October 6, 2015

The technology means children endure fewer surgeries.

 

Physicians with Vanderbilt’s Division of Pediatric Orthopaedics have begun using magnetic rods for scoliosis in young children. The controlled, magnetic growth of these rods results in a decrease in frequent surgeries and anesthesia.

Scoliosis is an abnormal, sideways curving of the spine, which in serious cases can lead to severe physical deformity, a shortened torso and, eventually, pulmonary and cardiac problems. In young patients with severe, uncontrolled scoliosis, magnetic rods can be inserted in the spine to ease the deformity and prevent the problem from getting worse.

Traditional growing rods have required minor surgery with general anesthesia about every six months to lengthen the rods as the child grows.

But with MAGEC, physicians hope to make the repetitive surgery and anesthesia almost disappear. MAGEC stands for MAGnetic Expansion Control, and involves inserting two adjustable magnetic rods into the child’s back during a minimally invasive surgery.

Jeff Martus, M.D., assistant professor of Orthopaedics and Rehabilitation and Pediatrics, said the technology will help reduce the psychological impact that patients may experience with multiple surgeries.

For a patient with traditional growing rods inserted at age 5, that translates to at least 10 surgeries by the age of 10.

“This is really exciting technology involving magnetically controlled growing rods approved by the FDA,” said Martus, an orthopaedic surgeon at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Surgery is still required to insert the rods, but the advantage is that the rods can then be lengthened in clinic without sedation using an external remote device. Ultimately, this treatment will lessen how often these children require surgery.”

The external remote controller is placed on the back and communicates via magnets how much the rod needs to lengthen.

Doctors can use radiographs or ultrasound to confirm that they’ve lengthened the rods correctly.

“The potential to be able to reduce the number of surgical procedures that, until now, have been a necessity in managing children with early onset scoliosis, is the most appealing aspect of this new technology,” said Gregory Mencio, M.D., director of Pediatric Orthopaedics at Children’s Hospital and vice chair of the Department of Orthopaedics.

“The efficacy and safety of this technique have been demonstrated in Europe and clinical trials in this country. We are excited to be able to offer this option to our patients and families.”

Using magnetic rods for scoliosis treatment is ideal for young children, who still have a lot of remaining skeletal growth. The surgery can allow the scoliosis to be controlled, while giving their spine and chest time to grow until surgeons perform a spinal fusion, which is designed to provide maximal correction of the scoliosis by stopping the spine’s growth through the deformed segment.

By January 2015, the Pediatric Orthopaedics division successfully implanted the rods in three patients.

“We are elated to be able to offer this leading-edge technology to our young patients, providing effective treatment while hopefully minimizing the anxiety and discomfort that can sometimes go along with multiple procedures for scoliosis,” said John W. Brock III, M.D., surgeon-in-chief, Monroe Carell Jr. Professor and director of the Division of Pediatric Urology.

“From a surgical standpoint, this tool adds to an already robust program of minimally invasive devices and innovations that will only continue to expand in the coming years.”

 

Christina Echegaray is an information officer for Vanderbilt University Medical Center. This story originally published in the VUMC Reporter.

Jeffrey Martus, M.D., M.S., is assistant professor of orthopaedic surgery and rehabilitation in Vanderbilt University Medical Center’s Division of Pediatric Orthopaedics.