早发性脊柱侧弯磁控生长棒（MCGRs）的内部机制故障：植入物取出分析研究的系统评价
Internal mechanism failure of magnetic controlled growing rods (MCGRs) for early-onset scoliosis: a systematic review of implant retrieval analysis studies.
作者信息
Mohammed Riaz, Shah Pranav, Massraf Bnar, Ahuja Sashin
机构信息
University Hospital of Wales NHS Trust, Cardiff, UK.
Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.
出版信息
Spine Deform. 2025 Aug 27. doi: 10.1007/s43390-025-01171-3.
PURPOSE
Magnetic controlled growing rods (MCGRs) are used to treat early-onset scoliosis when nonsurgical options fail, controlling curve progression and allowing for continued spinal growth. Recent reports of unplanned reoperations and mechanical failure of MCGRs have led to further research. This is a systematic review on the retrieval analysis of explanted MCGR rods. Understanding the failure mechanisms will shed light on the survivorship and complications associated with the implant.
METHODS
A Medline and EMBASE database search was performed, looking at all variations in the terms "magnetic controlled growing rods" and the terms "retrieval/explant/metallosis" All published retrieval analysis studies of MCGR were included, and all clinical outcome studies, biomechanical testing studies, review articles, and case reports were excluded. Data were collected regarding the source, year, and aim of the study; number of patients and rods analysed; duration of implantation; and main findings and conclusions.
RESULTS
Nine studies (454 rods) reported metallosis due to O-ring damage (67%), internal mechanism failure of locking pins (45%) and rod fracture (7%) in all MCGR generations. Actuator locking pin fractures reported in 174 rods (38.3%) continue to persist despite newer implant iterations. The pin fracture rates decreased from 52% in MAGEC 1.3 to 15% in MAGEC X.
CONCLUSIONS
MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC.
LEVELS OF EVIDENCE
MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC. This systematic review provides Level III evidence on failure mechanisms in MCGR, as the results were obtained from Level III studies. The levels of evidence for all relevant references can be found in the reference section.
LEVEL II
[1-4].
LEVEL III
[5-34].
LEVEL IV
[35-44].
LEVEL V
[45-50].
目的
当非手术治疗方法无效时，磁控生长棒（MCGRs）用于治疗早发性脊柱侧弯，控制侧弯进展并允许脊柱持续生长。最近关于MCGRs意外再次手术和机械故障的报道引发了进一步研究。这是一项关于取出的MCGR棒的检索分析的系统评价。了解失效机制将有助于揭示与该植入物相关的存活率和并发症情况。
方法
对Medline和EMBASE数据库进行检索，查找“磁控生长棒”以及“取出/植入/金属沉着病”等术语的所有变体。纳入所有已发表的MCGR检索分析研究，排除所有临床结局研究、生物力学测试研究、综述文章和病例报告。收集有关研究来源、年份和目的；分析的患者和棒的数量；植入持续时间；以及主要发现和结论的数据。
结果
九项研究（45根棒）报告了所有代MCGR中因O形环损坏导致的金属沉着病（67%）、锁定销内部机制故障（45%）和棒断裂（7%）。尽管有更新的植入物迭代，但在174根棒（38.3%）中报告的致动器锁定销骨折仍持续存在。销骨折率从MAGEC 1.3中的52%降至MAGEC X中的15%。
结论
MCGR失效是多因素的，由于对患者的长期影响未知，金属沉着病是一个重大问题。早期识别并原位翻修现有棒至关重要，同时要继续努力减少MAGEC未来迭代中的机械故障。
证据级别
MCGR失效是多因素的，由于对患者的长期影响未知，金属沉着病是一个重大问题。早期识别并原位翻修现有棒至关重要，同时要继续努力减少MAGEC未来迭代中的机械故障。本系统评价提供了关于MCGR失效机制的III级证据，因为结果来自III级研究。所有相关参考文献的证据级别可在参考文献部分找到。
II级：[1 - 4]。
III级：[5 - 34]。
IV级：[35 - 44]。
V级：[45 - 50]。
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