Mean 6-Year Follow-up of Magnetically Controlled Growing Rod Patients With Early Onset Scoliosis: A Glimpse of What Happens to Graduates

BACKGROUND: There is no agreement on frequency of distractions of magnetically controlled growing rods (MCGRs) but more frequent and smaller amounts of distractions mimic physiological spine growth. The mid-to long-term follow-up and management at skeletal maturity is unknown. OBJECTIVE: To analyze patientswith mean 6 yr of follow-up and describe the fate of MCGR graduates. METHODS: Early onset scoliosis (EOS) patients treated with MCGRs with minimum 4 yr of follow-up and/or at graduation were studied. Parameters under study included Cobb angle, spine and instrumented lengths, and rod distraction gains. Relationship between timing of rod exchanges with changes in rate of lengthening was studied. RESULTS: Ten EOS patients with mean 6.1 yr of follow-up were studied. The greatest Cobb angle correction occurred at the initial implantation surgery and was stable thereafter. Consistent gains in T1-12, T1-S1, and instrumented segment were observed. Rate of lengthening reduced after the first year of use but improved back to initial rates after rod exchange. Seven of the ten patients experienced complications with reoperation rate of 40% for rod distraction failure and proximal foundation problems. Only mild further improvements in all radiological parameters were observed pre- and postfinal surgery. No clinically significant curve progression was observed for rod removal only. All postfinal surgery parameters remained similar at postoperative 2 yr. CONCLUSION: This study provides an outlook of the end of MCGR treatment. Although this is a fusionless procedure, instrumented segments do experience stiffness limiting further correction and length gain during final surgery whether fusion or rod removal is performed.