Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis
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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