Advertisement

European Spine Journal

, Volume 26, Issue 6, pp 1618–1623 | Cite as

A pilot cadaveric study of temperature and adjacent tissue changes after exposure of magnetic-controlled growing rods to MRI

  • Selina PoonEmail author
  • Ryan Nixon
  • Stephen Wendolowski
  • Rachel Gecelter
  • Yen Hsun Chen
  • Jon-Paul DiMauro
  • Terry Amaral
  • Adam Graver
  • Daniel A. Grande
Original Article

Abstract

Purpose

To test for possible thermal injury and tissue damage caused by magnetic-controlled growing rods (MCGRs) during MRI scans.

Methods

Three fresh frozen cadavers were utilized. Four MRI scans were performed: baseline, after spinal hardware implantation, and twice after MCGR implantation. Cross connectors were placed at the proximal end and at the distal end of the construct, making a complete circuit hinged at those two points. Three points were identified as potential sites for significant heating: adjacent to the proximal and distal cross connectors and adjacent to the actuators. Data collected included tissue temperatures at baseline (R1), after screw insertion (R2), and twice after rod insertions (R3 and R4). Tissue samples were taken and stained for signs of heat damage.

Results

There was a slight change in tissue temperature in the regions next to the implants between baseline and after each scan. Average temperatures (°C) increased by 0.94 (0.16–1.63) between R1 and R2, 1.6 (1.23–1.97) between R2 and R3, and 0.39 (0.03–0.83) between R3 and R4. Subsequent histological analysis revealed no signs of heat induced damage.

Conclusion

Recurrent MRI scans of patients with MCGRs may be necessary over the course of treatment. When implanted into human cadaveric tissue, these rods appear to not be a risk to the patient with respect to heating or tissue damage. Further in vivo study is warranted.

Level of evidence

N/A.

Keywords

Early onset scoliosis Growing rods Magnetic-controlled growing rods Scoliosis Magnetic resonance imaging 

Notes

Acknowledgements

This research was supported by Ellipse Technologies, Inc. We gratefully acknowledge the contribution of the Northwell Health Bioskills Education Center for their facilities and support staff.

Compliance with ethical standards

Conflict of interest

None.

Funding

Research Grant from Ellipse Technologies, Inc. Dr. Poon has received a speaker’s fee from Nuvasive. The rest of the author’s do not report any financial disclosures.

References

  1. 1.
    Yang S, Andras LM, Redding GJ, Skaggs DL (2016) Early-onset scoliosis: a review of history, current treatment, and future directions. Pediatrics 137:e20150709CrossRefGoogle Scholar
  2. 2.
    Karol LA (2011) Early definitive spinal fusion in young children: what we have learned. Clin Orthop Relat Res 469:1323–1329. doi: 10.1007/s11999-010-1622-z CrossRefPubMedGoogle Scholar
  3. 3.
    Campbell RM Jr, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Alder ME, Duong HL, Surber JL (2003) The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Jt Surg Am 85-a:399–408CrossRefGoogle Scholar
  4. 4.
    Pehrsson K, Larsson S, Oden A, Nachemson A (1992) Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 17:1091–1096CrossRefGoogle Scholar
  5. 5.
    Robinson CM, McMaster MJ (1996) Juvenile idiopathic scoliosis. Curve patterns and prognosis in one hundred and nine patients. J Bone Jt Surg Am 78:1140–1148CrossRefGoogle Scholar
  6. 6.
    Goldberg CJ, Gillic I, Connaughton O, Moore DP, Fogarty EE, Canny GJ, Dowling FE (2003) Respiratory function and cosmesis at maturity in infantile-onset scoliosis. Spine (Phila Pa 1976) 28:2397–2406. doi: 10.1097/01.brs.0000085367.24266.ca CrossRefGoogle Scholar
  7. 7.
    Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA (2005) Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 30:S46–S57CrossRefGoogle Scholar
  8. 8.
    Bess S, Akbarnia BA, Thompson GH, Sponseller PD, Shah SA, El Sebaie H, Boachie-Adjei O, Karlin LI, Canale S, Poe-Kochert C, Skaggs DL (2010) Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Jt Surg Am 92:2533–2543. doi: 10.2106/jbjs.i.01471 CrossRefGoogle Scholar
  9. 9.
    Akbarnia BA, Cheung K, Noordeen H, Elsebaie H, Yazici M, Dannawi Z, Kabirian N (2013) Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients with early-onset scoliosis. Spine (Phila Pa 1976) 38:665–670. doi: 10.1097/BRS.0b013e3182773560 CrossRefGoogle Scholar
  10. 10.
    Hickey BA, Towriss C, Baxter G, Yasso S, James S, Jones A, Howes J, Davies P, Ahuja S (2014) Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 23(Suppl 1):S61–S65. doi: 10.1007/s00586-013-3163-0 CrossRefPubMedGoogle Scholar
  11. 11.
    Jenks M, Craig J, Higgins J, Willits I, Barata T, Wood H, Kimpton C, Sims A (2014) The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance. Appl Health Econ Health Policy 12:587–599. doi: 10.1007/s40258-014-0127-4 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Rolton D, Richards J, Nnadi C (2015) Magnetic controlled growth rods versus conventional growing rod systems in the treatment of early onset scoliosis: a cost comparison. Eur Spine J 24:1457–1461. doi: 10.1007/s00586-014-3699-7 CrossRefPubMedGoogle Scholar
  13. 13.
    Gupta P, Lenke LG, Bridwell KH (1998) Incidence of neural axis abnormalities in infantile and juvenile patients with spinal deformity. Is a magnetic resonance image screening necessary? Spine (Phila Pa 1976) 23:206–210CrossRefGoogle Scholar
  14. 14.
    Rajasekaran S, Kamath V, Kiran R, Shetty AP (2010) Intraspinal anomalies in scoliosis: an MRI analysis of 177 consecutive scoliosis patients. Indian J Orthop 44:57–63. doi: 10.4103/0019-5413.58607 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Budd HR, Stokes OM, Meakin J, Fulford J, Hutton M (2015) Safety and compatibility of magnetic-controlled growing rods and magnetic resonance imaging. Eur Spine J. doi: 10.1007/s00586-015-4178-5 PubMedGoogle Scholar
  16. 16.
    Goldstein LS, Dewhirst MW, Repacholi M, Kheifets L (2003) Summary, conclusions and recommendations: adverse temperature levels in the human body. Int J Hyperth 19:373–384. doi: 10.1080/0265673031000090701 CrossRefGoogle Scholar
  17. 17.
    Goetz JE, Pedersen DR, Robinson DA, Conzemius MG, Baer TE, Brown TD (2008) The apparent critical isotherm for cryoinsult-induced osteonecrotic lesions in emu femoral heads. J Biomech 41:2197–2205. doi: 10.1016/j.jbiomech.2008.04.032 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Muthusubramanian M, Limson KS, Julian R (2005) Analysis of rugae in burn victims and cadavers to simulate rugae identification in cases of incineration and decomposition. J Forensic Odontostomatol 23:26–29PubMedGoogle Scholar
  19. 19.
    Willinek WA, Schild HH (2008) Clinical advantages of 3.0 T MRI over 1.5 T. Eur J Radiol 65:2–14CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Selina Poon
    • 1
    Email author
  • Ryan Nixon
    • 2
  • Stephen Wendolowski
    • 2
  • Rachel Gecelter
    • 2
  • Yen Hsun Chen
    • 2
  • Jon-Paul DiMauro
    • 2
  • Terry Amaral
    • 2
  • Adam Graver
    • 2
  • Daniel A. Grande
    • 3
  1. 1.Department of OrthopaedicsShriners Hospitals for ChildrenLos AngelesUSA
  2. 2.Department of Pediatric OrthopaedicsCohen Children’s Medical CenterLake SuccessUSA
  3. 3.Orthopedic Research LaboratoryThe Feinstein Institute for Medical ResearchManhassetUSA

Personalised recommendations