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Traditional Growing Rods Versus Magnetically Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis: A Case-Matched 2-Year Study

  • Biomechanics
  • Published:
Spine Deformity Aims and scope Submit manuscript

Abstract

Introduction

Traditional growing rod (TGR) surgery is a treatment technique commonly used for progressive early-onset scoliosis. Studies have shown that repeated TGR lengthenings can significantly increase the risk of complications. Magnetically controlled growing rods (MCGR) are currently available outside of the United States and early results have been promising. The purpose of this study was to compare the effectiveness of MCGR versus TGR for the treatment of early-onset scoliosis.

Methods

Magnetically controlled growing rod patients were selected based on the following criteria: aged less than 10 years, major curve greater than 30°, thoracic height less than 22 cm, no previous spine surgery, and minimum 2-year follow-up. A total of 17 MCGR patients met the inclusion criteria, 12 of whom had complete data available for analysis. Each MCGR patient was matched with a TGR patient by etiology, gender, single versus dual rods, preoperative age, and preoperative major curve.

Results

Magnetically controlled growing rod patients had a mean age of 6.8 years and mean follow-up of 2.5 years. Mean follow-up was greater for TGR patients by 1.6 years. Major curve correction was similar between MCGR and TGR patients throughout treatment. The MCGR patients experienced an average of 8.1 mm/year increase in T1 –S1 during the lengthening period, compared with 9.7 mm/year for TGR patients (p = .73). There was a mean increase in Tl–T12 of 1.5 mm/year for MCGR patients and 2.3 mm/year for TGR patients (p = .83). The TGR patients had 73 open surgeries, 56 of which were lengthenings. The MCGR patients had 16 open surgeries and 137 noninvasive lengthenings. Three TGR patients underwent 5 unplanned revision surgeries whereas 3 MCGR patients underwent 4 unplanned revisions.

Conclusions

Major curve correction was similar between MCGR and TGR patients throughout treatment. Annual T1–S1 andT1–12 growth was also similar between groups. The MCGR patients had 57 fewer surgical procedures than TGR patients. Incidence of unplanned surgical revisions as a result of complications was similar between groups.

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Authors and Affiliations

  1. San Diego Center for Spinal Disorders, 4130 La Jolla Village Drive #300, San Diego, CA, 92037, USA

    Behrooz A. Akbarnia MD, Jeff B. Pawelek BS & Gregory M. Mundis MD

  2. Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China

    Kenneth M. C. Cheung MD

  3. Hacettepe University, Sihhiye, Ankara, 06100, Turkey

    Gokhan Demirkiran MD & Muharrem Yazici MD

  4. University of Cairo, 22 Degla Street, Mohandessine, Cairo, Giza, 12411, Egypt

    Hazem Elsebaie FRCS, MD

  5. Department of Orthopaedic Surgery, 300 Longwood Avenue, Boston, MA, 02115-5724, USA

    John B. Emans MD

  6. Texas Scottish Rite Hospital, 2222 Welborn Street, Dallas, TX, 75219-3993, USA

    Charles E. Johnston MD

  7. The Royal National Orthopaedic Hospital, 42 Addison Road, London, W14 8JH, UK

    Hilali Noordeen FRCS

  8. Children’s Hospital Los Angeles, 4650 W. Sunset Boulevard Orthopaedics, #69, Los Angeles, CA, 90027, USA

    David L. Skaggs MD, MMM

  9. Bloomberg Children’s Center, Suite 7359 A, 1800 Orleans Street, Baltimore, MD, 21287-0882, USA

    Paul D. Sponseller MD, MBA

  10. Rainbow Babies & Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH, 44106-5043, USA

    George H. Thompson MD

  11. Rady Children’s Hospital San Diego, 3030 Children’s Way, Suite 410, San Diego, CA, 92123, USA

    Burt Yaszay MD

Authors
  1. Behrooz A. Akbarnia MD
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  2. Jeff B. Pawelek BS
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  3. Kenneth M. C. Cheung MD
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  4. Gokhan Demirkiran MD
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  5. Hazem Elsebaie FRCS, MD
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  6. John B. Emans MD
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  7. Charles E. Johnston MD
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  8. Gregory M. Mundis MD
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  9. Hilali Noordeen FRCS
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  10. David L. Skaggs MD, MMM
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  11. Paul D. Sponseller MD, MBA
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  12. George H. Thompson MD
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  13. Burt Yaszay MD
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  14. Muharrem Yazici MD
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Consortia

Growing Spine Study Group

Corresponding author

Correspondence to Behrooz A. Akbarnia MD.

Additional information

Author disclosures: ABA (none); PJB (none); CKMC (none); DG (none); EH (none); EJB (none); JCE (none); MGM (none); NH (none); SDL (grants from POSNA and Scoliosis Research Society; personal fees from Biomet, Medtronic; non-financial support from Growing Spine Study Group, Scoliosis Research Society, Growing Spine Foundation Medtronic Strategic Advisory Board; personal fees from expert testimony; personal fees from Biomet, Medtronic, Stryker, Wolters Kluwer Health—Lippincott Williams & Wilkins; other from Medtronic, Stryker, Biomet, Medtronic, outside the submitted work; patent issued by Medtronic); SPD (none); TGH (none); YB (none); YM (none).

This study was financially supported by the Growing Spine Foundation and Ellipse Technologies.

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Akbarnia, B.A., Pawelek, J.B., Cheung, K.M.C. et al. Traditional Growing Rods Versus Magnetically Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis: A Case-Matched 2-Year Study. Spine Deform 2, 493–497 (2014). https://doi.org/10.1016/j.jspd.2014.09.050

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  • DOI: https://doi.org/10.1016/j.jspd.2014.09.050

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