Children’s National Health System is among the first in the country to offer a spinal growing rod for children with scoliosis. The MAGEC™ (MAGnetic Expansion Control) Spinal Growing Rod is a non-invasive treatment for children with early onset scoliosis.
After the initial procedure to implant the rod, doctors use an external remote control outside of the body to lengthen the magnetically controlled rod as a child grows. At Children’s National, we perform follow-up care in the office. It’s non-invasive, making the adjustments easier for patients during their course of treatment, because they need fewer surgeries.
Growing rods have become effective tools for children whose spinal curvature is too significant to control with racing or casting. The rods—which are surgically attached to the spine above and below the curve and then lengthened during follow-up surgical procedures—allow the spine to continue growing while managing the curve until the child is old enough for spinal fusion.
The problem: Children must bear the physical and psychological burden of undergoing lengthening procedures every six to 12 months until they are skeletally mature enough to have spinal fusion—typically around age 10 for girls and age 12 or 13 for boys.
“Traditional growing rods work, but they require multiple surgeries that increase complication rates and time spent in the hospital,” says Matthew Oetgen, MD, Interim Division Chief of Orthopaedic Surgery and Sports Medicine and Director of Orthopaedic Research at Children’s National. “We treat many children each year who have or are candidates for growing rods, so it’s important for us to embrace new technology to make the lengthening process easier and less painful for children while decreasing morbidity.” Dr. Oetgen and his colleagues believe they’ve found just such a technology in the MAGEC Spinal Bracing and Distraction System by Ellipse Technologies, Inc.
MAGEC rods are similar to traditional growing rods in that an orthopaedic surgeon attaches them to the spine through an incision in the patient’s back, a procedure requiring several days of inpatient recovery. Unlike with conventional growing rods, however, the surgeon lengthens the MAGEC rods in minutes during subsequent outpatient visits every three or four months using the MAGEC External Remote Controller (ERC)—no surgery required. The ERC communicates with the implants via a magnetic connection.
Candidates for MAGEC are children younger than age 10 with severe progressive scoliosis.
“Bracing won’t assist a 2- to 7-year-old child with curvature in excess of 50 or 60 degrees,” says Jeffrey Hanway, MD, orthopaedic surgeon and sports medicine physician, Vice Chair for Clinical Affairs, Division of Orthopaedic Surgery and Sports Medicine, at Children’s National, and Chief Surgical Officer at Pediatric Specialists of Virginia. “If a child is a candidate for growing rods, I’m not aware of any contraindications for MAGEC. I envision this system becoming the benchmark for growing rods.”
Like traditional growing rods, MAGEC is a means, not an end—the system provides a bridge treatment spanning the years between the initial lengthening surgery and spinal fusion.
Benefits of the Growing Rod
Growing rods can correct or control severe curvatures of the spine. Traditional treatment uses rods that require surgeries about twice a year to manually lengthen the rod while a child is still growing. With the growing rod, the rod is magnetically controlled with the external remote control, so our orthopaedic surgeons can lengthen the rod in a non-invasive way during a child’s course of treatment.
Our orthopaedic surgeons lengthen the rod every three to four months in the office using the electronic remote control. The procedure takes only a few minutes. We monitor the scoliosis and treatment progress with radiographs.
The benefits include fewer surgeries, less time for the procedure, and less pain.
Who May Be Eligible for the Growing Rod?
The MAGEC rod is approved for children with scoliosis greater than 50 degrees in magnitude and under 10 years of age.
On the Forefront of Change
Following MAGEC’s approval by the U.S. Food and Drug Administration in February 2014, surgeons at Children’s National performed two of the first 15 MAGEC implantations in the country, and the first in the greater Washington, DC, area. Dr. Hanway and Shannon Kelly, MD, orthopaedic surgeon, each performed a case at Children’s National on May 6.
“My patient was a somewhat atypical candidate because he was 10 years old, but he was a young 10, skeletally speaking,” Dr. Hanway says. “A brace adequately managed his curve for a while, but by this spring, a slow increase in the bend had pushed it past 50 degrees. When MAGEC became available, I said, ‘This is ideal for him.’ If he can continue with MAGEC for two or three years, he’ll be in a good place in terms of readiness for spinal fusion.”
For more information, call 202-476-2112.