Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
5-Year IF – 2.0, IF – 1.9, JCI (2024) – 0.43
Scopus CiteScore – 4.3
Q1 in SJR 2024, SJR score – 0.598, H-index: 49 (SJR)
ICV – 161.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 10, October, p. 1169–1174

doi: 10.17219/acem/126289

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Single vs dual rod constructs in early onset scoliosis treated with magnetically controlled growing rods

Wiktor Urbański1,2,A,B,C,D, Stewart Tucker2,A,E,F, Thomas Ember2,A,C,F, Ramesh Nadarajah2,C,F

1 Department of Neurosurgery, Wroclaw Medical University, Poland

2 Department of Orthopedic and Spine Surgery, Great Ormond Street Hospital, London, United Kingdom

Abstract

Background. Non-invasive distractions of recently introduced magnetically controlled growing rods (MGCRs) spare multiple operations in the surgical treatment of early onset scoliosis (EOS). Since the costs of the implants are high, concerns have been raised regarding cost-effective, optimal but safe MGCR options: single or dual constructs.
Objectives. To report deformity control, spinal growth and complication incidence in EOS patients treated with MCGR singleor dual-rod constructs.
Material and Methods. The study involved 47 patients with MCGRs inserted at Great Ormond Street Hospital, London (UK) in 2013–2014, who were followed up for at least 1 year. In 32 patients, T1–S1 distances, and coronal and sagittal curves were measured on preoperative and postoperative X-rays, and at a one-year follow-up. All complications were recorded. The patients were analyzed in 2 groups: those with single-rod constructs (24 patients) and those with dual-rod constructs (23 patients).
Results. Comparing postoperative with one-year follow-up measurements, T1–S1 length increase was better in the dual-rod group (3.29%) than in the single-rod group (0.34%) (p = 0.031). In the whole series, mean scoliosis magnitude dropped by 27.5% at the one-year follow-up. The dual-rod group showed better mean curve correction: 36.5% compared to 15.3% in the single-rod group (p = 0.0076). Overall, 34.04% of the patients had complications: 45.8% in the single-rod group and 30.4% in the dual-rod group (p = 0.0413). Metalwork failure was observed in 8 patients, lengthening problems in 5 and wound infections in 2; there was also 1 case of proximal junctional kyphosis (PJK). Preoperative hyperkyphosis was associated with more complications (75%, p = 0.037), most of which were metalwork failure (41.6%).
Conclusion. The MCGRs are efficient at controlling EOS; however, the complication rate is high, particularly in single-rod constructs. The use of dual-rod constructs allows for better curve control, greater T1–S1 length increase and a lower complication rate.

Key words

early onset scoliosis, magnetically controlled growing rod, dual rods, spinal growth

References (16)

  1. Dimeglio A, Canavese F, Bonnel F. Normal growth of the spine and thorax. In: Akbarnia BA, Yazici M, Thompson GH, et al, eds. The Growing Spine: Management of Spinal Disorders in Young Children. 2nd ed. Berlin-Heidelberg, Germany: Springer-Verlag; 2016.
  2. Yang S, Andras LM, Redding GJ, Skaggs DL. Early-onset scoliosis: A review of history, current treatment, and future directions. ­Pediatrics. 2016;137(1). doi:10.1542/peds.2015-0709
  3. Odenta T, Ilharreborde B, Miladi L, et al; Scoliosis Study Group (Groupe d’étude de la scoliose); French Society of Pediatric Orthopedics (SOFOP). Fusionless surgery in early-onset scoliosis. Orthop Traumatol Surg Res. 2015;101(6 Suppl):S281–S288.
  4. Cheung KM, Cheung JP, Samartzis D, et al. Magnetically controlled growing rods for severe spinal curvature in young children: A prospective case series. Lancet. 2012;379(9830):1967–1974.
  5. Akbarnia BA, Pawelek JB, Cheung KM, et al; Growing Spine Study Group. Traditional growing rods vs magnetically controlled growing rods for the surgical treatment of early-onset scoliosis: A case-matched 2-year study. Spine Deform. 2014;2(6):493–497.
  6. Teoh KH, Winson DM, James SH, et al. Magnetic controlled growing rods for early-onset scoliosis: A 4-year follow-up. Spine J. 2016;16(4 Suppl):S34–S39.
  7. Teoh KH, Winson DM, James SH, et al. Do magnetic growing rods have lower complication rates compared with conventional growing rods? Spine J. 2016;16(4 Suppl):S40–S44.
  8. Figueiredo N, Kananeh SF, Siqueira HH, Figueiredo RC, Al Sebai MW. The use of magnetically controlled growing rod device for pediatric scoliosis. Neurosciences. 2016;21(1):17–25.
  9. Dannawi Z, Altaf F, Harshavardhana NS, El Sebaie H, Noordeen H. Early results of a remotely-operated magnetic growth rod in early-onset scoliosis. Bone Joint J. 2013;95-B(1):75–80.
  10. Akbarnia BA, Cheung K, Noordeen H, et al. Next generation of growth-sparing techniques: Preliminary clinical results of a magnetically controlled growing rod in 14 patients with early-onset scoliosis. Spine (Phila Pa 1976). 2013;38(8):665–670.
  11. Hickey BA, Towriss C, Baxter G, et al. Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J. 2014;23(Suppl 1):S61–S65.
  12. La Rosa G, Oggiano L, Ruzzini L. Magnetically controlled growing rods for the management of early-onset scoliosis: A preliminary report. J Pediatr Orthop. 2017;37(2):79–85.
  13. Xu G-J, Fu X, Tian P, Ma J-X, Ma X-L. Comparison of single and dual growing rods in the treatment of early onset scoliosis: A meta-analysis. J Orthop Surg Res. 2016;11:80.
  14. Polly DW, Ackerman SJ, Schneider K, Pawelek JB, Akbarnia BA. Cost analysis of magnetically controlled growing rods compared with traditional growing rods for early-onset scoliosis in the US: An integrated health care delivery system perspective. Clinicoecon Outcomes Res. 2016;8:457–465.
  15. Cunin V. Early-onset scoliosis: Current treatment. Orthop Traumatol Surg Res. 2015;101(1 Suppl):S109–S118.
  16. Schroerlucke SR, Akbarnia BA, Pawelek JB, et al; Growing Spine Study Group. How does thoracic kyphosis affect patient outcomes in growing rod surgery? Spine (Phila Pa 1976). 2012;37(15):1303–1309.
© Wroclaw Medical University