The Use of MAGEC Growing Rods as a temporary distraction rod in Severe Kyphoscoliosis: 2 Case Reports. John T. Smith, MD Mary Scowcroft Perry Presidential.

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Presentation transcript:

The Use of MAGEC Growing Rods as a temporary distraction rod in Severe Kyphoscoliosis: 2 Case Reports. John T. Smith, MD Mary Scowcroft Perry Presidential Endowed Chair of Orthopaedics Professor, University of Utah Department of Orthopaedics Chief, Scoliosis Service Primary Children’s Hospital Salt Lake City, UT John A. Heflin, MD Assistant Professor, University of Utah Department of Orthopaedics Jessica Morgan University of Utah Department of Orthopaedics

Disclosures JT Smith: Consultant for: Depuy-Synthes, SpineGuard, Globus Medical, Biomet, Ellipse BOD: CSF John A. Heflin: Consultant for Globus Medical J Morgan: none

Case 1 11 +/- 2 year old female Severe kyphoscoliosis measuring >135° MRI showing no abnormalities of the spinal cord Adopted from an Ethopian Refugee Camp

Initial Visit: clinical appearance

First radiographs; Kyphoscoliosis >150°

Management plan Through clinical evaluation for co-morbidities Placement of halo Progressive halo-gravity traction Pulmonary rehab in halo Planned placement of Magnetically Controlled Growing Rod (MCGR) for continued outpatient expansion for 6 months

4 distractions over 6 months

Post-op definitive fusion after removal of MCGR

Case 2: Kyphoscoliosis >140°

Case 2 13 year old female Somali Refugee Severe kyphoscoliosis measuring >140° MRI showing no abnormalities of the spinal cord Management plan: similar to Case 1 including MRI and gradual halo-gravity traction for 6 weeks followed by placement of temporary MCGR.

10 distractions over 4 months Definitive fusion planned for November 2016

Discussion Gradual correction of severe scoliosis can be accomplished safely over time using halo-traction The MCGR can be used as a form of a temporary internal distraction rod in severe deformities Gradual distraction made definitive instrumentation and fusion easier and safer than a vertebral column resection References Sponseller P.D., Takenaga, R.K., Netown, P., et al. (2008). The use of traction in the treatment of severe spinal deformity. Spine 2008; 33: 2305-9. Buchowski, J.M., Bhatnagar, R., Skaggs, D.L., Sponseller, P.D., Temporary internal distraction as an aid to correction of severe scoliosis. J Bone Joint Surg Am 2006;88:2035-41. Cheung, J.P., Samartzis, D., & Cheung, K.M. (January 20, 2014). A novel approach to gradual correction of severe spinal deformity in a pediatric patient using the magnetically-controlled growing rod. The Spine Journal 14 (2014) e7-e13.