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Rod Fracture in Magnetically Controlled Growing Spine Rods

Tognini, Martina; Hothi, Harry; Bergiers, Sean; Broomfield, Edel; Tucker, Stewart; Henckel, Johann; Hart, Alister; (2023) Rod Fracture in Magnetically Controlled Growing Spine Rods. Journal of Pediatric Orthopaedics , 43 (4) pp. 211-217. 10.1097/BPO.0000000000002361. Green open access

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Abstract

Background: The mechanisms of fracture in magnetically controlled growing rods (MCGRs) and the risk factors associated with this are poorly understood. This retrospective analysis of explanted MCGRs aimed to add understanding to this subject. / Methods: From our cohort of over 120 retrieved MCGRs, we identified 7 rods that had fractured; all were single-rod constructs, retrieved from 6 patients. These were examined and compared with 15 intact single-rod constructs. Retrieval and fractographic analyses were used to determine the failure mode at the fracture site and the implant's functionality. Cobb angle, degree of rod contouring, and the distance between anchoring points were computed on anteroposterior and lateral radiographs. / Results: 5/7 versus 3/15 rods had been inserted after the removal of a previously inserted rod, in the fractured versus control groups. All fractured rods failed due to bending fatigue. Fractured rods had greater rod contouring angles in the frontal plane (P = 0.0407) and lateral plane (P = 0.0306), and greater distances between anchoring points in both anteroposterior and lateral planes (P = 0.0061 and P = 0.0074, respectively). / Conclusions: We found all failed due to a fatigue fracture and were virtually all single rod configurations. Fracture initiation points corresponded with mechanical indentation marks induced by the intraoperative rod contouring tool. Fractured rods had undergone greater rod contouring and had greater distances between anchoring points, suggesting that it is preferable to implant double rod constructs in patients with sufficient spinal maturity to avoid this complication.

Type: Article
Title: Rod Fracture in Magnetically Controlled Growing Spine Rods
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/BPO.0000000000002361
Publisher version: https://doi.org/10.1097/BPO.0000000000002361
Language: English
Additional information: Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: MCGR, MAGEC rods, early-onset scoliosis, fracture, growing rods
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10167757
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