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Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis

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Abstract

Purpose

To analyse the complication profile of magnetically controlled growing rods (MCGRs) in early onset scoliosis (EOS).

Methods

This is a systematic review using PUBMED, Medline, Embase, Google Scholar and the Cochrane Library (keywords: MAGEC, Magnetically controlled growing rods and EOS) of all studies written in English with a minimum of five patients and a 1-year follow-up. We evaluated coronal correction, growth progression (T1–S1, T1–T12) and complications.

Results

Fifteen studies (336 patients) were included (42.5% male, mean age 7.9 years, average follow-up 29.7 months). Coronal improvement was achieved in all studies (pre-operative 64.8°, latest follow-up 34.9° p = 0.000), as was growth progression (p = 0.001). Mean complication rate was 44.5%, excluding the 50.8% medical complication rate. The unplanned revision rate was 33%. The most common complications were anchor pull-out (11.8%), implant failure (11.7%) and rod breakage (10.6%). There was no significant difference between primary (39.8%) and conversion (33.3%) procedures (p = 0.462). There was a non-statistically significant increased complication rate with single rods (40 vs. 27% p = 0.588).

Conclusions

MCGRs improve coronal deformity and maintain spinal growth, but carry a 44.5% complication and 33% unplanned revision rate. Conversion procedures do not increase this risk. Single rods should be avoided.

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Acknowledgements

The authors thank Prof Frampton for his statistical input and Glynny Kieser for her editorial input.

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Authors and Affiliations

  1. Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxfordshire, England, UK

    Chrishan Thakar, Mihai Mardare, Shahnawaz Haleem, Jeremy Fairbank & Colin Nnadi

  2. Christchurch School of Medicine, University of Otago, Christchurch, New Zealand

    David Christopher Kieser

  3. Department of Orthopaedic Surgery and Musculoskeletal Medicine, Canterbury District Health Board, 2 Riccarton Avenue, Christchurch, 8011, New Zealand

    David Christopher Kieser

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  1. Chrishan Thakar
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  2. David Christopher Kieser
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  4. Shahnawaz Haleem
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  6. Colin Nnadi
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Correspondence to David Christopher Kieser.

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The authors declare that they have no competing interest.

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Thakar, C., Kieser, D.C., Mardare, M. et al. Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis. Eur Spine J 27, 2062–2071 (2018). https://doi.org/10.1007/s00586-018-5590-4

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  • DOI: https://doi.org/10.1007/s00586-018-5590-4

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