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‘Growing rods’ help ease surgical burden of scoliosis treatment

Jan. 15, 2015, 9:08 AM

The new technology to treat scoliosis in children allows implanted growing rods to be lengthened periodically without surgery by using a magnetic external controller. (photo courtesy of Ellipse Technologies)

Physicians with Vanderbilt’s Division of Pediatric Orthopaedics have started to employ a new, advanced technology that uses magnetically controlled growing rods to correct scoliosis in young children, reducing the need for frequent surgeries and anesthesia in these patients.

Scoliosis is an abnormal, sideways curvature of the spine, which in serious cases can lead to severe physical deformity, shortened trunk height and, eventually, pulmonary and cardiac problems. In young patients with severe, uncontrolled scoliosis, growing rods can be inserted in the spine to improve the deformity and prevent progressive worsening.

Traditional growing rods have required minor surgery with general anesthesia about every six months to lengthen the rods as the child grows.

But with MAGEC, physicians hope to make the repetitive surgery and anesthesia almost disappear. MAGEC stands for MAGnetic Expansion Control, and involves inserting two adjustable magnetic rods into the back during a minimally invasive surgery.

Jeff Martus, M.D., assistant professor of Orthopaedics and Rehabilitation and Pediatrics, said the technology will help reduce the psychological impact that patients may experience with multiple surgeries.

For a patient with traditional growing rods inserted at age 5, that would translate to at least 10 surgeries by the age of 10.

“This is really exciting technology involving magnetically controlled growing rods approved by the FDA,” said Martus, an orthopaedic surgeon at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Surgery is still required to insert the rods, but the advantage is that the rods can then be lengthened in clinic without sedation using an external remote device. Ultimately, this treatment will lessen how often these children require surgery.”

The external remote controller is placed on the back and communicates via magnets how much the rod needs to lengthen.

Doctors can use radiographs or ultrasound to confirm the rods have lengthened successfully.

“The potential to be able to reduce the number of surgical procedures that, until now, have been a necessity in managing children with early onset scoliosis, is the most appealing aspect of this new technology,” said Gregory Mencio, M.D., director of Pediatric Orthopaedics at Children’s Hospital and vice chair of the Department of Orthopaedics.

“The efficacy and safety of this technique have been demonstrated in Europe and clinical trials in this country. We are excited to be able to offer this option to our patients and families.”

MAGEC rods are ideal for young children, who still have a lot of remaining skeletal growth. The surgery can allow the scoliosis to be controlled, while giving their spine and chest time to grow until surgeons perform a spinal fusion, which is designed to provide maximal correction of the scoliosis by stopping the spine’s growth through the deformed segment.

The Pediatric Orthopaedics division has successfully implanted the rods in three patients.

“We are elated to be able to offer this leading-edge technology to our young patients, providing effective treatment while hopefully minimizing the anxiety and discomfort that can sometimes go along with multiple procedures for scoliosis,” said John W. Brock III, M.D., surgeon-in-chief, Monroe Carell Jr. Professor and director of the Division of Pediatric Urology.

“From a surgical standpoint, this tool adds to an already robust program of minimally invasive devices and innovations that will only continue to expand in the coming years.”

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