DISTRACTION of (MAGEC) Rod WHY and WHEN ?

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Presentation transcript:

DISTRACTION of (MAGEC) Rod WHY and WHEN ? Hilali Noordeen FRCS Tr & Orth

Early Onset Scoliosis Spinal Deformity in children < 5 years Natural History dismal and it is challenging Aim of Management: Stop curve progression Achieve max axial skeletal growth Allow lung and thoracic cage development to continue

Treatment Of EOS Distraction Based e.g: VEPTR Guided Growth e.g: Shilla Technique Compression Based e.g: tether, staples

Disadvantages of Conventional Growth Rod Multiple hospital admissions: Psychologically traumatic Repeated 6 monthly anaesthesia & its risks The law of diminishing returns: Large forces every time

The MAGEC™ System A Remotely Expandable Device for Non-invasive Lengthening of Growing Rod MAGEC™ comprises two major elements Implantable distraction rod External adjustment device

How Does It Work? Thrust Bearing Actuator Housing Magnet Radial Bearing O-ring dynamic seal Pin (holds lead screw to magnet housing) Nut Gland (groove in which O-ring resides) Lead Screw Inner space in proximal rod where nut resides Distal rod (shown short) Proximal rod (shown short)

MAGEC™ Distraction External Remote Controller (ERC) The ERC is a portable, hand held unit that uses a pair of permanent magnets to automatically modify the length of the implant through touch of a switch. The amount of applied distraction /retraction can be seen on a built in display. If dual rods are used, they can be distracted/retracted independently.

Advantages of MAGEC 1. One off surgery (EOS in neuromuscular disorders, e.g: SMA) Save theatre time and expenses of repeated surgery Pulmonary Function not compromised Addresses the limitations of VEPTR and Conv. GR

Frequency Of Distraction Rods are usually distracted every 3-6 months AP view of the whole spine is obtained during each visit Distraction can be: Targeted (predetermined) Non-targeted (Max length that the spine allows)

Case Presentation: Pre-op Post-op After 5 distractions: total 19mm T1-s1: 375mm T1-s1: 388 mm T1-s1: 415 mm Cobb ^le - 62 Cobb ^le - 52 Cobb ^le - 42

London 2012- Opening Ceremony Thank You London 2012- Opening Ceremony