Does bilateral rib augmentation with lamina bands enhance cranial anchoring in magnetically controlled growing rod treatment? Evaluation of complication rate.

Abstract

Early-Onset Scoliosis (EOS) presents a challenging condition often associated with severe health implications if left untreated. Magnetically Controlled Growing Rods (MCGR) have revolutionized EOS management, offering less-invasive spinal correction and growth preservation. Despite these advancements, high complication rates (21 %-66 % in MCGR-treated patients), particularly cranial screw loosening, remain a concern. This study evaluates the complication rates associated with MCGR implantation in EOS and investigates the impact of bilateral rib augmentation with lamina bands on cranial anchoring stability. A retrospective review was conducted on 62 EOS patients treated with MCGR between 2013 and 2022. Clinical and radiographic data, including Cobb angles, sagittal alignment, and complication profiles, were analyzed. Patients with and without bilateral lamina band augmentation were compared to assess its impact on cranial screw loosening. Statistical analyses were performed using SPSS, with significance set at p < 0.05. The cohort included 36 idiopathic (58 %) and 26 neuromuscular (42 %) scoliosis cases, with a mean age of 11.1 ± 2.4 years. Postoperative analysis demonstrated significant improvement in Cobb angle and apex deviation (p < 0.05). 13 of 62 patients (21 %) required an unplanned revision. Cranial screw loosening was reported in 13 cases (21 %), with 6 (10 %) of these requiring unplanned surgical revision. Bilateral rib augmentation with lamina bands showed a reduced rate of cranial screw loosening from 50 % to 10.9 % (OR = 8.2, p < 0.05). Thoracic kyphosis flattening post-implantation was linked to higher rates of cranial anchorage failure. MCGR treatment effectively corrects deformities and preserves spinal growth in EOS, but complications such as cranial screw loosening highlight the need for enhanced anchoring techniques. Rib augmentation with lamina bands significantly improves cranial stability and may reduce mechanical complications. Further research for optimizing surgical techniques and understanding biomechanical factors is crucial to improve outcomes.