Spinal Growing Rods
Traditional growing rods are intended for young patients with significant growth potential and a high risk of spinal deformity progression in the setting of scoliosis. Severe spinal deformity can cause limitations in lung growth, heart problems, and other life-threatening conditions. Traditional growing rod treatment for young patients with moderate to severe scoliosis involves an initial surgery to place hooks and/or screws and rods in a child’s back to help control the progression of the scoliosis curve. Because children are growing during treatment, an operation is required approximately every 6 months in order to lengthen the rods to accommodate the child’s growth.
Generally, patients with traditional growing rods undergo multiple distraction surgeries after the initial surgery which can cause an increased chance of postoperative infections, increased psychological distress, and increased exposure to x-rays and anesthesia. Typically, once the spine has reached its maximum length, and their chest is matured, the temporary rods and screws/hooks are removed and a spinal fusion is performed to permanently straighten the scoliosis and stabilize the spine.
While the vast majority of scoliosis cases can be successfully managed with observation or external braces, there are some individuals that benefit from surgical intervention, particularly those presenting with early onset scoliosis. The main goals of surgery are to stop progression of the curve, reduce deformity, and reduce pain which is classically done through a fusion procedure.
Fusion of the spine is when two or more adjacent vertebrae are permanently connected to grow together at the spinal joint and form a solid bone. This technique uses metal rods and screws to achieve better curvature correction and faster recovery times than in the past. Fusion has long been the gold standard treatment for scoliosis, however a drawback to the procedure is that any fused vertebral segment will lose mobility, which can permanently limit the ability for one to bend and twist.
If a patient is too young to undergo fusion then growing implants are the treatment of choice to help guide the spine as it grows, preventing the curve from worsening as the spine matures and eventually becomes ready for a fusion if needed.
Idiopathic scoliosis, or abnormal spine curvature, typically develops in young, female individuals greater than 10 years old. In young children with onset before 10 years old they are at an increased risk for impaired lung function because of the high risk of progressive spinal deformity and constraints during a critical time of lung development. The cause of scoliosis has yet to be elucidated, but a family history of scoliosis increases the risk.
Most cases of idiopathic scoliosis do not result in pain or neurological symptoms. Diagnosis is generally made incidentally at an annual checkup or school physical. Usually treatment falls into three categories observation, bracing, and surgery depending on curve severity and likelihood for progression.
The NuVasive MAGEC (MAGnetic Expansion Control) device allows scoliosis patients to undergo similar treatment to traditional growing rod procedures, but with noninvasive distractions. It works by using external magnets to control a rod implanted in the spine and is for children diagnosed with progressive early onset scoliosis who have not benefited from nonsurgical treatments.
With the MAGEC system, the patient can have the lengthening done in the office without anesthesia. There is typically no pain during the lengthening, no additional incisions or bandages, and the child can get back to activities immediately as tolerated. Overall, this procedure decreases the chance of infection, risk of anesthesia, as well as the anxiety, cost, and time experienced with repetitive surgeries. This has completely changed how we treat a young child with progressive scoliosis.