Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
School of Mechanical and Systems Engineering, Newcastle University, Newcastle upon Tyne, UK.
Eur Spine J. 2021 Jul;30(7):1905-1911. doi: 10.1007/s00586-021-06750-2. Epub 2021 Feb 5.
Determine the incidence of metallosis around MAGEC rods.
A multicentre explant database was searched to identify cases with complete intraoperative findings at rod removal. Surgeons removing rods detailed the presence or absence of tissue metallosis associated with rods. More recently surgeons measured the 'length' of tissue metallosis. Prior to rod disassembly, the majority underwent testing with an external remote controller (ERC). The impact of clinical and explant variables on metallosis was assessed.
Sixty-six cases were identified. Mean age at insertion was 8.1 ± 2.3 years with mean duration of implantation 37.6 ± 15.1 months. Tissue metallosis was noted at revision surgery in 52/66 cases (79%). Metallosis was noted more commonly when rods were removed during fusion surgery than rod removal/exchange (97% vs. 58% (p = < 0.01)). The mass at insertion was greater in cases with metallosis (25.9 ± 7.8 kg vs. 21.1 ± 6.2 kg, p = 0.04). Length of tissue metallosis was reported for 45 rods, median 9 cm (range 1-25). Metallosis was noted in 43/59 (73%) rods that produced no force and 22/30 (73%) rods that produced some force on ERC activation (p = 0.96). Wear debris was found within the actuator in all rods, and all but 3 rods had damaged O-rings.
MAGEC rods are associated with tissue metallosis in the majority of cases. It is seen with functional rods as well as failed rods and appears related to wear debris within the actuator and high rates of O-ring failure. Until the implications of metal debris in children are known, we urge caution with the use of this implant.
确定 MAGEC 棒周围金属腐蚀的发生率。
多中心取出物数据库用于识别在棒取出时具有完整术中发现的病例。移除棒的外科医生详细描述了与棒相关的组织金属腐蚀的存在或不存在。最近，外科医生测量了“组织金属腐蚀的长度”。在拆卸棒之前，大多数人都使用外部遥控器 (ERC) 进行了测试。评估了临床和取出物变量对金属腐蚀的影响。
确定了 66 例病例。插入时的平均年龄为 8.1 ± 2.3 岁，植入的平均时间为 37.6 ± 15.1 个月。在修复手术中，52/66 例（79%）发现组织金属腐蚀。在融合手术中取出棒时比取出/更换棒时更常见金属腐蚀（97%比 58%（p<0.01））。有金属腐蚀的病例的插入处质量更大（25.9 ± 7.8 千克比 21.1 ± 6.2 千克，p=0.04）。为 45 根棒报告了组织金属腐蚀的长度，中位数为 9 厘米（范围 1-25）。在未产生力的 43/59 根（73%）棒和产生一些力的 22/30 根（73%）棒上都发现了金属腐蚀（p=0.96）。在所有棒的执行器内都发现了磨损碎片，除了 3 根棒外，所有棒的 O 形圈都损坏了。
在大多数情况下，MAGEC 棒与组织金属腐蚀有关。它可见于功能性棒和失效棒，似乎与执行器内的磨损碎片和 O 形圈的高故障率有关。在了解儿童金属碎片的影响之前，我们敦促谨慎使用这种植入物。
