Cadaveric Study of the Safety and Device Functionality of Magnetically Controlled Growing Rods After Exposure to Magnetic Resonance Imaging

Poon, Selina; Chen, Yen Hsun; Wendolowski, Stephen; Graver, Adam; Nixon, Ryan; Amaral, Terry; DiMauro, Jon-Paul; Walz, Daniel M.; Gecelter, Rachel; Grande, Daniel

doi:10.1016/j.jspd.2017.11.003

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…Each intact cadaveric pelvis was thawed to room temperature before undergoing pre and postoperative MRI and CT imaging of the pelvis, from the iliac crest to midfemoral diaphysis. 43,44 All MRIs were performed on a 1.5 T MAGNETOM Espree system (Siemens Healthcare) using an MRI sequence previously described 25 with the following modifications: field of view = 540 × 288 mm, total scan time = 9 min and 11 s, resulting in 144 axial slices. The previously described sequence has been shown to provide CT-like images from MRI to be used for bone segmentation.…”

Section: Imaging and Image Processingmentioning

confidence: 99%

MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

Guidetti

Malloy

Alter

et al. 2021

Journal Orthopaedic Research

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The purpose of this in vitro study was to quantify the bone resected from the proximal femur during hip arthroscopy using metrics generated from magnetic resonance imaging (MRI) and computed tomography (CT) reconstructed threedimensional (3D) bone models. Seven cadaveric hemipelvises underwent both a 1.5 T MRI and CT scan before and following an arthroscopic proximal femoral osteochondroplasty. The images from MRI and CT were segmented to generate 3D proximal femoral surface models. A validated 3D-3D registration method was used to compare surface-to-surface distances between the 3D models before and following surgery. The new metrics of maximum height, mean height, surface area and volume, were computed to quantify bone resected during osteochondroplasty.Stability of the metrics across imaging modalities was established through paired sample t-tests and bivariate correlation. Bivariate correlation analyses indicated strong correlations between all metrics (r = 0.728-0.878) computed from MRI and CT derived models. There were no differences in the MRI-and CT-based metrics used to quantify bone resected during femoral osteochondroplasty. Preoperative and postoperative MRI and CT derived 3D bone models can be used to quantify bone resected during femoral osteochondroplasty, without significant differences between the imaging modalities.

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Section: Imaging and Image Processingmentioning

confidence: 99%

MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

Guidetti

Malloy

Alter

et al. 2021

Journal Orthopaedic Research

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“…This difference seems also clinically relevant in revision cases where TGRs should be given a priority (23). TGRs are also indicated in patients who need repeated MR images for medical followup, as MCGR prevents high quality MR images of the of spinal cord and perivertebral structures (38). Such follow-up might be needed, e.g., in the follow-up of children with neurofibromatosis.…”

Section: Comparison Of Traditional and Mcgrsmentioning

confidence: 99%

Standard and magnetically controlled growing rods for the treatment of early onset scoliosis

Helenius¹

2020

Ann Transl Med

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Distraction based spinal instrumentation represents the most common and standard surgical technique to correct early onset scoliosis (EOS), i.e., scoliosis which has been diagnosed before the age of 10 years. Surgical treatment of EOS aims at controlling spinal deformity while maintaining spinal growth which is mandatory for the development of normal lung capacity. To achieve these goals the spinal instrumentation needs to be distracted to facilitate spinal growth during treatment. Distraction can be obtained by repeated surgical lengthenings (traditional growing rods, TGRs) or using magnetically controlled growing rods (MCGRs), which can be lengthened using external remote controller on an outpatient basis.The outcomes of TGR instrumentation for EOS are well described with follow-up until skeletal maturity: normal spinal growth can be maintained, 40-50% of the scoliosis can be corrected, but there is an over 50% risk of complications including deep wound infection, rod failure, and instrumentation pull-out. MCGR instrumentation may reduce the risk of wound related complications, provides similar deformity correction, but may not provide as much spinal growth. Metallosis around the instrumentation necessitates MCGR removal and definitive final instrumented fusion at the end of growth friendly management. Even severe EOS can be treated using distraction based spinal instrumentation.

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“…However, a known limitation of this technique is the resulting diminished visualization when imaging the postoperative spine. The ferromagnetic actuators within MCGRs induce circumferential artifact measuring nearly 30 cm from the magnets, with the greatest amount when dual MCGRs are implanted in a standard, offset configuration 28 . Accordingly, there was agreement that MCGRs are not recommended in children with NF1 who have a known spinal tumor burden that requires ongoing routine MRI surveillance, particularly in the setting of known intraspinal tumors.…”

Section: Discussionmentioning

confidence: 99%

“…The ferromagnetic actuators within MCGRs induce circumferential artifact measuring nearly 30 cm from the magnets, with the greatest amount when dual MCGRs are implanted in a standard, offset configuration. 28 Accordingly, there was agreement that MCGRs are not recommended in children with NF1 who have a known spinal tumor burden that requires ongoing routine MRI surveillance, particularly in the setting of known intraspinal tumors. For these patients, alternative constructs should be utilized, such as traditional growing rods or a single MCGR with the magnet placed at the caudal end to limit MRI artifact.…”

Section: Discussionmentioning

confidence: 99%

Consensus-Based Best Practice Guidelines for the Management of Spinal Deformity and Associated Tumors in Pediatric Neurofibromatosis Type 1: Screening and Surveillance, Surgical Intervention, and Medical Therapy

Suresh

Gómez

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Spinal conditions, such as scoliosis and spinal tumors, are prevalent in neurofibromatosis type 1 (NF1). Despite the recognized importance of their early detection and treatment, there remain knowledge gaps in how to approach these manifestations. The purpose of this study was to utilize the experience of a multidisciplinary committee of experts to establish consensus-based best practice guidelines (BPGs) for spinal screening and surveillance, surgical intervention, and medical therapy in pediatric patients with NF1. Methods: Using the results of a prior systematic review, 10 key questions that required further assessment were first identified. A committee of 20 experts across medical specialties was then chosen based on their clinical experience with spinal deformity and tumors in NF1. These were 9 orthopaedic surgeons, 4 neuro-oncologists/oncologists, 3 neurosurgeons, 2 neurologists, 1 pulmonologist, and 1 clinical geneticist. An initial online survey on current practices and opinions was conducted, followed by 2 additional surveys via a formal consensus-based modified Delphi method. The final survey involved voting on agreement or disagreement with 35 recommendations. Items reaching consensus (≥70% agreement or disagreement) were included in the final BPGs. Results: Consensus was reached for 30 total recommendations on the management of spinal deformity and tumors in NF1. These were 11 recommendations on screening and surveillance, 16 on surgical intervention, and 3 on medical therapy. Five recommendations did not achieve consensus and were excluded from the BPGs. Conclusion: We present a set of consensus-based BPGs comprised of 30 recommendations for spinal screening and surveillance, surgical intervention, and medical therapy in pediatric NF1.

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Cadaveric Study of the Safety and Device Functionality of Magnetically Controlled Growing Rods After Exposure to Magnetic Resonance Imaging

Abstract: Level V.

Cited by 8 publications

References 22 publications

MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

Standard and magnetically controlled growing rods for the treatment of early onset scoliosis

Consensus-Based Best Practice Guidelines for the Management of Spinal Deformity and Associated Tumors in Pediatric Neurofibromatosis Type 1: Screening and Surveillance, Surgical Intervention, and Medical Therapy

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Cadaveric Study of the Safety and Device Functionality of Magnetically Controlled Growing Rods After Exposure to Magnetic Resonance Imaging

Abstract: Level V.

Cited by 8 publications

References 22 publications

MRI‐­ and CT‐­based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

MRI‐­ and CT‐­based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

Standard and magnetically controlled growing rods for the treatment of early onset scoliosis

Consensus-Based Best Practice Guidelines for the Management of Spinal Deformity and Associated Tumors in Pediatric Neurofibromatosis Type 1: Screening and Surveillance, Surgical Intervention, and Medical Therapy

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MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome

MRI‐ and CT‐based metrics for the quantification of arthroscopic bone resections in femoroacetabular impingement syndrome