The spine center at the NewYork Presbyterian Morgan Stanley Children’s Hospital is unique in New York in offering this new and exciting treatment for the young child with scoliosis. “The MAGEC (MAGnetic Expansion Control) device, which uses external magnets to control a rod implanted in the spine, is for children diagnosed with progressive early-onset scoliosis who have not benefited from nonsurgical treatments,” says Dr. Vitale. He performed New York City’s first procedure using this device in a 5 year-old with early onset scoliosis.
The initial procedure is much like that of the traditional growing rod or VEPTR. It is attached to the ribs or the spine at the top of the device, and then attached to the spine or the hips at the bottom of the device. The initial procedure requires admission to the hospital for 3-5 days. In the post-operative period there is no casting or bracing necessary and regular activities are not limited. The majority of children return to school within 4 weeks and can often return to full activity including sports within 6 months if not sooner. If the device is attached to the spine at top or bottom of the device, then kids get back to contact sports after about 6 months.
The main difference between the traditional Growing Rod/VEPTR and the MAGEC is the lengthening device in the middle. In the VEPTR or traditional Growing Rod, the patient must return to the operating room to have the device lengthened every 6-9 months. With the MAGEC system, the patient can have the lengthening done in the office without anesthesia. The lengthening will involve placing an external remote controller over the location of the magnet and the rod is lengthened in a matter of minutes. The patient then has an Xray done to confirm the amount of lengthening that was achieved. There is typically not any pain involved during the lengthening. There are no additional incisions or bandages. The child can get back to activities immediately as tolerated. The lengthenings are typically done every 3 months but this can vary based on the patient’s age and curve. It decreases the chance of infection and risk of anesthesia because the lengthenings are done without an incision or anesthesia. This has completely changed how we treat a young child with a progressive scoliosis despite conservative treatment.