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

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The Use of MAGEC Growing Rods as a temporary distraction rod in Severe Kyphoscoliosis: A Case Report. 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 Jessica Morgan

Disclosures JT Smith: Consultant: Depuy-Synthes, SpineGuard; Globus; Biomet,; Ellipse BOD: CSF J Morgan: none

Initial Visit 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 Coontrolled Growing Rod (MCGR) for continued outpatient expansion for 6 months

Radiograph after 4 weeks of progressive Halo-Traction

Initial Placement of MCGR and halo removal

4 distractions over 6 months

Post-op definitive fusion after removal of MCGR

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 defnitive instrumentation and fusion easier and safer than a VCR

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.