Comparison of Magnetically Controlled Growing Rods with Other Distraction-Based Surgical Technologies for Early-Onset Scoliosis

Bednar, E Dimitra; Bergin, Brad; Kishta, Waleed

doi:10.2106/jbjs.rvw.20.00062

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…Без сомнения, авторами подчеркнуты преимущества неинвазивных дистракций в амбулаторных условиях как более комфортных для пациента и его родителей [63].…”

Section: Magnetically Controlled Growing Rods (Mcgr)unclassified

The effectiveness of growth-friendly systems in the treatment of early onset scoliosis: a systematic review

Molotkov,

Ryabykh,

Filatov

et al. 2023

Hir. pozvonoč.

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Objective. To perform a systematic analysis of the literature evaluating the effectiveness of growth-friendly systems in the treatment of early onset scoliosis.Material and Methods. A subject search was conducted in the Google Scholar database for the terms “growing rods”, “early onset scoliosis”, “treatment”, “surgery” and “growth-friendly” using AND or OR logical operators with a search depth of 10 years. At the first stage, 824 abstracts of publications were selected. The second stage of search was carried out in accordance with the PICOS criteria, 38 abstracts of original studies, case series and reviews of surgical techniques for spinal deformity correction with preservation of growth potential were selected. The evaluation criteria were divided into four groups: general data, correction of the frontal and sagittal components of the deformity, complications and unplanned scenarios.Results. In the analyzed studies, gender equality of distribution was observed, and the average age at the time of the primary operation was 6.6 years for patients with traditional growing rods (TGR) and Schilla/Luque trolley and 4.9 years for patients with Vertical Expandable Prosthetic Titanium Rib (VEPTR). From the point of view of the magnitude of spinal deformity correction, the VEPTR systems demonstrated the minimum result (18 % correction), and the TGR and Schilla results were comparable (42.1 and 53.1 %, respectively), as well as the indicators of the dynamics of body lengthening.Conclusion. The use of VEPTR systems is associated with a high risk of complications and a somewhat lower efficiency of spinal deformity correction, however, VEPTR is indispensable in the treatment of thoracic insufficiency syndrome, as well as severe deformities of the axial skeleton in young children using non-vertebral fixation points. Growth modulation systems (Schilla and Luque trolley) showed deformity correction results similar to those of TGR.

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Section: Magnetically Controlled Growing Rods (Mcgr)unclassified

The effectiveness of growth-friendly systems in the treatment of early onset scoliosis: a systematic review

Molotkov,

Ryabykh,

Filatov

et al. 2023

Hir. pozvonoč.

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“…The early stages of scoliosis are typically asymptomatic, which can result in delayed recognition and potential exacerbation of the condition's progression [8]. Neglecting the early signs of scoliosis can increase the risk of severe spinal deformities, profound cardiopulmonary compromise, respiratory dysfunction, and even disability [9]. Notably, when the scoliosis angle exceeds 30° during childhood, it significantly raises the risk of developing degenerative scoliosis in adulthood -a condition associated with various health problems and a diminished quality of life [10][11][12].…”

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confidence: 99%

Variations in the prevalence of scoliosis by age, sex, geographic region, and subtype among Chinese children: A systematic review and modelling study

Cao,

Sun,

Zheng

et al. 2024

J Glob Health

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Background Scoliosis is a prevalent spinal condition typically detected in children, yet its prevalence in China has not been fully understood. This study aimed to estimate the prevalence of scoliosis among Chinese children and explore its variations by age, sex, geographic region, and subtype. MethodsWe conducted a comprehensive search of seven bibliographic databases to identify epidemiological studies that reported the prevalence of scoliosis among Chinese children published since 1990. Scoliosis was defined as a Cobb angle equal to or greater than 10°, as detected radiographically. We used a multilevel mixed-effect meta-regression to estimate the age-and sex-specific prevalence of idiopathic scoliosis (IS). The overall prevalence and total cases of IS among Chinese children aged 5-18 years in 2020 were generated by applying the China census data. A random-effects meta-analysis was conducted to estimate the pooled prevalence of IS with varying curvatures (10-19°, 20-39°, and ≥40°) and locations (thoracic curve, lumbar curve, thoracolumbar curve, and double curve), as well as congenital scoliosis (CS).Results A total of 46 articles covering 1 112 163 Chinese children were included. The prevalence of IS ranged from 0.06% (95% confidence interval (CI) = 0.00-0.26) among children aged five years to 1.44% (95% CI = 0.89-2.13) among those aged 18 years, peaking at 1.79% (95% CI = 1.18-2.53) among those aged 16 years. In 2020, the overall prevalence of IS among Chinese children aged 5-18 was 0.79% (95% CI = 0.45-1.27), translating to an estimated 1.81 million (95% CI = 1.04-2.91) affected children. Notably, IS prevalence was nearly double in girls compared to boys (1.03%, 95% CI = 0.63-1.57 vs. 0.58%, 95% CI = 0.29-1.01). Among the six geographic regions, the prevalence of IS was the highest in Northwest China (1.54%, 95% CI = 0.75-2.65) and the lowest in North China (0.33%, 95% CI = 0.11-0.73). The most commonly identified IS subtypes were curvatures of 10-19° and thoracolumbar curves, with a pooled prevalence of 7.14‰ (95% CI = 3.44-12.15) and 2.00‰ (95% CI = 0.83-3.65), respectively. As for CS, the pooled prevalence was 3.03 per 10 000 (95% CI = 1.88-4.43). ConclusionsThe prevalence of scoliosis among Chinese children exhibits considerable variations across age, sex, geographic regions, and subtypes. It is imperative to develop targeted public health strategies and optimise the allocation of regional health resources. High-quality epidemiological research is still needed to unmask the diverse burden of scoliosis in children.Registration PROSPERO CRD42023406260.

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“…The main claimed advantage of MCGR is the ability for noninvasive lengthening of the implanted rods 11 . This avoids multiple surgeries often required with other types of implants while decreasing the physiologic burdens of repeated surgery and general anesthesia on already vulnerable individuals 12 …”

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confidence: 99%

“…11 This avoids multiple surgeries often required with other types of implants while decreasing the physiologic burdens of repeated surgery and general anesthesia on already vulnerable indivi duals. 12 The World Health Organisation (WHO) recommends the use of Z (standard) scores to describe weightfor-age. The Z-score system conveys weight-for-age as the number of SDs or Z-score below or above the reference mean or median value in a specific population.…”

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confidence: 99%

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

Turner

Hayes

McManus

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Early-onset scoliosis (EOS) is frequently associated with complex spine and chest wall deformities that may lead to severe cardiopulmonary impairment and malnutrition. The aim of this study is to evaluate the change in the nutritional status of EOS patients after treatment with magnetically controlled growing rod instrumentation (MCGR) in a single center. Methods: We prospectively collected data of patients treated with MCGR for EOS in a single center. Exclusion criteria were <2 years’ follow-up and incomplete weight-for-age Z-scores (WAZ) data. Preoperative and postoperative WAZ, radiographic parameters, including major coronal curve, kyphosis angle, space available for lung ratios, thoracic height, and unplanned returns to the operating room (UPROR), were analyzed. SD and 95% Confidence intervals (CI) are presented with means. Results: Sixty-eight patients (37 males/31 females) were included. The mean age at surgery was 8.2 years (SD 2.8, range 1.8–14.2), and the mean follow-up time was 3.8 years (SD 1.0, range 2.1–6.8). The study population was categorized by the primary diagnosis as follows: 23 neuromuscular, 18 idiopathic, 15 congenital, and 12 syndromic patients. The major coronal curve improved between the preoperative and latest visits by 40% (P<0.005, SD 27, CI 33–47), while the space available for lung ratios improved by 8% (P<0.005, SD 13, CI 5–12). Thoracic height increased by 25% (P<0.005, SD 13, CI 22–28), and kyphosis angle decreased by 25% (P<0.005, SD 26, CI 9–39). Eighteen patients (27%) required a total of 53 UPRORs. WAZ improved significantly between the preoperative and the latest follow-up (P=0.005). Regression analysis showed WAZ improvements were most significant in the underweight patients and the Idiopathic or Syndromic EOS patients. UPROR was not associated with deterioration in WAZ. Conclusions: Treatment of EOS patients with MCGR resulted in an improvement in nutritional status, as evidenced by the significant increase in WAZ. Underweight, Idiopathic and Syndromic EOS patients, and those who required UPROR all had significant improvement in their WAZ with MCGR treatment. Level of Evidence: Therapeutic Study—Level II.

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Comparison of Magnetically Controlled Growing Rods with Other Distraction-Based Surgical Technologies for Early-Onset Scoliosis

Cited by 8 publications

References 31 publications

The effectiveness of growth-friendly systems in the treatment of early onset scoliosis: a systematic review

The effectiveness of growth-friendly systems in the treatment of early onset scoliosis: a systematic review

Variations in the prevalence of scoliosis by age, sex, geographic region, and subtype among Chinese children: A systematic review and modelling study

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

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