285.4 mm versus 334.9 mm).…”

Section: Magec In Cohort Studies: Clinical and Radiological Resultsmentioning

confidence: 99%

<p>Magnetic Controlled Growth Rods in the Treatment of Scoliosis: Safety, Efficacy and Patient Selection</p>

Roberts

2020

MDER

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Early-onset scoliosis is defined as a spinal curvature greater than 10°in children prior to 10 years of age. Untreated EOS may lead to progressively severe spinal deformity, impaired pulmonary development, restrictive lung disease, and both increased morbidity and mortality. Limitations of established conservative treatments include inability to correct severe deformity, as well as challenges with compliance when casting and bracing is applied. In addition, surgical treatment in the form of traditional growing rods requires regular surgical lengthenings and is associated with complications inherent with repeated invasive procedures and exposure to general anesthesia. MAGEC is an evolving magnetically controlled growing rod system for the treatment of EOS. After initial implantation, lengthening is achieved non-invasively by using magnetic external remote control. MAGEC offers the potential to control moderate and severe EOS, while avoiding repeated surgical procedures and associated complications. In this review, we examine the results from clinical, radiological and explant studies following the use of MAGEC, in the context of other established and emerging treatments for EOS.

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“…However, the question about which spinal implant is the best for growing spine still remains controversial. Nowadays there are a plenty of growth friendly constructs but data referred to complications, reoperation rate and a risk of correction loss differs from study to study [6,8,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Otherwise, traditional growing rods (TGR) being the most popular implant for EOS surgery, can lead to a different complications rate mainly associated with open implant distractions. Unlike TGR new implants such as MAGEC and Shilla don't require additional operation for distraction procedures, although there isn't any reliable evidence for one of these implants being superior to another [10].…”

Section: Introductionmentioning

confidence: 99%

Two-stage operative management of early onset scoliosis

Semenov¹,

Koroteev²,

Tarasov³

et al. 2019

AREM

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Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis

Abstract: MCGRs improve coronal deformity and maintain spinal growth, but carry a 44.5% complication and 33% unplanned revision rate. Conversion procedures do not increase this risk. Single rods should be avoided. These slides can be retrieved under Electronic Supplementary material.

Cited by 118 publications

References 34 publications

3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis

3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis

<p>Magnetic Controlled Growth Rods in the Treatment of Scoliosis: Safety, Efficacy and Patient Selection</p>

Two-stage operative management of early onset scoliosis

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