Behrooz A Akbarnia1, Jeff B Pawelek2, Kenneth M C Cheung3, Gokhan Demirkiran4, Hazem Elsebaie5, John B Emans6, Charles E Johnston7, Gregory M Mundis2, Hilali Noordeen8, David L Skaggs9, Paul D Sponseller10, George H Thompson11, Burt Yaszay12, Muharrem Yazici4. 1. San Diego Center for Spinal Disorders, 4130 La Jolla Village Drive #300, San Diego, CA 92037, USA. Electronic address: akbarnia@ucsd.edu. 2. San Diego Center for Spinal Disorders, 4130 La Jolla Village Drive #300, San Diego, CA 92037, USA. 3. Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, SAR, China. 4. Hacettepe University, Sihhiye, Ankara 06100, Turkey. 5. University of Cairo, 22 Degla Street, Mohandessine, Cairo, Giza 12411, Egypt. 6. Department of Orthopaedic Surgery, 300 Longwood Avenue, Boston, MA 02115-5724, USA. 7. Texas Scottish Rite Hospital, 2222 Welborn Street, Dallas, TX 75219-3993, USA. 8. The Royal National Orthopaedic Hospital, 42 Addison Road, London W14 8JH, United Kingdom. 9. Children's Hospital Los Angeles, 4650 W. Sunset Boulevard Orthopaedics, #69 Los Angeles, CA 90027, USA. 10. Bloomberg Children's Center, Suite 7359 A, 1800 Orleans Street, Baltimore, MD 21287-0882, USA. 11. Rainbow Babies & Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106-5043, USA. 12. Rady Children's Hospital San Diego, 3030 Children's Way, Suite 410, San Diego, CA 92123, USA.
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 T1-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 and T1-12 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.
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 T1-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 and T1-12 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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