Early results of a remotely-operated magnetic growth rod in early-onset scoliosis

Abstract

Conventional growing rods are the most commonly used distraction-based devices in the treatment of progressive early-onset scoliosis. This technique requires repeated lengthenings with the patient anaesthetised in the operating theatre. We describe the outcomes and complications of using a non-invasive magnetically controlled growing rod (MCGR) in children with early-onset scoliosis. Lengthening is performed on an outpatient basis using an external remote control with the patient awake.Between November 2009 and March 2011, 34 children with a mean age of eight years (5 to 12) underwent treatment. The mean length of follow-up was 15 months (12 to 18). In total, 22 children were treated with dual rod constructs and 12 with a single rod. The mean number of distractions per patient was 4.8 (3 to 6). The mean pre-operative Cobb angle was 69° (46° to 108°); this was corrected to a mean 47° (28° to 91°) post-operatively. The mean Cobb angle at final review was 41° (27° to 86°). The mean pre-operative distance from T1 to S1 was 304 mm (243 to 380) and increased to 335 mm (253 to 400) in the immediate post-operative period. At final review the mean distance from T1 to S1 had increased to 348 mm (260 to 420).Two patients developed a superficial wound infection and a further two patients in the single rod group developed a loss of distraction. In the dual rod group, one patient had pull-out of a hook and one developed prominent metalwork. Two patients had a rod breakage; one patient in the single rod group and one patient in the dual rod group. Our early results show that the MCGR is safe and effective in the treatment of progressive early-onset scoliosis with the avoidance of repeated surgical lengthenings.

Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis

“…There is very little published literature on the use of MAGEC as a revision procedure; however, comparing our results for MAGEC performed as a primary procedure, or results for correction and control are comparable. For example, Dannawi et al [8] recently reported 32 % improvement in Cobb angle, compared with our initial correction of 43 %. Akbarnia et al [3] also found a 43 % improvement in Cobb angle following surgery in 14 patients who had MAGEC performed as a primary procedure [3,8] and Cheung et al [7] found 57 % correction.…”

“…Patients had rod extensions in clinic every 6-8 weeks. Scoliograms were performed on average 11 times per year (8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…Mean Cobb angle at most recent follow-up was 44°(28-67) ( Table 1). Mean initial percentage lengthening was 8 % [3][4][5][6][7][8][9][10]. Two of the four patients experienced loss of distraction (Table 2).…”

“…A. Hickey Á C. Towriss (&) Á G. Baxter Á S. Yasso Á S. James Á A. Jones Á J. Howes Á P. Davies Á S. Ahuja Trauma and Orthopaedics, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK e-mail: Chris.towriss@googlemail.com developed to address the drawbacks of traditional systems, allowing lengthening procedures to be performed in the outpatient clinic under the control of an externally applied magnet remote control device. Recently, this technology has been reported to be safe and effective at short-term follow-up [3,7,8]. Our aim is to report our early experience of a magnetically controlled growing rod system (MAGEC, Ellipse).…”

Safety and compatibility of magnetic-controlled growing rods and magnetic resonance imaging

“…[8][9][10] In order to minimize the limitations of traditional growing rod systems magnetically-controlled growing rods (MCGR) were developed, and their safety and efficacy has been reported in humans. [10][11][12][13] . Their implantation is supported following a clinical and economical evaluation by the National Institute of Clinical Excellence in the United Kingdom as part of an evidence medical technologies guidance.…”