Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases.

Studer, D; Heidt, C; Büchler, Philippe; Hasler, C C (2019). Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases. Journal of children's orthopaedics, 13(2), pp. 196-205. EPOS 10.1302/1863-2548.13.180203

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Purpose

The treatment of early onset scoliosis continues to be a major challenge, even when using motorized growth-sparing implants. We report on 30 cases operated on with magnetically controlled growing rods (MCGRs) at our institution, analyzing radiological parameters and complications, comparing our results with the literature and presenting a special implant fixation technique. A separate focus highlights the challenges of conversion from previous non-motorized implants.

Methods

Consecutive case series. The nature and effects of complications were recorded for all patients. Radiographic evaluations were performed for patients with a minimum follow-up of two years. Separate analyses were carried out for patients who were previously treated with non-motorized growth-sparing implants.

Results

There were 12 documented complications in 11/30 (37%) patients leading to 13 unplanned returns to the operating room. In all, 18/30 patients had a minimum follow-up of two years. Major curve and main kyphosis, as well as T1 to T12 and T1 to S1 distances significantly improved with MCGR implantation, however, less in patients converted from previous growth-sparing surgical treatment. While the achieved correction of the major curve was maintained, there was a loss of kyphosis correction with subsequent implant lengthening. Gain in implant length decreased with increasing number of extensions.

Conclusion

Despite improved patient's comfort, MCGR show a considerable complication rate. Coronal plane deformities can be well controlled, but diminished implant lengthening is already apparent within two years after MCGR implantation. Central databases should help to clarify unresolved aspects and optimize the treatment of these young patients.

Level of Evidence

IV.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Computational Bioengineering
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Musculoskeletal Biomechanics
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB [discontinued]
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

UniBE Contributor:

Büchler, Philippe

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

1863-2521

Publisher:

EPOS

Language:

English

Submitter:

Philippe Büchler

Date Deposited:

17 Dec 2019 15:44

Last Modified:

26 Jun 2024 16:11

Publisher DOI:

10.1302/1863-2548.13.180203

PubMed ID:

30996745

Uncontrolled Keywords:

complications early onset scoliosis growth-sparing surgery

BORIS DOI:

10.7892/boris.135572

URI:

https://boris.unibe.ch/id/eprint/135572

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