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Innovative technique with magnetic growing rod for treatment of severe scoliosis.

Introduction: Severe scoliosis correction has always represented a challenging surgical procedure with high risk of neurological complications. Objective: To evaluate the efficacy, safety and limits of a new surgical technique for the management of severe scoliosis. It consists in applying a temporary magnetic growing rod to the curve’s concavity, that can be used as a gradual distraction and staged correction before the definitive surgery. Methods: Twenty patients with severe scoliosis treated from 2014 to 2018 were retrospectively reviewed. They underwent implant of a temporary magnetic growing rod, followed by definitive fusion after a 3 week period. The mean age of the patients was 15.5 yrs (12-26), 15 females and 5 males with severe scoliosis, among which 14 were idiopathic, 3 syndromic (1 sd. Noonan, 1 sd. Marfan and 1 NF1), 1 thoracogenic, 2 were the consequences of tumors (intramedullary ependymoma and neuroblastoma). In the series, 4 cases presented with spinal cord malformations before undergoing surgery. Patients had a pre-operative Cobb Angle of 114.3° on average (range 91 ° -137 °) and 71.8 ° of kyphosis (range 15 ° -126 °). During the three-week period between surgeries, we performed a daily lengthening of the magnetic rod (about 2-3mm every day). Results and Discussion: Thoracic main curve improved from a mean pre-op 114.3 ° Cobb (range 91°-137°) to a mean post-op 77.2° Cobb after the implant of a temporary magnetic growing rod (range 48° - 103°). Mean correction after final surgery was 56.2° (range 31° -82°). We also evaluated the lengthening of the magnetic rod (14,4mm on average) and correlated it to BMI, age, gender, Cobb Angle and kyphosis angle. BMI had