The Role of Magnetically-controlled Growing Rods as a Temporary Internal Brace for Treatment of Adolescent Idiopathic Scoliosis with Failed Bracing

Abstract

Summary: A patient with adolescent idiopathic scoliosis (AIS) is treated with dual magnetically controlled growing rods (MCGRs) after failed bracing. At maturity, the rods were removed and the resulting Cobb angle and truncal balance was improved. Hypothesis: MCGRs are a viable option as an internal brace for AIS patients who failed conventional bracing. Design: Case report. Introduction: Bracing is a time-honored treatment to prevent curve progression in AIS. Compliance to bracing is the major obstacle for successful conservative treatment. MCGRs have been shown to be an effective treatment for early onset scoliosis its role as an internal brace for AIS has yet to be determined. Methods: A 10-year-old girl with a major thoracic AIS and truncal imbalance was managed with a Boston brace. Her initial Cobb angle was 31 degrees from T5-12 with good correction in brace down to 9.6 degrees. However, bracing failed due to intolerance and the curve progressed to 40 degrees. Dual MCGRs were inserted as an internal brace. Results: The Cobb angle measured 18 degrees with the dual MCGRs inserted. Seven distractions were performed and the MCGRs were removed when the patient reached skeletal maturity. After removal, the Cobb angle was 32.8 degrees which was better than preoperatively and was well maintained up to 2-years follow-up after removal. The truncal balance was also corrected with the surgery and well-maintained. Scoliosis Research Society 22-item questionnaire (SRS-22) scores were improved in general during MCGR treatment as compared to during bracing.