Skip to main content
Download PDF
  • Systematic Review
  • Open access
  • Published:

Magnetically controlled growing rods in the management of early onset scoliosis: a systematic review

Journal of Orthopaedic Surgery and Research volume 17, Article number: 309 (2022) Cite this article

Abstract

Background

Early onset scoliosis (EOS) presents in patients younger than 10 years. Magnetically controlled growing rods (MCGR) were developed as an outpatient distraction system for EOS, allowing to avoid multiple surgeries. This systematic review investigated the efficacy and feasibility of MCGR in EOS.

Methods

This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Scopus were accessed in May 2022. All the clinical trials which investigate the role of MCGR for early onset scoliosis were accessed. Only studies reporting data in patients younger than 10 years with a preoperative Cobb Angle greater than 40° were eligible. The following data was extracted at baseline and at last follow-up: mean kyphosis angle, overall mean Cobb angle, mean T1–S1 length. Data from complication were also collected.

Results

Data from 23 clinical studies (504 patients) were included in the present study. 56% (282 of 504) were females. The average length of the follow-up was 28.9 ± 16.0 months. The mean age of the patients was 8.7 ± 1.9 years old. The mean BMI was 17.7 ± 7.6 kg/m2. The mean kyphosis angle had reduced by the last follow-up (P = 0.04), as did the overall mean Cobb angle (P < 0.0001), while the overall T1–S1 length increased (P = 0.0002). Implant-associated complications, followed by spinal alignment failure, wound healing ailments, pulmonary complications, progressive trunk stiffness, persistent back pain, and fracture.

Conclusion

The management of EOS remains challenging. The current evidence indicates that MCGR may be effective to distract the spine and model the curve in EOS.

Introduction

Early onset scoliosis (EOS) presents in patients younger than 10 years [1, 2]. EOS is classified according to the age of the patient at the start of the deformity as early (0–5 years old) or late (> 5 years old) onset scoliosis [3,4,5]. Surgery in patients with EOS aims to correct the deformity avoiding complications improving the patient’s long-term health-related quality of life [6,7,8,9]. Concomitant neuromuscular, congenital, or syndromic scoliosis are associated with greater morbidity and mortality [3, 10, 11]. If left untreated, EOS may lead to cardiopulmonary and neurological complications [12, 13]. Given their growth-friendly nature, traditional growing rods (TGR) have been used to treat EOS. However, surgical distraction every 6–8 months is required, increasing the risk of complication [6, 14,15,16]. Magnetically controlled growing rods (MCGR) were developed as an outpatient distraction system, allowing to avoid multiple surgeries [17, 18]. Spinal distraction using MCGR is performed by placing a manual magnetic external remote controller over the internal magnet. Next, the rotation of the magnet within the rod is induced by external magnetic field leads to extension of rod. At the moment, the MAGEC (Magnetic Expansion Control; NuVasive; San Diego; USA) is the only magnetically regulated growing rod system [6, 18]. In Europe, the system was licensed in 2009 and it was approved by the FDA in 2017 [6]. Although this methodology reduces the number of surgical interventions, it has been associated with several complications [15, 19].

This systematic review investigated the efficacy and feasibility of MCGR in EOS. The focus of the present study was on kyphosis, Cobb angle, T1–S1 length, and complications associated with MCGR.

Material and methods

Search strategy

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA guidelines [20]. The PICO algorithm was preliminary pointed out:

  • P (Population) Early onset scoliosis;

  • I (Intervention) MCGR;

  • C (Comparison) efficacy and feasibility;

  • O (Outcomes) reliability and safety.

Data source

Two authors (**;**) independently accessed PubMed, Google scholar, Embase, and Scopus in April 2022. The following keywords were used in combination: early onset scoliosis, scoliosis, spine, young, children, childhood, magnetic controlled growing rods, MCGR, three dimensional spinal deformity correction, apical control of vertebrae. The same authors independently screened the resulting titles and abstract. The full-text of the articles which matched the topic was accessed. A cross reference of the bibliographies was also performed by hand. Disagreement was debated and solved by a third author (**).

Eligibility criteria

All the clinical trials which investigate the role of MCGR for early onset scoliosis were accessed. Given the authors language capabilities, articles in English, German, Italian, French, Spanish, and Chinese were eligible. Only level I–III of evidence articles, according to Oxford Centre of Evidence-Based Medicine [21], were considered. Only studies reporting data in patients younger than 10 years with a preoperative Cobb Angle greater than 40° were eligible. Only studies with minimum 9 months’ follow-up are considered. Both single and double rod MCGR were considered. Reviews, letters, expert opinion, editorials, and comments were not eligible. Animal, cadaveric, and biomechanics studies were excluded. Only articles reporting quantitative data under the outcomes of interest were considered for inclusion. Missing data under the outcomes of interest warranted the exclusion from this study.

Data extraction

Two authors (**;**) independently performed data extraction. Studies generalities (author, year, design, length of the follow-up) were extracted, as were patient demographic (size, gender, mean age, and BMI). Data of the patient baseline characteristics were extracted. The following data was extracted at baseline and at last follow-up: mean kyphosis angle, overall mean Cobb angle, mean T1–S1 length. Data from complication were also collected.

Methodology quality assessment

For the methodology quality assessment, the Coleman Methodology Score (CMS) was used [22]. Each of the included studies was evaluated under several items, such as the population size, length of follow-up, number of surgical approaches, diagnosis, surgical techniques with description, outcomes and related assessing procedure, and patient recruitment. The CMS evaluated every included article in a value from 0 to 100. A mean overall value > 60 points is considered as ‘satisfactory’.

Data synthesis

The statistical analyses were performed using the IBM SPSS Software version 25. For descriptive statistics, mean and standard deviation were used. For continuous variables, the mean difference (MD) effect measure was adopted. The t-test was used to assess whether the change of variables from baseline to last follow-up were statistically significant, with values of P < 0.05 considered satisfactory. The rate of adverse events was evaluated as frequency (%).

RESULTS

Search result

The literature search resulted in 663 articles, 209 of them were excluded from this study as they were duplicated. Another 431 articles were excluded since they did not fulfil the preferred eligibility criteria: language limitation (n = 68), type of studies (n = 167), type of analysis (n = 178) and revision settings (n = 18). Finally, 41 articles were rejected as they did not provide qualitative data under outcomes of interest. This left 23 investigations for the present study. The literature search results are shown in Fig. 1.

Fig. 1
figure 1

Flow chart of the literature search

Full size image

Methodological quality assessment

The limited study size, along with the retrospective design of most of the included studies represent important limitations of this study. The average length of the follow-ups was acceptable in most studies. Diagnosis and surgical approach were well-described in most articles. The rehabilitation process was barely reported. Outcome measures and timing of assessment were satisfactory defined. The procedures for assessing outcomes and subject selection were often biased and not adequately described. The CMS for the articles was 66/100, attesting the good quality of the methodology assessment (Table 1).

Table 1 CMS
Full size table

Patient demographics

504 patients were included in the present study. 56% (282 of 504) were females. The average length of the follow-up was 28.9 ± 16.0 months. The mean age of the patients was 8.7 ± 1.9 years old. The mean BMI was 17.7 ± 7.6 kg/m2. Studies generalities and patient baseline is shown in Table 2.

Table 2 Generalities and patient baseline of the included studies (please define the abbreviations)
Full size table

Imaging

The mean kyphosis angle had reduced by the last follow-up (− 10.9°; P = 0.04), as did the overall mean Cobb angle (− 31.6; P < 0.0001), while the overall T1–S1 length increased (+ 27.1 mm; P = 0.0002). The mean kyphosis, Cobb angle, and T1–S1 length are shown in greater detail in Table 3.

Table 3 Improvement from baseline
Full size table

Complications

Implant-associated complications, including proximal screw pull out from the rod, pull out of the rod, re-operation for trimming of the prominent rod, connector breakage, completed breakage, detachment of pedicle screw hand/screw misplaced, and screw/plug loosening were the most common ones. The following spinal alignment were found: coronal imbalance, proximal junctional kyphosis, pelvic obliquity, secondary lumbar scoliosis. Delayed wound healing, wound dehiscence, and infections were seldom reported. Pulmonary complications, such as pneumonia, pulmonary embolism, pleural effusion, and progressive trunk stiffness, persistent back pain and fracture occurred rarely (Table 4).

Table 4 Overall complications
Full size table

Discussion

The management of EOS remains challenging. MCGR is effective to distract the spine and model the curve in EOS, and is associated with a low rate of complication in the short term. Compared to the increase lengthening method of TGR, MCGR is a noninvasive procedure that avoids periodic invasive distraction procedures, exposing the patients to less anaesthesia episodes, rate of postoperative complications, reducing the physical and psychological burden of the young patients. Moreover, MCGR can be performed as outpatients, which may lead to a marked reduction in costs compared to the traditional TGR. However, is necessary to ascertain mid to long research whether the good preliminary outcomes persist [19, 43, 44].

The most common sagittal plane abnormality remains thoracic lordosis or thoracic hypokyphosis. To measure the magnitude of frontal plane deformity in scoliosis the Cobb angle is commonly used. The Cobb angle is used to determine in a relatively easy fashion the degree of curvature of the spine [45,46,47]. The Cobb angle is determined in posteroanterior radiographies. To assess the Cobb angle, the beginning and end of the spinal curve must be identified. Two lines, one tangential to the cranial endplate of the beginning vertebrae and one tangential to the caudal endplate of the last vertebrae are drawn. In a person with a straight spine, these lines would be parallel. In people with spinal curvatures, perpendicular lines are drawn from these lines until they intersect. The lines follow the inclination of the vertebrae and are angled. The Cobb angle is the angle at the point of intersection [48, 49]. The overall mean Cobb angle and the dorsal kyphosis at last follow-up reduced considerably of 31.6° and 10.9°, respectively. The T1–S1 vertebral lengthening at last follow-up also improved significantly of 27 mm. These data suggest that MCGR is effective and comparable with TGR [50, 51]. One limitation of the Cobb angle is that people can stand four to six degrees off when taking the measurement [47, 52]. This can mean the difference between bracing and surgery, making such measurements critical [53, 54]. Additionally, this measurement identifies the spine as a two-dimensional object on radiographies, when in fact the spine exists in three dimensions [55, 56]. The Cobb angle does not consider the twisting of the spine that often accompanies the development of a side-to-side curvature [57, 58]. A patient might have a small Cobb angle, but a severely twisted spine [59, 60].

Overall, a total of 124 complications were reported in 504 patients (25%). The foremost frequent complications were: proximal screw out of the rod, loss initial height, proximal pull out of the hooks, screw/plug loosening, and reoperation for trimming of outstanding rod. Failure of distraction, connexion breakage, complete blockage/rod breakage, proximal junctional humpback. Thought the rate of complications was high, this value is lower than what observed following TGR, at approximately 46–55% [43, 44, 61].

MCGR is initially more expensive compared to the TGR; however, the lower number of surgeries required, the outpatient regime, and the lower rate of complications results in a lower burden in the mid to long term in favour of MCGR [62, 63]. The cumulative costs of MCGR are approximately 50% greater than TGR at 1 year follow-up; however, they are lower of about 17% at 5 years follow-up [64].

This study has several limitations. The retrospective nature of the present study represents an important limitation, which increase the risk of selection bias. The study size was limited and the length of the follow-up was too short in most included studies. Surgical approach, eligibility criteria, and rehabilitation protocols were often biased and biased. Outcome measures and timing of assessment were often defined, providing moderate reliability. General health measures were seldom described. The timing of the evaluation of the results was often biased. Future high-quality studies involving a larger number of patients and longer follow-up are required to proper validate MCGR in the clinical setting. Given these limitations, data from the present study must be considered carefully.

Conclusion

The management of EOS remains challenging. The current evidence indicates that MCGR may be effective to distract the spine and model the curve in EOS.

Availability of data and materials

The data underlying this article are available in the article and in its online supplementary material.

Abbreviations

EOS:

Early onset scoliosis

MCGR:

Magnetically controlled growing rods

MAGEC:

Magnetic expansion control

BMI:

Body mass index

CMS:

Coleman methodology score

MD:

Mean difference

TGR:

Traditional growing rods

References

  1. Yang S, Andras LM, Redding GJ, et al. Early-onset scoliosis: a review of history, current treatment, and future directions. Pediatrics. 2016;137.

  2. Helenius IJ. Treatment strategies for early-onset scoliosis. EFORT Open Rev. 2018;3:287–93.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Fletcher ND, Bruce RW. Early onset scoliosis: current concepts and controversies. Curr Rev Musculoskelet Med. 2012;5:102–10.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Vollner F, Dingeldey E, Schmitz S, et al. Conservative and surgical treatment of idiopathic scoliosis. Orthopade. 2020;49:635–46.

    Article  PubMed  Google Scholar 

  5. Janicki JA, Alman B. Scoliosis: review of diagnosis and treatment. Paediatr Child Health. 2007;12:771–6.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tsirikos AI, Roberts SB. Magnetic controlled growth rods in the treatment of scoliosis: safety, efficacy and patient selection. Med Devices (Auckl). 2020;13:75–85.

    Google Scholar 

  7. Skov ST, Li H, Hansen ES, et al. New growth rod concept provides three dimensional correction, spinal growth, and preserved pulmonary function in early-onset scoliosis. Int Orthop. 2020;44:1773–83.

    Article  PubMed  Google Scholar 

  8. Miller DJ, Flynn JJM, Pasha S, et al. Improving health-related quality of life for patients with nonambulatory cerebral palsy: who stands to gain from scoliosis surgery? J Pediatr Orthop. 2020;40:e186–92.

    Article  PubMed  Google Scholar 

  9. Rodrigues JB, Saleme NA, Batista JL Jr, et al. Quality of life in patients submitted to surgical treatment of idiopathic scoliosis. Acta Ortop Bras. 2015;23:287–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Campbell RM Jr, Smith MD, Mayes TC, et al. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Jt Surg Am. 2003;85:399–408.

    Article  Google Scholar 

  11. Phillips JH, Knapp DR Jr, Herrera-Soto J. Mortality and morbidity in early-onset scoliosis surgery. Spine (Phila Pa 1976). 2013;38:324–7.

    Article  Google Scholar 

  12. Akbarnia BA. Management themes in early onset scoliosis. J Bone Joint Surg Am. 2007;89(Suppl 1):42–54.

    PubMed  Google Scholar 

  13. Noorda RJ, Wuisman PI, Fidler MW, et al. Severe progressive osteoporotic spine deformity with cardiopulmonary impairment in a young patient A case report. Spine (Phila Pa 1976). 1999;24:489–92.

    Article  CAS  Google Scholar 

  14. Wijdicks SPJ, Skov ST, Li H, et al. 3-Year follow-up of a single magnetically controlled growing rod with contralateral gliding system and apical control for early onset scoliosis. Spine Deform. 2020;8:751–61.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Peiro-Garcia A, Bourget-Murray J, Suarez-Lorenzo I, et al. Early complications in vertical expandable prosthetic titanium rib and magnetically controlled growing rods to manage early onset scoliosis. Int J Spine Surg. 2021;15:368–75.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Thompson GH, Akbarnia BA, Campbell RM Jr. Growing rod techniques in early-onset scoliosis. J Pediatr Orthop. 2007;27:354–61.

    Article  PubMed  Google Scholar 

  17. Abdelaal A, Munigangaiah S, Trivedi J, et al. Magnetically controlled growing rods in the treatment of early onset scoliosis: a single centre experience of 44 patients with mean follow-up of 4.1 years. Bone Jt Open. 2020;1:405–14.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cheung JPY, Cheung KM. Current status of the magnetically controlled growing rod in treatment of early-onset scoliosis: what we know after a decade of experience. J Orthop Surg (Hong Kong). 2019;27:2309499019886945.

    Article  Google Scholar 

  19. Kwan KYH, Alanay A, Yazici M, et al. Unplanned reoperations in magnetically controlled growing rod surgery for early onset scoliosis with a minimum of two-year follow-up. Spine (Phila Pa 1976). 2017;42:E1410–4.

    Article  Google Scholar 

  20. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Howick J CI, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, Moschetti I, Phillips B, Thornton H, Goddard O, Hodgkinson M. 2011. The 2011 oxford levels of evidence. Oxford centre for evidence-based medicine Available at http://www.cebm.net/index.aspx?o=5653.

  22. Coleman BD, Khan KM, Maffulli N, et al. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian institute of sport tendon study group. Scand J Med Sci Sports. 2000;10:2–11.

    Article  CAS  PubMed  Google Scholar 

  23. Akbarnia BA, Cheung K, Noordeen H, et al. Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients with early-onset scoliosis. Spine (Phila Pa 1976). 2013;38:665–70.

    Article  Google Scholar 

  24. Burstein J, Rupprecht M, Kunkel P, et al. A minimum of 2 years results of magnetically controlled growing rods for early onset scoliosis. Spine J. 2017;6:1000401.

    Google Scholar 

  25. Cheung KM, Cheung JP, Samartzis D, et al. Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series. Lancet. 2012;379:1967–74.

    Article  PubMed  Google Scholar 

  26. Cheung JPY, Yiu K, Kwan K, et al. Mean 6-year follow-up of magnetically controlled growing rod patients with early onset scoliosis: a glimpse of what happens to graduates. Neurosurgery. 2019;84:1112–23.

    Article  PubMed  Google Scholar 

  27. Cheung JPY, Cheung PWH, Cheung KMC. The effect of magnetically controlled growing rods on three-dimensional changes in deformity correction. Spine Deform. 2020;8:537–46.

    Article  PubMed  Google Scholar 

  28. Dahl B, Dragsted C, Ohrt-Nissen S, et al. Use of a distraction-to-stall lengthening procedure in magnetically controlled growing rods: a single-center cohort study. J Orthop Surg (Hong Kong). 2018;26:2309499018779833.

    Article  Google Scholar 

  29. Dannawi Z, Altaf F, Harshavardhana NS, et al. Early results of a remotely-operated magnetic growth rod in early-onset scoliosis. Bone Jt J. 2013;95-B:75–80.

    Article  CAS  Google Scholar 

  30. Di Silvestre M, Zanirato A, Greggi T, et al. Severe adolescent idiopathic scoliosis: posterior staged correction using a temporary magnetically-controlled growing rod. Eur Spine J. 2020;29:2046–53.

    Article  PubMed  Google Scholar 

  31. Doany ME, Olgun ZD, Kinikli GI, et al. Health-related quality of life in early-onset scoliosis patients treated surgically: EOSQ scores in traditional growing rod versus magnetically controlled growing rods. Spine (Phila Pa 1976). 2018;43:148–53.

    Article  Google Scholar 

  32. Heydar AM, Sirazi S, Okay E, et al. Short segment spinal instrumentation in early-onset scoliosis patients treated with magnetically controlled growing rods: surgical technique and mid—short-term outcomes. Spine (Phila Pa 1976). 2017;42:1888–94.

    Article  Google Scholar 

  33. Hickey BA, Towriss C, Baxter G, et al. Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J. 2014;23(Suppl 1):S61-65.

    Article  PubMed  Google Scholar 

  34. Keskinen H, Helenius I, Nnadi C, et al. Preliminary comparison of primary and conversion surgery with magnetically controlled growing rods in children with early onset scoliosis. Eur Spine J. 2016;25:3294–300.

    Article  PubMed  Google Scholar 

  35. La Rosa G, Oggiano L, Ruzzini L. Magnetically controlled growing rods for the management of early-onset scoliosis: a preliminary report. J Pediatr Orthop. 2017;37:79–85.

    Article  PubMed  Google Scholar 

  36. Lebon J, Batailler C, Wargny M, et al. Magnetically controlled growing rod in early onset scoliosis: a 30-case multicenter study. Eur Spine J. 2017;26:1567–76.

    Article  PubMed  Google Scholar 

  37. Pepke W, Almansour H, Diebo BG, et al. Correction of the spine with magnetically controlled growing rods in early onset scoliosis: a pre-to-post analysis of 21 patients with 1year follow-up. Orthopade. 2020;49:1086–97.

    Article  CAS  PubMed  Google Scholar 

  38. Ridderbusch K, Rupprecht M, Kunkel P, et al. Preliminary results of magnetically controlled growing rods for early onset scoliosis. J Pediatr Orthop. 2017;37:e575–80.

    Article  PubMed  Google Scholar 

  39. Studer D, Heidt C, Buchler P, et al. Treatment of early onset spinal deformities with magnetically controlled growing rods: a single centre experience of 30 cases. J Child Orthop. 2019;13:196–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Teoh KH, Winson DM, James SH, et al. Magnetic controlled growing rods for early-onset scoliosis: a 4-year follow-up. Spine J. 2016;16:S34-39.

    Article  PubMed  Google Scholar 

  41. Thompson W, Thakar C, Rolton DJ, et al. The use of magnetically-controlled growing rods to treat children with early-onset scoliosis: early radiological results in 19 children. Bone Jt J. 2016;98-B:1240–7.

    Article  CAS  Google Scholar 

  42. Yoon WW, Sedra F, Shah S, et al. Improvement of pulmonary function in children with early-onset scoliosis using magnetic growth rods. Spine (Phila Pa 1976). 2014;39:1196–202.

    Article  Google Scholar 

  43. Akbarnia BA, Mundis GM Jr, Salari P, et al. Innovation in growing rod technique: a study of safety and efficacy of a magnetically controlled growing rod in a porcine model. Spine (Phila Pa 1976). 2012;37:1109–14.

    Article  Google Scholar 

  44. Choi E, Yaszay B, Mundis G, et al. Implant complications after magnetically controlled growing rods for early onset scoliosis: a multicenter retrospective review. J Pediatr Orthop. 2017;37:e588–92.

    Article  PubMed  Google Scholar 

  45. Committee SG, Weiss HR, Negrini S, et al. Indications for conservative management of scoliosis (guidelines). Scoliosis. 2006;1:5.

    Article  Google Scholar 

  46. Lechner R, Putzer D, Dammerer D, et al. Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis. Int Orthop. 2017;41:957–62.

    Article  PubMed  Google Scholar 

  47. Tanure MC, Pinheiro AP, Oliveira AS. Reliability assessment of Cobb angle measurements using manual and digital methods. Spine J. 2010;10:769–74.

    Article  PubMed  Google Scholar 

  48. Vrtovec T, Pernus F, Likar B. A review of methods for quantitative evaluation of spinal curvature. Eur Spine J. 2009;18:593–607.

    Article  PubMed  Google Scholar 

  49. Bettany-Saltikov J, Turnbull D, Ng SY, et al. Management of spinal deformities and evidence of treatment effectiveness. Open Orthop J. 2017;11:1521–47.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Tang N, Zhao H, Shen JX, et al. Magnetically controlled growing rod for early-onset scoliosis: systematic review and meta-analysis. World Neurosurg. 2019;125:e593–601.

    Article  PubMed  Google Scholar 

  51. Bess S, Akbarnia BA, Thompson GH, et al. Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Jt Surg Am. 2010;92:2533–43.

    Article  Google Scholar 

  52. Negrini S, Donzelli S, Aulisa AG, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoli Spin Disord. 2018;13:3.

    Google Scholar 

  53. Zhang J, Lou E, Le LH, et al. Automatic Cobb measurement of scoliosis based on fuzzy hough transform with vertebral shape prior. J Digit Imaging. 2009;22:463–72.

    Article  PubMed  Google Scholar 

  54. Allen S, Parent E, Khorasani M, et al. Validity and reliability of active shape models for the estimation of cobb angle in patients with adolescent idiopathic scoliosis. J Digit Imaging. 2008;21:208–18.

    Article  PubMed  Google Scholar 

  55. Glowka P, Politarczyk W, Janusz P, et al. The method for measurement of the three-dimensional scoliosis angle from standard radiographs. BMC Musculoskelet Disord. 2020;21:475.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Illes TS, Lavaste F, Dubousset JF. The third dimension of scoliosis: the forgotten axial plane. Orthop Traumatol Surg Res. 2019;105:351–9.

    Article  PubMed  Google Scholar 

  57. Lam GC, Hill DL, Le LH, et al. Vertebral rotation measurement: a summary and comparison of common radiographic and CT methods. Scoliosis. 2008;3:16.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Hawes MC, O’Brien JP. The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment. Scoliosis. 2006;1:3.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Easwar TR, Hong JY, Yang JH, et al. Does lateral vertebral translation correspond to Cobb angle and relate in the same way to axial vertebral rotation and rib hump index? A radiographic analysis on idiopathic scoliosis. Eur Spine J. 2011;20:1095–105.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Samuelsson L, Noren L. Trunk rotation in scoliosis. The influence of curve type and direction in 150 children. Acta Orthop Scand. 1997;68:273–6.

    Article  CAS  PubMed  Google Scholar 

  61. Thakar C, Kieser DC, Mardare M, et al. Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis. Eur Spine J. 2018;27:2062–71.

    Article  PubMed  Google Scholar 

  62. Luhmann SJ, McAughey EM, Ackerman SJ, et al. Cost analysis of a growth guidance system compared with traditional and magnetically controlled growing rods for early-onset scoliosis: a US-based integrated health care delivery system perspective. Clinicoecon Outcomes Res. 2018;10:179–87.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Su AW, Milbrandt TA, Larson AN. Magnetic expansion control system achieves cost savings compared to traditional growth rods: an economic analysis model. Spine (Phila Pa 1976). 2015;40:1851–6.

    Article  Google Scholar 

  64. Rolton D, Richards J, Nnadi C. Magnetic controlled growth rods versus conventional growing rod systems in the treatment of early onset scoliosis: a cost comparison. Eur Spine J. 2015;24:1457–61.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

None

Funding

Open Access funding enabled and organized by Projekt DEAL. No external source of funding was used.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Trauma, and Reconstructive Surgery, University Clinic Aachen, RWTH Aachen University Hospital, Pauwelsstraße 31, 52074, Aachen, Germany

    Filippo Migliorini & Alice Baroncini

  2. Master Program of Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany

    Wai On Chiu

  3. Department of Neurosurgery, University Hospital of Salerno, Fisciano, Italy

    Raffaele Scrofani & Giorgio Iaconetta

  4. MBBS School of Medicine, Jinan University, Guangzhou, China

    Wai Kwong Chiu

  5. Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, Italy

    Nicola Maffulli

  6. School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, ST4 7QB, Stoke-on-Trent, England, UK

    Nicola Maffulli

  7. Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, E1 4DG, London, England, UK

    Nicola Maffulli

Authors
  1. Filippo Migliorini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wai On Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raffaele Scrofani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wai Kwong Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alice Baroncini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giorgio Iaconetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nicola Maffulli
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

FM contributed to conception and design of the study, writing, statistical analysis, interpretation of data, final approval; WOC contributed to literature search, data extraction, methodological quality assessment, final approval; WKC contributed to literature search, data extraction, methodological quality assessment, final approval; NM contributed to revision and final approval; SC contributed to writing, final approval; GI and AB contributed to supervision, final approval. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Filippo Migliorini.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Professor Maffulli is Editor in Chief of the Journal of Orthopaedic Surgery and Research.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Migliorini, F., Chiu, W.O., Scrofani, R. et al. Magnetically controlled growing rods in the management of early onset scoliosis: a systematic review. J Orthop Surg Res 17, 309 (2022). https://doi.org/10.1186/s13018-022-03200-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13018-022-03200-7

Keywords

Journal of Orthopaedic Surgery and Research

ISSN: 1749-799X