All-pedicle screw posterior spinal fusion after magnetically controlled growing rods in walking early-onset scoliosis patients: radiographic and surgical outcomes.

Purpose: Early-onset scoliosis (EOS) significantly affects lung development and life expectancy. Magnetically Controlled Growing Rods (MCGR) effectively promote thoracic growth while managing curvature progression. This study aims to assess the impact of definitive spinal fusion on residual deformity and complications in EOS patients treated with MCGRs.

Methods: The study included 27 EOS patients who underwent final fusion surgery between January 2017 and September 2022. The primary outcome was the evaluation of coronal and sagittal radiographic parameters postoperatively and at a minimum of 2 years of follow-up (FUP). Secondary outcomes included major complications (≥ IIIB, according to Clavien-Dindo Classification), surgery duration, blood loss and length of hospital stay (LOS).

Results: Major curve (45.5° and 33.5°, p = 0.003, Brunner-Munzel Test Statistic = - 3.869254) and Thoracic Kyphosis (TK) (19.8° and 13.5°, p = 0.002, Brunner-Munzel Test Statistic = - 2.258845) were statistically impacted by arthrodesis, and maintained at the final follow-up. The surgeries had an average duration of 254.2 ± 39.5 min (range: 195-336 min) and an average blood loss of 574.1 ± 255.1 mL (range: 200-1300 mL). The mean LOS was 8.5 ± 1.8 days (range: 6-13 days). Following the final fusion, 5 patients (18.5%) developed a complication, of which one was classified as major.

Conclusions: This study demonstrated substantial improvements in coronal and sagittal alignment following graduation surgery, with results maintained at the two-year FUP. Further research with larger sample sizes is needed to provide a more comprehensive assessment of radiographic and surgical outcomes and to establish guidelines for implant density in MCGR graduation surgery.