Cincinnati Children’s Hospital Medical Center

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Presentation transcript:

Sonographic Evaluation of MAGEC Growing Scoliosis Rods in Pediatric Patients Cincinnati Children’s Hospital Medical Center Department of Orthopaedics Department of Radiology Peter Sturm, MD Sara M. O’Hara, MD Lindsay Schultz, BS,CCRP

Disclosures Peter Sturm, MD- Consultant for Medtronic Consultant for Ellipse Sara M. O’Hara, MD- Speakers bureau Toshiba Medical Ultrasound Lindsay Schultz, BS,CCRP - NONE

Purpose Adjustable, magnetically controlled “growing” scoliosis rods (MAGEC rods) are increasingly used in pediatric patients, and require periodic adjustments and confirmation of lengthening following this non-invasive procedure. Previously, adjustable rods required open surgical procedures for lengthening. The purpose of our study was to determine if these MAGEC rods could be adequately visualized and measured with ultrasound, thereby minimizing radiation exposure from serial spine X-rays. MAGEC ROD Expanded segment Expandable rod housing Motor and housing

MAGEC ROD Segment we measure Motor Rod housing Extended segment of rod

Materials & Methods All patients with recently implanted MAGEC rods were examined with ultrasound before and after their first transcutaneous magnetic rod lengthening procedures. Measurements obtained sonographically were compared with the length programmed into the magnetic motor used to extend the rod. Measurements will also be compared with scoliosis X-rays obtained once or twice each year. Sets the motor driver parameters, then activates on patient Motor is audible, stops automatically, not painful! Ortho localizes the motor with magnetic wand (blue) or with ultrasound, and marks site(s),

Ultrasound can readily identify: Gap between housing and extended rod and tapered end of rod We measure and report distance between gap and TOP of slope, pre & post lengthening

Results 12 patients have been studied to this point (3 month period) 6 female, and 6 male, between 6 and 10 years of age All of the MAGEC rods were well visualized sonographically before and after lengthening procedure. All of the patients showed good correlation between post-op scoliosis measurements and first, pre-lengthening ultrasound measurements. 4 of the 13 patients rods showed less lengthening than expected based on the length programmed into the magnetic motor driver. All patients will be re-imaged in the next few months to quantify measurement reliability and compare with expected extension parameters.

Conclusion MAGEC rods can be reliably imaged with ultrasound before and after transcutaneous lengthening procedures, thereby reducing radiation exposure. In addition, the ultrasound may offer additional confidence that the rods have in fact extended the length programmed into the magnetic motor.