Department of Orthopaedics, Trauma, and Reconstructive Surgery, University Clinic Aachen, RWTH Aachen University Hospital, Pauwelsstraße 31, 52074, Aachen, Germany.
Master Program of Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
J Orthop Surg Res. 2022 Jun 11;17(1):309. doi: 10.1186/s13018-022-03200-7.
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.
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.
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/m. 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.
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.
早发性脊柱侧凸（EOS）发生在 10 岁以下的患者中。磁控生长棒（MCGR）作为一种门诊牵引系统，用于 EOS，可避免多次手术。本系统评价研究了 MCGR 在 EOS 中的疗效和可行性。
本系统评价按照 PRISMA 指南进行。2022 年 5 月检索 PubMed、Google scholar、Embase 和 Scopus，检索到研究 MCGR 治疗早发性脊柱侧凸作用的所有临床试验。只有报告术前 Cobb 角大于 40°的 10 岁以下患者数据的研究才符合入选标准。在基线和最后一次随访时提取以下数据：平均后凸角、总平均 Cobb 角、T1-S1 长度平均值。还收集了并发症的数据。
本研究纳入了 23 项临床研究（504 例患者）的数据。56%（282/504）为女性。平均随访时间为 28.9±16.0 个月。患者平均年龄为 8.7±1.9 岁。平均 BMI 为 17.7±7.6 kg/m。平均后凸角在最后一次随访时减小（P=0.04），总平均 Cobb 角也减小（P<0.0001），而总 T1-S1 长度增加（P=0.0002）。与脊柱对线失败、伤口愈合不良、肺部并发症、进行性躯干僵硬、持续性背痛和骨折相比，植入物相关并发症更为常见。
EOS 的治疗仍然具有挑战性。目前的证据表明，MCGR 可能有效分散脊柱并矫正 EOS 中的曲线。
