Magnetically controlled growing rods in the management of early onset scoliosis: a systematic review

Abstract

Background Early onset scoliosis (EOS) presents in patients younger than 10 years. Magnetically controlled growing rods (MCGR) were developed as an outpatient distraction system for EOS, allowing to avoid multiple surgeries. This systematic review investigated the efficacy and feasibility of MCGR in EOS. Methods This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Scopus were accessed in May 2022. All the clinical trials which investigate the role of MCGR for early onset scoliosis were accessed. Only studies reporting data in patients younger than 10 years with a preoperative Cobb Angle greater than 40° were eligible. The following data was extracted at baseline and at last follow-up: mean kyphosis angle, overall mean Cobb angle, mean T1–S1 length. Data from complication were also collected. Results Data from 23 clinical studies (504 patients) were included in the present study. 56% (282 of 504) were females. The average length of the follow-up was 28.9 ± 16.0 months. The mean age of the patients was 8.7 ± 1.9 years old. The mean BMI was 17.7 ± 7.6 kg/m2. The mean kyphosis angle had reduced by the last follow-up (P = 0.04), as did the overall mean Cobb angle (P < 0.0001), while the overall T1–S1 length increased (P = 0.0002). Implant-associated complications, followed by spinal alignment failure, wound healing ailments, pulmonary complications, progressive trunk stiffness, persistent back pain, and fracture. Conclusion The management of EOS remains challenging. The current evidence indicates that MCGR may be effective to distract the spine and model the curve in EOS.

The Generational Differences in Growth-Friendly Treatment Utilization for Early-Onset Scoliosis

“…30.6% (15) of OG surgeons reported using TGR >10 times in the past 3 years compared to 5.3% (2) of YG surgeons (p=0.0031, Figure 2). Further, 6.1% (3) of OG surgeons reported never using TGR in the past 3 years as compared to 26.3% (10) of YG surgeons (p=0.0088, Figure 2). For the MCGR construct, initial Chi-square analysis showed a statistically significant difference in usage rates between the groups across all frequencies (p=0.026, Figure 3).…”

“…9 MCGR utilizes a magnetic actuator inside the rod that allows the rod to be lengthened non-surgically and without anesthesia through the use of an externally applied remote. 10 Lastly, certain techniques, like Shilla growth guidance, allow for spinal growth through the use of sliding screw heads that allow the spine to grow along the implanted rods without the need for active lengthenings. [11][12][13] Despite the recent increase in studies related to EOS, there remains little consensus on treatment strategies as well as substantial variability in how spine deformity surgeons choose to treat EOS.…”

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

“…Эти имплантаты представляют несомненный научный интерес для отечественных исследователей, однако иной (неинвазивный) принцип дистракции требует отдельного рассмотрения, а отсутствие регистрации и высокая стоимость имплантата ограничивают его широкое применение в Российской Федерации. Кроме того, за последний год опубликованы крупный систематизированный литературный обзор и один метаанализ, посвященные этой проблеме, мы взяли основные данные из этих источников и рассмотрели в разделе «Обсуждение» [7].…”

“…По результатам систематизированного обзора [7], охватившего 23 статьи с 504 пациентами (56 % девочек и 44 % мальчиков), средний возраст имплантации составил 8,7 ± 1,9 года, а период наблюдения -28,0 ± 16,0 мес. (в среднем 2 года).…”