Cargando…

Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases

PURPOSE: The treatment of early onset scoliosis continues to be a major challenge, even when using motorized growth-sparing implants. We report on 30 cases operated on with magnetically controlled growing rods (MCGRs) at our institution, analyzing radiological parameters and complications, comparing...

Descripción completa

Detalles Bibliográficos
Autores principales: Studer, D., Heidt, C., Büchler, P., Hasler, C. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442503/
https://www.ncbi.nlm.nih.gov/pubmed/30996745
http://dx.doi.org/10.1302/1863-2548.13.180203
_version_ 1783407720605417472
author Studer, D.
Heidt, C.
Büchler, P.
Hasler, C. C.
author_facet Studer, D.
Heidt, C.
Büchler, P.
Hasler, C. C.
author_sort Studer, D.
collection PubMed
description PURPOSE: The treatment of early onset scoliosis continues to be a major challenge, even when using motorized growth-sparing implants. We report on 30 cases operated on with magnetically controlled growing rods (MCGRs) at our institution, analyzing radiological parameters and complications, comparing our results with the literature and presenting a special implant fixation technique. A separate focus highlights the challenges of conversion from previous non-motorized implants. METHODS: Consecutive case series. The nature and effects of complications were recorded for all patients. Radiographic evaluations were performed for patients with a minimum follow-up of two years. Separate analyses were carried out for patients who were previously treated with non-motorized growth-sparing implants RESULTS: There were 12 documented complications in 11/30 (37%) patients leading to 13 unplanned returns to the operating room. In all, 18/30 patients had a minimum follow-up of two years. Major curve and main kyphosis, as well as T1 to T12 and T1 to S1 distances significantly improved with MCGR implantation, however, less in patients converted from previous growth-sparing surgical treatment. While the achieved correction of the major curve was maintained, there was a loss of kyphosis correction with subsequent implant lengthening. Gain in implant length decreased with increasing number of extensions. CONCLUSION: Despite improved patient’s comfort, MCGR show a considerable complication rate. Coronal plane deformities can be well controlled, but diminished implant lengthening is already apparent within two years after MCGR implantation. Central databases should help to clarify unresolved aspects and optimize the treatment of these young patients. LEVEL OF EVIDENCE: IV
format Online
Article
Text
id pubmed-6442503
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher The British Editorial Society of Bone & Joint Surgery
record_format MEDLINE/PubMed
spelling pubmed-64425032019-04-17 Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases Studer, D. Heidt, C. Büchler, P. Hasler, C. C. J Child Orthop Original Clinical Article PURPOSE: The treatment of early onset scoliosis continues to be a major challenge, even when using motorized growth-sparing implants. We report on 30 cases operated on with magnetically controlled growing rods (MCGRs) at our institution, analyzing radiological parameters and complications, comparing our results with the literature and presenting a special implant fixation technique. A separate focus highlights the challenges of conversion from previous non-motorized implants. METHODS: Consecutive case series. The nature and effects of complications were recorded for all patients. Radiographic evaluations were performed for patients with a minimum follow-up of two years. Separate analyses were carried out for patients who were previously treated with non-motorized growth-sparing implants RESULTS: There were 12 documented complications in 11/30 (37%) patients leading to 13 unplanned returns to the operating room. In all, 18/30 patients had a minimum follow-up of two years. Major curve and main kyphosis, as well as T1 to T12 and T1 to S1 distances significantly improved with MCGR implantation, however, less in patients converted from previous growth-sparing surgical treatment. While the achieved correction of the major curve was maintained, there was a loss of kyphosis correction with subsequent implant lengthening. Gain in implant length decreased with increasing number of extensions. CONCLUSION: Despite improved patient’s comfort, MCGR show a considerable complication rate. Coronal plane deformities can be well controlled, but diminished implant lengthening is already apparent within two years after MCGR implantation. Central databases should help to clarify unresolved aspects and optimize the treatment of these young patients. LEVEL OF EVIDENCE: IV The British Editorial Society of Bone & Joint Surgery 2019-04-01 /pmc/articles/PMC6442503/ /pubmed/30996745 http://dx.doi.org/10.1302/1863-2548.13.180203 Text en Copyright © 2019, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Original Clinical Article
Studer, D.
Heidt, C.
Büchler, P.
Hasler, C. C.
Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title_full Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title_fullStr Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title_full_unstemmed Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title_short Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
title_sort treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442503/
https://www.ncbi.nlm.nih.gov/pubmed/30996745
http://dx.doi.org/10.1302/1863-2548.13.180203
work_keys_str_mv AT studerd treatmentofearlyonsetspinaldeformitieswithmagneticallycontrolledgrowingrodsasinglecentreexperienceof30cases
AT heidtc treatmentofearlyonsetspinaldeformitieswithmagneticallycontrolledgrowingrodsasinglecentreexperienceof30cases
AT buchlerp treatmentofearlyonsetspinaldeformitieswithmagneticallycontrolledgrowingrodsasinglecentreexperienceof30cases
AT haslercc treatmentofearlyonsetspinaldeformitieswithmagneticallycontrolledgrowingrodsasinglecentreexperienceof30cases