Chrishan Thakar, David Christopher Kieser, Mihai Mardare, Shahnawaz Haleem, Jeremy Fairbank, Colin Nnadi


August 2018, Volume 27, Issue 9, pp 2062 - 2071 Review Read Full Article 10.1007/s00586-018-5590-4

First Online: 19 April 2018

Purpose

To analyse the complication profile of magnetically controlled growing rods (MCGRs) in early onset scoliosis (EOS).

Methods

This is a systematic review using PUBMED, Medline, Embase, Google Scholar and the Cochrane Library (keywords: MAGEC, Magnetically controlled growing rods and EOS) of all studies written in English with a minimum of five patients and a 1-year follow-up. We evaluated coronal correction, growth progression (T1–S1, T1–T12) and complications.

Results

Fifteen studies (336 patients) were included (42.5% male, mean age 7.9 years, average follow-up 29.7 months). Coronal improvement was achieved in all studies (pre-operative 64.8°, latest follow-up 34.9° p = 0.000), as was growth progression (p = 0.001). Mean complication rate was 44.5%, excluding the 50.8% medical complication rate. The unplanned revision rate was 33%. The most common complications were anchor pull-out (11.8%), implant failure (11.7%) and rod breakage (10.6%). There was no significant difference between primary (39.8%) and conversion (33.3%) procedures (p = 0.462). There was a non-statistically significant increased complication rate with single rods (40 vs. 27% p = 0.588).

Conclusions

MCGRs improve coronal deformity and maintain spinal growth, but carry a 44.5% complication and 33% unplanned revision rate. Conversion procedures do not increase this risk. Single rods should be avoided.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.[Figure not available: see fulltext.]


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