Purpose

A two-staged posterior correction, using a temporary magnetically controlled growing rod (MCGR), was employed to gradually and safely correct severe adolescent idiopathic scoliosis (AIS). The aim of the study is illustrating the results of this procedure.

Methods

A retrospective review of a consecutive series of 17 severe AIS. The first surgery was a posterior release (multiple Ponte osteotomies) with implant of pedicle screws and MCGR on the concave side of the curve. In post-operative days, a distraction was applied with MCGR, which allowed to obtain a total mean lengthening of 2 cm in about 2 weeks, with no complications arising. In the second posterior surgery, MCGR was removed and the definitive rods were applied for final fusion. The mean pedicle screws density was 93.3% (85–100). The extension of the final posterior fusion-instrumentation was of 13.8 levels (12–15).

Results

At an average follow-up (FU) of 2.9 years, the main scoliosis curves from average pre-operative Cobb angle of 98.2° (91°–138°) bent down to 38.3° (35°–76°) after definitive fusion (p < 0.05); at last FU, the overall correction was 58.7% (50.4–71.2), with an average correction loss of 2.1° (1.5°–3.1°). At last FU, no complications were reported.

Conclusions

Gradual traction with MCGR in severe AIS proved to be a safe method to achieve progressive curve correction before posterior final fusion, with no neurologic complications associated to more aggressive one-stage surgeries. In a staged approach, MCGR appears as an alternative to halo traction, avoiding frequent traction-related complications.

中文翻译：

---

严重的青少年特发性脊柱侧弯：使用临时磁控生长棒进行后段矫正。

目的

使用临时磁控生长棒 (MCGR) 进行的两阶段后路矫正被用于逐渐安全地矫正严重的青少年特发性脊柱侧弯 (AIS)。该研究的目的是说明该程序的结果。

方法

对 17 个严重 AIS 连续系列的回顾性审查。第一次手术是后路松解（多次 Ponte 截骨术），在曲线的凹侧植入椎弓根螺钉和 MCGR。在术后几天，使用 MCGR 进行牵引，在大约 2 周内获得总平均延长 2 厘米，没有出现并发症。在第二次后路手术中，MCGR 被移除并应用最终的棒进行最终融合。平均椎弓根螺钉密度为 93.3% (85-100)。最终后路融合器械的延伸为 13.8 级 (12-15)。

结果

在平均 2.9 年的随访 (FU) 中，主要脊柱侧弯曲线从术前平均 Cobb 角 98.2° (91°–138°) 弯曲至最终融合后的 38.3° (35°–76°)。p  < 0.05); 最后FU，整体矫正率为58.7%（50.4-71.2），平均矫正损失为2.1°（1.5°-3.1°）。最后FU，没有并发症的报道。

结论

在严重 AIS 中使用 MCGR 逐渐牵引被证明是在后路最终融合之前实现渐进式曲线矫正的安全方法，没有与更积极的一期手术相关的神经系统并发症。在分阶段的方法中，MCGR 似乎是晕轮牵引的替代方案，避免了频繁的牵引相关并发症。