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Article: Magnetically controlled growing rods for severe spinal curvature in young children: A prospective case series

TitleMagnetically controlled growing rods for severe spinal curvature in young children: A prospective case series
Authors
Issue Date2012
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet
Citation
The Lancet, 2012, v. 379 n. 9830, p. 1967-1974 How to Cite?
AbstractScoliosis in skeletally immature children is often treated by implantation of a rod to straighten the spine. Rods can be distracted (lengthened) as the spine grows, but patients need many invasive operations under general anaesthesia. Such operations are costly and associated with negative psychosocial outcomes. We assessed the eff ectiveness and safety of a new magnetically controlled growing rod (MCGR) for non-invasive outpatient distractions. Methods We implanted the MCGR in fi ve patients, two of whom have now reached 24 months' follow-up. Each patient underwent monthly outpatient distractions. We used radiography to measure the magnitude of the spinal curvature, rod distraction length, and spinal length. We assessed clinical outcome by measuring the degree of pain, function, mental health, satisfaction with treatment, and procedure-related complications. Findings In the two patients with 24 months' follow-up, the mean degree of scoliosis, measured by Cobb angle, was 67° (SD 10°) before implantation and 29° (4°) at 24 months. Length of the instrumented segment of the spine increased by a mean of 1·9 mm (0·4 mm) with each distraction. Mean predicted versus actual rod distraction lengths were 2·3 mm (1·2 mm) versus 1·4 mm (0·7 mm) for patient 1, and 2·0 mm (0·2 mm) and 2·1 mm (0·7 mm) versus 1·9 mm (0·6 mm) and 1·7 mm (0·8 mm) for patient 2's right and left rods, respectively. Throughout follow-up, both patients had no pain, had good functional outcome, and were satisfi ed with the procedure. No MCGR-related complications were noted. Interpretation The MCGR procedure can be safely and eff ectively used in outpatient settings, and minimises surgical scarring and psychological distress, improves quality of life, and is more cost-eff ective than is the traditional growing rod procedure. The technique could be used for non-invasive correction of abnormalities in other disorders.
Persistent Identifierhttp://hdl.handle.net/10722/170201
ISSN
2015 Impact Factor: 44.002
2015 SCImago Journal Rankings: 14.638
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorCheung, JPYen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorMak, KCen_HK
dc.contributor.authorWong, YWen_HK
dc.contributor.authorCheung, WYen_HK
dc.contributor.authorAkbarnia, BAen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2012-10-30T06:06:09Z-
dc.date.available2012-10-30T06:06:09Z-
dc.date.issued2012en_HK
dc.identifier.citationThe Lancet, 2012, v. 379 n. 9830, p. 1967-1974en_HK
dc.identifier.issn0140-6736en_HK
dc.identifier.urihttp://hdl.handle.net/10722/170201-
dc.description.abstractScoliosis in skeletally immature children is often treated by implantation of a rod to straighten the spine. Rods can be distracted (lengthened) as the spine grows, but patients need many invasive operations under general anaesthesia. Such operations are costly and associated with negative psychosocial outcomes. We assessed the eff ectiveness and safety of a new magnetically controlled growing rod (MCGR) for non-invasive outpatient distractions. Methods We implanted the MCGR in fi ve patients, two of whom have now reached 24 months' follow-up. Each patient underwent monthly outpatient distractions. We used radiography to measure the magnitude of the spinal curvature, rod distraction length, and spinal length. We assessed clinical outcome by measuring the degree of pain, function, mental health, satisfaction with treatment, and procedure-related complications. Findings In the two patients with 24 months' follow-up, the mean degree of scoliosis, measured by Cobb angle, was 67° (SD 10°) before implantation and 29° (4°) at 24 months. Length of the instrumented segment of the spine increased by a mean of 1·9 mm (0·4 mm) with each distraction. Mean predicted versus actual rod distraction lengths were 2·3 mm (1·2 mm) versus 1·4 mm (0·7 mm) for patient 1, and 2·0 mm (0·2 mm) and 2·1 mm (0·7 mm) versus 1·9 mm (0·6 mm) and 1·7 mm (0·8 mm) for patient 2's right and left rods, respectively. Throughout follow-up, both patients had no pain, had good functional outcome, and were satisfi ed with the procedure. No MCGR-related complications were noted. Interpretation The MCGR procedure can be safely and eff ectively used in outpatient settings, and minimises surgical scarring and psychological distress, improves quality of life, and is more cost-eff ective than is the traditional growing rod procedure. The technique could be used for non-invasive correction of abnormalities in other disorders.en_HK
dc.languageengen_US
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lanceten_HK
dc.relation.ispartofThe Lanceten_HK
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in The Lancet. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Lancet, 2012, v. 379 n. 9830, p. 1967-1974. DOI# 10.1016/S0140-6736(12)60112-3-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAdolescenten_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshKyphosis - Radiography - Surgeryen_US
dc.subject.meshMagnetsen_US
dc.subject.meshMaleen_US
dc.subject.meshOrthopedic Procedures - Instrumentationen_US
dc.subject.meshPatient Satisfactionen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshProstheses And Implantsen_US
dc.subject.meshScoliosis - Radiography - Surgeryen_US
dc.subject.meshSpine - Radiography - Surgeryen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleMagnetically controlled growing rods for severe spinal curvature in young children: A prospective case seriesen_HK
dc.typeArticleen_HK
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_HK
dc.identifier.emailCheung, JPY: jcheung98@hotmail.comen_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authorityCheung, JPY=rp01685en_HK
dc.description.naturepostprinten_US
dc.identifier.doi10.1016/S0140-6736(12)60112-3en_HK
dc.identifier.pmid22520264-
dc.identifier.scopuseid_2-s2.0-84861456617en_HK
dc.identifier.hkuros207312-
dc.identifier.hkuros212333-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84861456617&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume379en_HK
dc.identifier.issue9830en_HK
dc.identifier.spage1967en_HK
dc.identifier.epage1974en_HK
dc.identifier.eissn1474-547X-
dc.identifier.isiWOS:000304757700031-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridCheung, JPY=24554121300en_HK
dc.identifier.scopusauthoridSamartzis, D=55171428200en_HK
dc.identifier.scopusauthoridMak, KC=51663738600en_HK
dc.identifier.scopusauthoridWong, YW=36247941700en_HK
dc.identifier.scopusauthoridCheung, WY=36655523900en_HK
dc.identifier.scopusauthoridAkbarnia, BA=6701415194en_HK
dc.identifier.scopusauthoridLuk, KDK=55171413200en_HK
dc.identifier.citeulike10584341-

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