The Clunking Phenomenon in Magnetically-controlled growing rods: Possible risk factors James Tan, Dino Samartzis, Cora Bow, Jason Pui Yin Cheung, Kenneth.

Slides:

Advertisements

Similar presentations

GET THE FACTS ABOUT SCOLIOSIS I.M. Doctor, M.D. My Office My City, State.

Advertisements

Hospital for Special Surgery Weill Medical College of Cornell University New York, New York.

The Safety and Effectiveness of Convex Anterior and Posterior Hemiepiphysiodesis for the Treatment of Congenital Scoliosis Andrew Thome, Jr. 1, Roshan.

SCOLIOSIS A NURSING OVERVIEW Ann S. Goodson, R.N.,MSN,ONC Nurse Coordinator Pediatric/Orthopedics.

F Schwab 1,2, JP Farcy 1,2, K Bridwell 2, S Berven 2, S Glassman 2,

Surgery of Spinal Deformities Rizzoli Orthopaedic Institute Bologna, Italy Surgical options in progressive scoliosis in pediatric patients with Neurofibromatosis.

Scoliosis Surgery Mark Wilms, CST ST Program Director Anthem College Aurora, Colorado.

Fusionless Correction for Early Onset Scoliosis (EOS) Emma Orton BME 281.

Biomechanical comparative study of the JuggerKnot™ soft anchor technique with other common mallet finger fracture fixation techniques Jason Pui Yin Cheung,

Cincinnati Children’s Hospital Medical Center

A Comparison of Patients Treated with Shilla Growing Rods for Early Onset Scoliosis 9 th International Congress on Early Onset Scoliosis November 19-20,

In the first 5 years of Treatment, the Charges for Guided Growth Constructs are 30% less than Growing Rods Lindsay M. Andras MD 1, Liam Harris BS 1, Scott.

Comparison of deformity correction and complications with VEPTR and early primary posterior spinal fusion in young children with idiopathic scoliosis:

NS Harshavardhana, TJ Guillaume, MHH Noordeen, JH Perra What is Magical about Magnet driven Growth Rods (MdGR) Used for Early- onset Scoliosis (EOS)?

A minimum of 2 year follow up of 22 EOS patients who were treated with 2 nd generation MCGR Karsten Ridderbusch, Christian Hagemann, Ralf Stücker Childrens.

John T. Wilkinson m. d. , Chad E. Songy m. d. , Frances l

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.

K O B E U N I V E R S I T Y O R T H O P E D I C S A K O B E U N I V E R S I T Y O R T H O P E D I C S A Nippon Steel Hirohata Hospital Nippon Steel Hirohata.

Authors: Pooria Hosseini MD, Jeff Pawelek BS, Gregory Mundis MD, Burt Yazsay MD, John Ferguson MD, Ilkka Helenius MD, Kenneth Cheung MD, Gokhan Demirkiran.

Incidence of Proximal junctional kyphosis with Magnetic Expansion Control Rods in early onset scoliosis P Inaparthy, JC Queruz, C Thakar, D Rolton, C Nnadi.

The Rib Construct (RC) has provided secure proximal fixation for management of patients with EOS and severe thoracic hyperkyphosis Alaa Azmi Ahmad – MD.

Final Fusion in Patients Treated with Rib Based Distraction: A Review of Peri- operative Results THE UNIVERSITY OF UTAH Department of Orthopaedic Surgery.

Correlation between Head Position and Trunk Shift in Congenital Cervicothoracic Junctional Deformities Michael Ruf, Attallah Hassanain, Lynn Letko, Tobias.

Burt Yaszay, MD Jeff B. Pawelek, BS John Emans, MD Patrick Cahill, MD Bo Robertson Gregory M. Mundis, MD Behrooz A. Akbarnia, MD Children’s Spine Study.

Authors: Pooria Hosseini MD MSc, Jeff Pawelek BS, Stacie Nguyen MPH, George H. Thompson MD, Suken A. Shah MD, John M. Flynn MD, John P. Dormans MD, Behrooz.

Complications of Growing Rods - has the Magec Rod overcome all of it ?

Xingye Li, Jianxiong Shen, M.D.

Management of Spinal and Thoracic Deformity in Patients with Myelomeningocele Using Vertical Expandable Prosthetic Titanium Rib Ajeya P. Joshi, David Limon,

Pediatric orthopedic surgeon – Ramallah - Palestine

ICEOS 2016 Utrecht, November 2016

How is definitive treatment effective in early onset scoliosis treated with Growing implants? Review of one centre series Tiziana Greggi, Elena Maredi,

VEPTR Implantation for Children with congenital scoliosis under Age 3

DISCREPANCY BETWEEN PROGRAMMED AND OBSERVED DISTRACTIONS IN MAGNETICALLY-CONTROLLED GROWING ROD TREATED PATIENTS María del Mar Pozo-Balado, PhD; Noelia.

Growth Friendly Surgery is Effective at Treating Scoliosis Associated with Goldenhar Syndrome Braydon Connell, Jonathan Oore, Joshua Pahys, George Thompson,

A. Aoude, L. Simoes, S. Aldebeyan, J. Ouellet McGill University

Prevalence of osteoarthritis after conservative versus reconstructive treatment of anterior cruciate ligament rupture. D. Tsoukas V.Ch. Fotopoulos Orthopaedic.

Pediatric orthopedic surgeon – Ramallah - Palestine

Children’s National Health System ICEOS 2016 – Utrecht, Holland

Surgical treatment of severe scoliosis in young children using magnetically controlled growing rods – initial experience in a prospective cohort Benny.

What Is The Role for Elongation, Derotation, Flexion Casting in Treating Early-Onset Scoliosis in Children With Connective Tissue Disorders? Graham T.

PELVIC OBLIQUITY CONTROL IN CHILDREN WITH NEUROMUSCULAR EARLY ONSET SCOLIOSIS TREATED WITH MAGNETICALLY-CONTROLLED GROWING RODS María del Mar Pozo-Balado,

Distraction-to-stall ensures spinal growth in Magnetically Controlled Growing Rods Benny Dahl1), Casper Dragsted2), Søren Ohrt-Nissen2), Thomas Andersen2),

John T. Smith, MD Jessica V. Morgan John A. Heflin, MD

Novel approach to multilevel congenital scoliosis in young children

Distraction-Based Surgeries Increase Spine Length for Patients with Non-Idiopathic EOS - 5 Year Follow up Yehia ElBromboly, Jennifer Hurry, Kedar Padhye,

R. Vazquez B.Ing. C.E. Aubin Ph.D., H. Labelle M.D.

O C Shirley, A Field, A Barrie, J Ferguson

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.

Early Experience of Frequent Small Increments Lengthening of Magnetic Spinal Growing Rods in Children with Severe Early Onset Scoliosis Joseph Ivan Krajbich.

Hospital Universitario La Paz, Madrid, Spain

Evaluation of Pulse Oximetry in Pre- and Post Casting

Expanding Indications of Reverse Shoulder Arthroplasty

Magnetically Controlled Growing Rods: Sagittal Plane Analysis and the Risk of Proximal Junctional Kyphosis Purnendu Gupta, Felix Brassard, Jennifer Schottler,

Complications of Anchors in the Growing Rod Technique

Garrido E†, Bermejo F†, Tucker SK†‡, Noordeen HNN†‡, Morley TR‡

B Ilharreborde, S Moreau, K Mazda

Is Vertical Expandable Prosthetic Titanium Rib (VEPTR) Application a Sufficient Method to Provide Expected Spinal Growth in Congenital Scoliosis? M. Bulent.

John A Heflin, MD John T. Smith, MD

Long-term results in surgical management of congenital scoliosis (CS): A minimum 10 years follow-up study Debnath UK Harshavardhana NS Hegarty J Grevitt.

M. Bulent Balioglu, Y. Emre Akman, Yunus Atici,

Sumeet Garg, MD The Children’s Hospital, Colorado

Modifications on cervical spine sagittal alignment after magnetic growing rod instrumentation. Is there a correlation with proximal giunctional kyphosis?

Is fusion surgery always the end point?

MAGNETICALLY CONTROLLED GROWING ROD IN EARLY ONSET SCOLIOSIS: RETROSPECTIVE REVIEW FOCUSING ON COMPLICATIONS Francesco Lolli, Elena Maredi, Konstantinos.

VU VIET CHINH –VO QUANG ĐINH NAM – ĐO TRAN KHANH - ĐAU THE CANH

HAZEM B ELSEBAIE FRCS, MD

Suken A. Shah, MD Jon Oda, MD William Mackenzie, MD

Scoliosis surgery with hybrid system in osteogenesis imperfecta (OI)

ARTHROGRYPOSIS AND VEPTR

Management of Implant Related Infections:

Presentation transcript:

The Clunking Phenomenon in Magnetically-controlled growing rods: Possible risk factors James Tan, Dino Samartzis, Cora Bow, Jason Pui Yin Cheung, Kenneth Cheung Department of Orthopaedics and Traumatology The University of Hong Kong

Disclosure Professor Kenneth Man Chee Cheung was a consultant and received research support for Ellipse Technologies Inc.

Aim: To assess the occurrence and potential determinants associated with “distraction failure” or slippage of the MCGR during distraction. Lancet Distraction of rods Standard Offset

Methods 5 EOS patients with dual rods inserted Congenital, CHARGE syndrome, Ehlers-Danlos syndrome, JIS, neurofibromatosis Single surgeon – Dec Oct months minimum FU Monthly distractions ~2mm Standard rods distracted first

Definition of “Distraction Failure” – Rod slippage of the magnetic mechanism during the distraction procedure – Recognize via a “clunk” sound & feeling Demographic Age at surgery and first clunking, number and frequency of clunking, BMI Radiologic Side of curve convexity, Cobb angle, sagittal profile, curve flexibility, distance of rod to apex of curve, distance between the two magnets

Magnet to apex Between two magnets

Results One patient excluded due to faulty rod design (EDS) Mean age 12.7y at initial surgery 1 st clunk within 1 year from initial surgery No difference in BMI, Cobb angle and flexibility assessments

Total failure episodes in Standard Rod Time period to 1 st failure (months) Total failure episodes in Offset Rod Time period to 1 st failure (months) Idiopathic Syndromic Congenital Neurofibromatosis650- Total Results (n=4) Standard RodOffset Rod Idiopathic0/235/23 Syndromic0/249/24 Congenital3/160/16 Neurofibromatosis11/2115/21 Total14/84 (17%)29/84 (35%) Distraction failure more prevalent in off-set rod Distraction failure occurs within 1 st year Frequency of Distraction Failure

Rods that clunked were nearer to the apex of the major curve Distance between internal magnets – Single rod clunking (56mm) Offset rod (68mm) Standard rod (31mm) – Dual rod (33mm)

First study to identify “distraction failure” or rod slippage - may help predict distraction potential – can occur within the first year since initial rod implantation may continue thereafter – more prevalent to occur in the offset rod Potential complication or risk factor ? – rod breakage, revision surgery, loss of correction, improper spinal growth, etc Naturally occurring ? – physiological fail-safe mechanism that benefits the patient ? Larger studies are needed to further validate our findings and elaborate Conclusions