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Metallosis is commonly associated with magnetically controlled growing rods; results from an independent multicentre explant database

Lookup NU author(s): Dr Simon Smith, Andrew Bowey, Professor Tom Joyce

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Abstract

© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.Purpose: Determine the incidence of metallosis around MAGEC rods. Methods: A multicentre explant database was searched to identify cases with complete intraoperative findings at rod removal. Surgeons removing rods detailed the presence or absence of tissue metallosis associated with rods. More recently surgeons measured the ‘length’ of tissue metallosis. Prior to rod disassembly, the majority underwent testing with an external remote controller (ERC). The impact of clinical and explant variables on metallosis was assessed. Results: Sixty-six cases were identified. Mean age at insertion was 8.1 ± 2.3 years with mean duration of implantation 37.6 ± 15.1 months. Tissue metallosis was noted at revision surgery in 52/66 cases (79%). Metallosis was noted more commonly when rods were removed during fusion surgery than rod removal/exchange (97% vs. 58% (p = < 0.01)). The mass at insertion was greater in cases with metallosis (25.9 ± 7.8 kg vs. 21.1 ± 6.2 kg, p = 0.04). Length of tissue metallosis was reported for 45 rods, median 9 cm (range 1–25). Metallosis was noted in 43/59 (73%) rods that produced no force and 22/30 (73%) rods that produced some force on ERC activation (p = 0.96). Wear debris was found within the actuator in all rods, and all but 3 rods had damaged O-rings. Conclusion: MAGEC rods are associated with tissue metallosis in the majority of cases. It is seen with functional rods as well as failed rods and appears related to wear debris within the actuator and high rates of O-ring failure. Until the implications of metal debris in children are known, we urge caution with the use of this implant.


Publication metadata

Author(s): Rushton PRP, Smith SL, Fender D, Bowey AJ, Gibson MJ, Joyce TJ

Publication type: Article

Publication status: Published

Journal: European Spine Journal

Year: 2021

Pages: epub ahead of print

Online publication date: 05/02/2021

Acceptance date: 23/01/2021

ISSN (print): 0940-6719

ISSN (electronic): 1432-0932

Publisher: Springer Science and Business Media Deutschland GmbH

URL: https://doi.org/10.1007/s00586-021-06750-2

DOI: 10.1007/s00586-021-06750-2


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