Article
Magnetically controlled growing rods in scoliosis treatment – analysis of complications in a single center series with a minimum follow up of 2 years
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Authors
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Tobias Lange
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Münster, Deutschland
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Lukas Lampe
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Münster, Deutschland
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Georg Gosheger
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Münster, Deutschland
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Tobias L. Schulte
- St. Josef-Hospital Bochum, Orthopädie und Unfallchirurgie, Bochum, Deutschland
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Albert Schulze Bövingloh
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Münster, Deutschland
| Published: | June 18, 2018 |
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Outline
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Objective: Although first results of early onset scoliosis treatment by magnetically controlled growing rods (MCGR) are encouraging (1), larger series with a long follow up (FU) are rare (2). Our objective was to evaluate the effectiveness of Cobb angle correction and complications of MCGR in a single-center series with a minimum FU of 24 month.
Methods: We report of 34 consecutive MCGR cases over the past 5 years. 22 patients fulfilled the inclusion criteria of a minimum FU of 24 months. 6 patients have already been converted from MCGR to a final fusion (FF) after skeletal maturation as graduates. We analyzed the demographic data, complications, revision surgeries and the primary curve Cobb angle and the proximal junctional kyphosis (PJK)-angle at four time points: preoperative (preOP), postoperative (postOP), at FU and after FF. Descriptive values are given as mean ± SD (range).
Results: The enrolled patients showed different etiologies including 9 idiopathic, 8 neuromuscular, 4 syndromic and 1 congenital scoliosis. Mean age at surgery was 10.5 ±2.4 years (7.1-15.9) with a mean FU of 36.6 ±10.1 months (24-56).
Mean Cobb was 68°±18° (45-117) preOP and a correction of 44% to 37°±11° (8-47) (p<0.05) postOP could be achieved. At latest FU Cobb was 39°±10° (24-61) (p<0.05) and 27°±6° (21-38) (p<0.05) after FF.
No intraoperative complication could be observed but 9 patients had complications postOP (41%) including cranial screw pull out (n=1), lumbar curve progression (n=2), soft tissue infection (n=2), traumatic rod breakage (n=1), proximal adjacent vertebral burst fracture due to a trampoline injury (n=1) and PJK (n=2). In total 20 revision surgeries were needed. The calculated revision rate per patient and year after index MCGR procedure was 0.29.
Conclusion: The use of MCGR in the growing spine leads to a significant deformity correction and avoids repeated surgical procedures for lengthening. However, it has a substantialcomplicationrate which has to be taken into account while carefully planning this individual surgical treatment.
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