Magnetic controlled growing rods for early-onset scoliosis: a 4-year follow-up

Teoh, Kar Hao; Winson, Daniel M.G.; James, Stuart H.; Jones, Alwyn; Howes, J; Davies, Paul; Ahuja, Sashin

doi:10.1016/j.spinee.2015.12.098

Cited by 87 publications

(59 citation statements)

References 5 publications

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“…A recent clinical study suggests that patients previously treated with the traditional growing rods can be converted to MCGRs with comparable positive results [12]. Clinical cases reporting pin fracture and failure to distract have been published over the last 2 years [11][12][13][14][15]; this is the first retrieval paper using state-of-the-art forensic analysis to determine the mechanism leading to pin fracture. We examined nine retrieved MCGRs and found that a third of them had a fractured pin.…”

Section: Discussionmentioning

confidence: 99%

“…The most current update from National Institute of Health and Care Excellence (NICE) states that there have been only two alterations to the original design of the MCGR [9]; in 2010, the addition of a keeper plate to prevent the internal magnet from rotating, and in 2012, the A recent 4 year follow-up mentioned the company's intention to increase the pin's diameter [15]. However, we could not find any design updates regarding the shielding of the internal mechanism from fluid ingress.…”

Section: Discussionmentioning

confidence: 99%

“…The lengthening procedure lasts approximately 40 s per rod and the total length is measured using a plain radiograph [8]. Recent studies have also investigated the reliability of other imaging modalities, including ultrasound [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

et al. 2017

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Purpose We aim to describe a mechanism of failure in magnetically controlled growth rods which are used for the correction of the early onset scoliosis. Methods This retrieval study involved nine magnetically controlled growth rods, of a single design, revised from five patients for metal staining, progression of scoliosis, swelling, fractured actuator pin, and final fusion. All the retrieved rods were radiographed and assessed macroscopically and microscopically for material loss. Two implants were further analysed using micro-CT scanning and then sectioned to allow examination of the internal mechanism. No funding was obtained to analyse these implants. There were no potential conflicts interests. Results Plain radiographs revealed that three out of nine retrieved rods had a fractured pin. All had evidence of surface degradation on the extendable telescopic rod. There was considerable corrosion along the internal mechanism. Conclusions We found that a third of the retrieved magnetically controlled growth rods had failed due to pin fracture secondary to corrosion of the internal mechanism. We recommend that surgeons consider that any inability of magnetically controlled growth rods to distract may be due to corrosive debris building up inside the mechanism, thereby preventing normal function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

et al. 2017

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“…However, mid-term studies on MCGR are rare. Teoh and Winson reports on 8 patients (3 single rod, 5 double rod technique) with a minimum on 44 months follow up [12]. This single center investigation reports on a minimum of two years results on safety and efficiency of MCGR adhering to a specific lengthening protocol every 4 months.…”

Section: Introductionmentioning

confidence: 99%

A Minimum of Two Years Results of Magnetically Controlled Growing Rods for Early Onset Scoliosis

Burstein¹,

Rupprecht²,

Kunkel³

et al. 2017

J Spine

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Objectives: To determine mid-term results and complications of a single center on magnetically controlled growing rod (MCGR) technique in Early Onset Scoliosis (EOS). Recently a number of preliminary reports about safety and effectiveness of MCGR have been published. We present a minimum of two years follow up of the MCGR treatment. All patients were treated in one center with the same protocol.Methods: 22 patients with EOS of different etiologies underwent primary surgical treatment with MCGR in double rod technique. There were 15 female and 7 male patients. Average age at surgery was 8.8 (range 4.6-14.3). Mean follow-up was 31 (24-46) months. Cobb angle changes, T1-T12 and T1-S1 length were calculated. Results were analyzed to measure correction of spinal deformity and gain in spinal length. Results:The mean preoperative curve measured 61° (40-96) and improved to 28° (11-53) (p<0.001) after surgery. At follow-up the Cobb angle was further reduced to 26° (11-64) (p=0.54). The T1-T12-as well as the T1-S1-length increased significantly (p<0.001). The average preoperative thoracic kyphosis decreased from 44° (-32-86) to 28° (9-50) after surgery, respectively to 35° (8-62) at time of FU. Four patients developed a junctional kyphosis. Three of them had to be revised. One patient developed a lumbar "adding on", one patient a deep wound infection and in another patient a screw pullout occurred that all required revision. Conclusion:The study supports that the MCGR is an efficient and safe technique to treat EOS. Morbidity and complications are less than treatment with conventional GR´s. After 2 years transcutaneous lengthening is still possible without loss of correction and autofusion has not yet been detected.

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“…The MCGR technique decreases complications, costs, and loss of functionality by avoiding successive surgical corrections every 6 months [3,4,5,6,7,8,9,10]. However, only a few studies have presented clinical experience with MCGR [6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Magnetically Controlled Growing Rod in Early-Onset Scoliosis: A Minimum of 2-Year Follow-Up

et al. 2016

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Purpose: The magnetically controlled growing rod technique decreases complications, costs, and loss of functionality by avoiding successive surgical corrections every 6 months in patients with early-onset scoliosis. However, only a few studies have presented clinical experience with the magnetically controlled growing rod. In this study we aimed to present our single-center experience in patients with early-onset scoliosis who underwent the magnetically controlled growing rod technique and follow-up for at least 2 years. Materials and Methods: We made an observational study by evaluating patients with early-onset scoliosis who underwent the magnetically controlled growing rod technique between February 2012 and December 2013. Demographic and clinical data were obtained from the patients charts. We included patients who were followed up for at least 2 years. Radiological data were obtained from plain anterior-posterior and lateral scoliosis X-rays. Results: Eight patients with early-onset scoliosis who underwent surgery using the magnetic system were treated with dual rods. None of the spines were fused to the sacrum. We observed no intra- and/or postsurgical complications. The average number of external rod lengthenings was 7.6. The average amount of lengthening was 30.6 mm on the right side and 27.8 mm on the left side by the time of last clinical follow-up. The average coronal and sagittal Cobb values at the final clinical evaluation were 10.5° (thoracic coronal), 13.75° (lumbar coronal), 6.25° (lumbosacral coronal), 24.5° (thoracic sagittal), and 40° (lumbar sagittal), respectively. Conclusions: The magnetically controlled growing rod is beneficial in early-onset scoliosis, since it enables spinal growth and decreases additional surgeries, complications, and costs. Even though we had a small sample size, our follow-up period was enough to declare long-term outcomes of our patients. Multicenter and large sample-sized studies are needed to make more conclusive statements regarding this promising scoliosis treatment approach.

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Magnetic controlled growing rods for early-onset scoliosis: a 4-year follow-up

Cited by 87 publications

References 5 publications

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

A Minimum of Two Years Results of Magnetically Controlled Growing Rods for Early Onset Scoliosis

Magnetically Controlled Growing Rod in Early-Onset Scoliosis: A Minimum of 2-Year Follow-Up

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