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Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years

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Abstract

Purpose

The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.

Methods

This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.

Results

A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1–9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3–68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5–17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up.

After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.

Conclusion

Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.

Level of evidence

Level 4.

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Achnowledgements

We would like to thank all the surgeons who enabled us to compile this record of patients: Pr Pierre Journeau, Pr Brice Ilharreborde, Pr Yan Lefevre, Pr Richard Gouron, Dr Jean-Damien Metaizeau, Dr Vincent Cunin, Pr Thierry Haumont, Dr Elie Choufani, Pr Sebastien Pesenti.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Jeanne de Flandre Hospital, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France

    Nicolas Mainard, Eric Nectoux, Damien Fron & Federico Canavese

  2. Orthopaedic and Reconstructive Surgery in Children, Hôpital Armand-Trousseau - AP-HP, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France

    Elie Saghbini & Raphael Vialle

  3. Paediatrics - Orthopaedic, Traumatological and Plastic Surgery, Children’s Hospital, 330, Avenue de Grande Bretagne - TSA, 70034 - 31059, Toulouse, France

    Tristan Langlais, Jerome Sales de Gauzy & Federico Canavese

  4. Faculty of Medicine, University of Lille Henri Warembourg, 2 Av Eugène Avinée, 59120, Loos, France

    Eric Nectoux

  5. Department of Pediatric Surgery, Jeanne de Flandre Hospital, Avenue Eugène Avinée, 59037, Lille Cedex, France

    Nicolas Mainard, Eric Nectoux & Damien Fron

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  1. Nicolas Mainard
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Contributions

NM contributed to Writing—original draft preparation. Writing—review and editing. Investigation. ES contributed to Writing—review and editing, statistical analysis. TL contributed to Writing—review and editing, Investigation. RV contributed to Writing—review and editing, Supervision, Validation. EN contributed to Writing—review and editing, Investigation, Validation. JSdeG contributed to Writing—review and editing, Investigation. DF contributed Writing—review and editing, Investigation, Supervision, Project administration, Validation, Conceptualization. FC contributed to Writing—review and editing, Investigation, Supervision, Project administration, Validation.

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Correspondence to Nicolas Mainard.

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Mainard, N., Saghbini, E., Langlais, T. et al. Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years. Eur Spine J 32, 3118–3132 (2023). https://doi.org/10.1007/s00586-023-07834-x

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