A novel approach to gradual correction of severe spinal deformity in a pediatric patient using the magnetically-controlled growing rod

BACKGROUND CONTEXT: Acute correction of severe spinal deformities significantly increases the risk of neurologic complications. Previously used methods to safely correct these deformities include halo-traction devices and internal distraction rods. PURPOSE: This report introduces a novel method for gradual correction of severe spinal deformity by using the magnetically controlled growing rod (MCGR). STUDY DESIGN: This is a case report. METHODS: A 12-year-old girl with severe kyphoscoliosis and concurrent syringomyelia and Arnold-Chiari Type I malformation underwent implantation of the MCGR. After implantation of the device, daily distractions of the implant were performed over the course of 2.5 months. RESULTS: The patient underwent MCGR implantation without acute correction of her leftsided thoracic scoliosis (109 degrees from T6 to T11) and upper thoracic kyphosis (72 degrees). After 2.5 months of daily distractions in the ward, the scoliosis improved to 66 degrees and the kyphosis to 62 degrees. Final fusion was performed without problems, and her overall truncal balance was much improved. CONCLUSIONS: This report is the first to note the safety and efficacy of the MCGR in treating young patients with severe spinal deformities. This technique allows correction of the deformity while the patient is awake so that neurology can be continuously monitored. The patient is also ambulatory throughout the distraction process and can be distracted on an outpatient basis. Repeated surgery can be avoided, and the MCGR has been shown to be safe and effective with this case illustration. (C) 2014 Elsevier Inc. All rights reserved.