Magnetically controlled growing rods in early onset scoliosis

Early onset scoliosis (EOS) remains one of the most challenging aspects of pediatric spine deformity care. The management is often complex, and options are non-operative care with casting or bracing and operative interventions. Surgical treatment includes distraction-based, compression-based and growth-guided techniques. The decision making should focus on preservation of growth, control of curve progression, minimizing complications, but most importantly improvement of the quality of life. Distraction-based techniques are the most commonly used growth-friendly surgery and the magnetically controlled growing rods (MCGR) technique is being utilized increasingly more in the USA over the past 10 years. The MCGR technique was cleared by the Food and Drug Administration (FDA) and available in the USA since 2014. It is indicated for the treatment of progressive EOS in immature patients and those at risk for thoracic insufficiency syndrome (TIS) with the goal of reducing the number of planned open surgical procedures for lengthening and minimizing the complications of more conventional techniques, such as traditional growing rods (TGR). The advent of MCGR has been a game changer for patients with EOS where the distractions are non-invasive and can be performed in outpatient clinics. Long-term follow-up is essential in understanding the outcome of any new treatment method especially in a very young and growing child. Multicenter registries with prospective data collection of pediatric spine deformity patients is imperative for understanding the outcomes of different methods of treatment, minimizing the complications and improving the quality of life of these children.