Tognini, Martina;
(2023)
Analysis of Magnetically Controlled Growing Rods.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Early Onset Scoliosis (EOS) is defined as a curvature of the spine of more than 10° with onset before 10 years of age. Magnetically Controlled Growing Rods (MCGRs) are used to surgically treat these patients with the aim of correcting the curvature and bracing the spine while allowing for growth of the child. Due to concerns related to high failure rates and potential metal release from these constructs, MCGRs were withdrawn from the UK market. In the European Union, they were temporarily withdrawn and subsequently reinstated. Despite ongoing debates concerning the safety and efficacy of these constructs, a significant proportion of surgeons would return to implanting them if allowed by the regulatory agencies, due to its clinical advantages. The overarching aims of this thesis were to study the mechanisms of failure of MCGRs, identify surgeon, implant and patient related risk factors for failure and investigate how these patients could be better clinically monitored. This was achieved by developing a multicentre spinal surgeon network which enabled the collection of 218 MCGRs that were retrieved from 125 patients following removal surgery. The performance of these rods was investigated through their physical analysis and examination of clinical and medical imaging data. The work of this thesis has (1) identified the key mechanisms of failure of these rods; (2) identified the configurations in which their clinical performance may be optimised; (3) demonstrated how advanced medical imaging may be used to better assess clinical outcomes in these patients and (4) demonstrated the necessity for blood metal ion testing to be developed for this patient group. A post-market clinical follow up study (PMCF) is now being adopted by the Medicines and Healthcare products Regulatory Agency (MHRA) to build on this work with the aim of investigating the utility of this testing as a biomarker for implant function.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Analysis of Magnetically Controlled Growing Rods |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184540 |
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