Chloie Jacobs, 9, prepares for a follow-up scan of her congenital scoliosis — a sideways curvature of the spine present at birth — and climbs into a new X-ray imaging device at the pediatric orthopaedic clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt.
But this isn’t just any X-ray machine. For Chloie, the cutting-edge technology, known as EOS, feels more like a teletransporter, because of its outer space-like design. For her parents, Michael and Amber, the machine serves as peace of mind.
The EOS X-ray imaging system uses ultra-low radiation doses (up to 50 times lower depending on the scan type) to capture 2-D and 3-D images. The scan, complete in about eight to 15 seconds, obtains an image of the body in an upright, load-bearing position, which is more representative of the body’s natural function.
Previously, these patients had radiologic images taken with traditional X-ray machines and higher amounts of radiation, often in the supine position.
“She has X-rays at least three times a year, so anything with less radiation is always better,” Amber Jacobs said.
If a child can’t stand unassisted in the EOS machine, a chair specifically designed for the machine allows the child to sit while being scanned.
Children’s Hospital’s pediatric orthopaedic clinicians are using the imaging device for children, adolescents and young adults who have spinal deformities such as scoliosis; kyphosis (curvature of the spine that causes bowing or rounding of the back); limb length inequality; and lower extremity deformities, including hip dysplasia, torsional abnormalities and genu varum (bow-leggedness) and genu valgum (knock-knee).
Less radiation for high-quality scans is appealing to doctors and parents because the cumulative effects of too much radiation can be harmful to a child, increasing the risk of cancer.
“With children and adolescents, the goal is always to minimize the radiation dose. This is the ALARA concept: ‘as low as reasonably achievable.’ The EOS technology allows for substantial reduction in radiation exposure,” said Jeff Martus, MD, associate professor of Orthopaedic Surgery and Rehabilitation. “For scoliosis patients, this may be a reduction of six to nine times compared to standard X-rays. There is also a microdose protocol for follow-up imaging that may reduce exposure by 45 to 50 times. We estimate that approximately 2,000 patients per year will benefit from this technology in our practice.”
Pediatric orthopaedics is always looking for cutting-edge technology to improve the quality of life for patients and reduce risks.
About four years ago, the team began employing new, advanced technology that uses magnetically controlled growing rods, called MAGEC, to correct scoliosis in young children, reducing the need for frequent surgeries and anesthesia in these patients.
Traditional growing rods have required minor surgery with general anesthesia every six months to lengthen the rods as the child grows. MAGEC (MAGnetic Expansion Control), however, reduces the need for repetitive surgeries and anesthesia. It involves inserting two adjustable magnetic rods into the back during a minimally invasive surgery. The rods are lengthened using a machine outside the body that uses a magnetic force.
Chloie, minutes before her EOS scan, had her MAGEC rods lengthened, and she was already showing off her ability to do the splits. The rods were implanted almost two years ago.
“Every six months, she used to have to go into surgery to have her rods done,” Amber said. “Now, we just go to a regular doctor’s appointment. It’s so much easier on her.”