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Surgeon Survey Shows No Adverse Events With MRI in Patients With Magnetically Controlled Growing Rods (MCGRs)

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Abstract

Study Design

Surgeon survey.

Objectives

To determine if magnetic resonance imaging (MRI) following implantation of magnetically controlled growing rods (MCGRs) is associated with any adverse events.

Summary of Background Data

Magnetically controlled growing rods have been shown to reduce the need for repeated surgical procedures and improve costs when compared to traditional growing rods, but concerns about MRI compatibility exist. MRIs are often clinically indicated in the EOS population.

Methods

Pediatric spine surgeons who are members of the Growing Spine Study Group, Children’s Spine Study Group, and early international users of this technology were surveyed regarding MRI use after performing MCGR surgery.

Results

A total of 118 surgeons were surveyed. Four surgeons reported that 10 patients had an MRI with an implanted MCGR. Loss of fixation (0%, 0/10), movement of implants (0%, 0/10), unintended lengthening/shortening (0%, 0/10), or noticeable heating of MCGR (0%, 0/10) were not observed. No problems were observed with function of the MCGR following MRI, and a mean of 2.1 mm was obtained at the next lengthening (range, 0.5-3.0 mm). Two patients had brain MRIs, both of which could be interpreted. All cervical spine MRIs could be interpreted without excessive artifact (100%, 7/7). Six patients had MRIs of the thoracic or lumbar spine, but these were considered uninterpretable as a result of artifact from the MCGR device (0%, 0/6).

Conclusion

These are the first reported cases of MRI use in humans with MCGR. There were no adverse events observed. MCGR rods lengthened as expected following MRI. MRIs of the brain and cervical spine were able to be interpreted, but MRIs of the thoracolumbar spine could not be interpreted because of MCGR artifact. MRIs can be safely performed in patients with MCGRs; however, MRIs of thoracic and thoracolumbar spine may be of limited clinical benefit because of artifact.

Level of Evidence

Level IV, case series.

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Author information

Authors and Affiliations

  1. Children’s Orthopaedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd. Mailstop #69, 90027, Los Angeles, CA, USA

    Regina P. Woon MPH, Lindsay M. Andras MD & David L. Skaggs MD, MMM

  2. The Royal National Orthopaedic Hospital, Brockley Hill, HA7 4LP, Stanmore, Middlesex, UK

    Hilali Noordeen MD

  3. North Bristol NHS Trust, Southmead Hospital, Southmead Rd, BS10 5NB, Bristol, UK

    Stephen Morris MD

  4. Spire Bristol Hospital, Redland Hill, BS6 6UT, Bristol, UK

    John Hutchinson MD

  5. Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, 19803, Wilmington, DE, USA

    Suken A. Shah MD

  6. San Diego Center for Spinal Disorders, 4130 La Jolla Village Dr, 92037, La Jolla, CA, USA

    Jeff Pawelek BS

  7. Texas Scottish Rite Hospital for Children, 2222 Welborn St, 75219, Dallas, TX, USA

    Charles E. Johnston MD

Authors
  1. Regina P. Woon MPH
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  2. Lindsay M. Andras MD
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  3. Hilali Noordeen MD
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  4. Stephen Morris MD
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  5. John Hutchinson MD
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  6. Suken A. Shah MD
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  7. Jeff Pawelek BS
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  8. Charles E. Johnston MD
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  9. David L. Skaggs MD, MMM
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Consortia

Children’s Spine Study Group

Growing Spine Study Group

Corresponding author

Correspondence to David L. Skaggs MD, MMM.

Additional information

Author disclosures: RPW (none); LMA (personal fees from Biomet; Medtronic, other from Eli Lilly, other from Orthobullets, other from Journal of Pediatric Orthopaedics, other from Pediatric Orthopaedic Society of North America and the Scoliosis Research Society, outside the submitted work); HN (personal fees from BAXTER, personal fees from K2M, personal fees from ELLIPSE TECHNOLOGIES, personal fees from KSPINE, non-financial support from Spine, non-financial support from Spine Deformity, personal fees from Stryker, outside the submitted work); SM (none); JH (none); SAS (grants from Setting Scoliosis Straight Foundation, personal fees from DePuy Synthes Spine, personal fees from NuVasive, outside the submitted work); JP (other from San Diego Spine Foundation, outside the submitted work); CEJ (other from Medtronic, other from Elsevier, outside the submitted work); DLS (other from Growing Spine Study Group; Scoliosis Research Society; Growing Spine Foundation, personal fees from ZimmerBiomet; Medtronic; Zipline Medical, Inc.; Orthobullets; Grand Rounds [a healthcare navigation company], Greensunmedical, grants from Pediatric Orthopaedic Society of North America & Scoliosis Research Society, Paid to Columbia University; Elipse [co–principal investigator, paid to GSF], other from Zipline Medical, Inc. Green Sun Medical, Orthobullets, personal fees from ZimmerBiomet; Medtronic; Johnson & Johnson, other from Medtronic & ZimmerBiomet, non-financial support from Wolters Kluwer Health - Lippincott Williams & Wilkins; Biomet Spine, other from Orthobullets, Co-Editor in Chief, outside the submitted work); Children’s Spine Study Group (none); Growing Spine Study Group (grants from Nuvasive, grants from Growing Spine Foundation, grants from US Food and Drug Administration, during the conduct of the study; and the Growing Spine Foundation financially supports the Growing Spine Study Group which provided the research data for this study. The GSF receives donations from the study group’s surgeon members, medical device industry, grateful patients and other donors).

This study has been carried out with approval from the Committee on Clinical Investigations at Children’s Hospital Los Angeles.

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Woon, R.P., Andras, L.M., Noordeen, H. et al. Surgeon Survey Shows No Adverse Events With MRI in Patients With Magnetically Controlled Growing Rods (MCGRs). Spine Deform 6, 299–302 (2018). https://doi.org/10.1016/j.jspd.2017.10.004

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  • DOI: https://doi.org/10.1016/j.jspd.2017.10.004

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