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Severe adolescent idiopathic scoliosis: posterior staged correction using a temporary magnetically-controlled growing rod

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Abstract

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.

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Authors and Affiliations

  1. Spine Surgery Department, Ospedale Santa Corona, Pietra Ligure, SV, Italy

    Mario Di Silvestre, Andrea Zanirato, Davide Vallerga & Simona Legrenzi

  2. Spine Surgery Department, Istituti Ortopedici Rizzoli, Bologna, Italy

    Tiziana Greggi & Antonio Scarale

  3. Orthopedic Clinic, Ospedale San Martino, Genova, Italy

    Matteo Formica & Lamberto Felli

Authors
  1. Mario Di Silvestre
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  2. Andrea Zanirato
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  3. Tiziana Greggi
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  4. Antonio Scarale
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  5. Matteo Formica
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  6. Davide Vallerga
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  7. Simona Legrenzi
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  8. Lamberto Felli
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Correspondence to Mario Di Silvestre.

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Di Silvestre, M., Zanirato, A., Greggi, T. et al. Severe adolescent idiopathic scoliosis: posterior staged correction using a temporary magnetically-controlled growing rod. Eur Spine J 29, 2046–2053 (2020). https://doi.org/10.1007/s00586-020-06483-8

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  • DOI: https://doi.org/10.1007/s00586-020-06483-8

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