Background: Metal ions released from spinal instruments can cause localized debris and distribute systemically to settle on distant organs. Children with early-onset deformities live with metallic implants for a substantial amount of time. No research focused on metal distribution in growth-friendly instrumentations. The aim of this study was to compare age-matched growing rod (GR) and magnetically controlled growing rod (MCGR) groups to noninstrumented controls.
Methods: The study was designed as a multicenter, prospective, cross-sectional case series. GR and MCGR applications of three institutions were included. A total of 52 children were enrolled. Blood samples were collected between December 2014 and February 2015. Biochemical serum analyses were performed to trace and quantify titanium, vanadium, aluminum, and boron. The GR group included 15 children. Mean age was 10.7 (range 6-15). MCGR group included 22 children. Mean age was 8.5 (range 2-13). Fifteen age-matched nonoperated children formed the control group. The mean age was 10.4 (range 5-15). One-way analysis of variance, Kruskal-Wallis, and Mann-Whitney U tests were used for comparisons.
Results: The mean serum titanium level in control, GR, and MCGR groups were 2.8 ± 1.4, 7.3 ± 4.3, and 10.2 ± 6.8 μg/L, respectively. GR and MCGR group titanium levels were higher than controls' (p = .008 and p < .001). The mean serum vanadium level in control, GR, and MCGR groups were 0.2 ± 0.0, 0.2 ± 0.0, and 0.5 ± 0.5 μg/L, respectively. MCGR group vanadium level was higher than control (p < .001) and GR groups (p = .004). Mean serum levels in control, GR, and MCGR groups were, respectively, 5.4 ± 4.1, 8.1 ± 7.4, and 7.8 ± 5.1 μg/L for aluminum and 86.7 ± 2.7, 86.9 ± 2.5, and 85.0 ± 6.6 μg/L for boron. The distribution of aluminum and boron were similar across groups (p = .675 and p = .396).
Conclusions: Both GR and MCGR applications significantly release titanium and possibly aluminum. MCGR further releases vanadium. MCGR possibly releases more titanium than traditional GR. Time-dependent alterations of serum ion levels, structural properties of the MCGR device, and exposure caused by magnetic distraction processes warrant investigation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jspd.2017.06.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Supine Traction vs Fulcrum Bending Radiographs in Preoperative Imaging of Scoliosis Patients Treated With Magnetically Controlled Growing Rods (MCGR) - which Technique is Better to Predict Surgical Correction of the Main Curve?
Global Spine J
January 2025
Department of Orthopaedics, University Clinic Heidelberg, Heidelberg, Germany.
Study Design: Retrospective Cohort Study.
Objectives: Flexibility radiographs such as traction or bending radiographs are essential in preoperative imaging to assess for curve flexibility and to estimate the amount of operative correction in order to determine the type and length of instrumentation in growth-accompanying scoliosis treatment. Both traction and bending radiographs are controversially discussed in the literature.
Outcomes of Growth-Friendly Surgical Treatment of Early Onset Scoliosis in Children With Prune Belly Syndrome: A Preliminary Report.
J Pediatr Orthop
December 2024
Department of Orthopaedic Surgery, C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI.
Background: Prune belly syndrome (PBS) is a rare condition characterized by absence of abdominal musculature, cryptorchidism, and obstructive uropathy. The most common orthopaedic problem is scoliosis, yet no reports on growth-friendly surgical treatment of early-onset scoliosis (EOS) exist. Our purpose was to evaluate outcomes of distraction-based implants in children with PBS.
View Article and Find Full Text PDFLIV selection in 'tweener' patients treated with magnetically controlled growing rods vs. posterior spinal fusion.
Spine Deform
December 2024
Children's Hospital Los Angeles, Jackie and Gene Autry Orthopedic Center, Los Angeles, CA, USA.
Purpose: The purpose of this study was to compare the LIV selection in 'tweener' patients treated with MCGR or PSF.
Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8-11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed.
Magnetically controlled growing rods increase 3D true spine length in idiopathic early onset scoliosis patients: results from a multicenter study.
Spine Deform
November 2024
Division of Orthopedic Surgery, IWK Health Centre, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K6R8, Canada.
Purpose: To determine, at 2 year follow-up, 3D spine growth for idiopathic early onset scoliosis (iEOS) patients treated with magnetically controlled growing rods (MCGR).
Methods: From an international EOS registry, patients with iEOS treated with MCGR were identified. Scoliosis, kyphosis, traditional coronal height, and 3D true spine length (3D-TSL) were measured pre-index surgery, post-index, and at 2 year follow-up.
Actuator Size of Magnetic Controlled Growth Rod (7 cm vs. 9 cm) is Not Predictive of Unplanned Return to the Operating Room: A Retrospective Multicenter Comparative Cohort Study.
J Pediatr Orthop
October 2024
Children's Hospital Colorado, Aurora, CO United States.
Background: Magnetic controlled growth rods (MCGR) are the most common type of implant used for operative treatment of patients with early-onset scoliosis (EOS). Rods can have either a 7-cm actuator, allowing 2.8 cm of potential expansion, or a 9-cm actuator which allows 4.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!