{"title":"磁控生长棒（MCGRs）治疗早发性脊柱侧凸的内部机制失效：对植入物回收分析研究的系统回顾。","authors":"Riaz Mohammed, Pranav Shah, Bnar Massraf, Sashin Ahuja","doi":"10.1007/s43390-025-01171-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic controlled growing rods (MCGRs) are used to treat early-onset scoliosis when nonsurgical options fail, controlling curve progression and allowing for continued spinal growth. Recent reports of unplanned reoperations and mechanical failure of MCGRs have led to further research. This is a systematic review on the retrieval analysis of explanted MCGR rods. Understanding the failure mechanisms will shed light on the survivorship and complications associated with the implant.</p><p><strong>Methods: </strong>A Medline and EMBASE database search was performed, looking at all variations in the terms \"magnetic controlled growing rods\" and the terms \"retrieval/explant/metallosis\" All published retrieval analysis studies of MCGR were included, and all clinical outcome studies, biomechanical testing studies, review articles, and case reports were excluded. Data were collected regarding the source, year, and aim of the study; number of patients and rods analysed; duration of implantation; and main findings and conclusions.</p><p><strong>Results: </strong>Nine studies (454 rods) reported metallosis due to O-ring damage (67%), internal mechanism failure of locking pins (45%) and rod fracture (7%) in all MCGR generations. Actuator locking pin fractures reported in 174 rods (38.3%) continue to persist despite newer implant iterations. The pin fracture rates decreased from 52% in MAGEC 1.3 to 15% in MAGEC X.</p><p><strong>Conclusions: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC.</p><p><strong>Levels of evidence: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC. This systematic review provides Level III evidence on failure mechanisms in MCGR, as the results were obtained from Level III studies. The levels of evidence for all relevant references can be found in the reference section.</p><p><strong>Level ii: </strong>[1-4].</p><p><strong>Level iii: </strong>[5-34].</p><p><strong>Level iv: </strong>[35-44].</p><p><strong>Level v: </strong>[45-50].</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Internal mechanism failure of magnetic controlled growing rods (MCGRs) for early-onset scoliosis: a systematic review of implant retrieval analysis studies.\",\"authors\":\"Riaz Mohammed, Pranav Shah, Bnar Massraf, Sashin Ahuja\",\"doi\":\"10.1007/s43390-025-01171-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Magnetic controlled growing rods (MCGRs) are used to treat early-onset scoliosis when nonsurgical options fail, controlling curve progression and allowing for continued spinal growth. Recent reports of unplanned reoperations and mechanical failure of MCGRs have led to further research. This is a systematic review on the retrieval analysis of explanted MCGR rods. Understanding the failure mechanisms will shed light on the survivorship and complications associated with the implant.</p><p><strong>Methods: </strong>A Medline and EMBASE database search was performed, looking at all variations in the terms \\\"magnetic controlled growing rods\\\" and the terms \\\"retrieval/explant/metallosis\\\" All published retrieval analysis studies of MCGR were included, and all clinical outcome studies, biomechanical testing studies, review articles, and case reports were excluded. Data were collected regarding the source, year, and aim of the study; number of patients and rods analysed; duration of implantation; and main findings and conclusions.</p><p><strong>Results: </strong>Nine studies (454 rods) reported metallosis due to O-ring damage (67%), internal mechanism failure of locking pins (45%) and rod fracture (7%) in all MCGR generations. Actuator locking pin fractures reported in 174 rods (38.3%) continue to persist despite newer implant iterations. The pin fracture rates decreased from 52% in MAGEC 1.3 to 15% in MAGEC X.</p><p><strong>Conclusions: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC.</p><p><strong>Levels of evidence: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC. This systematic review provides Level III evidence on failure mechanisms in MCGR, as the results were obtained from Level III studies. The levels of evidence for all relevant references can be found in the reference section.</p><p><strong>Level ii: </strong>[1-4].</p><p><strong>Level iii: </strong>[5-34].</p><p><strong>Level iv: </strong>[35-44].</p><p><strong>Level v: </strong>[45-50].</p>\",\"PeriodicalId\":21796,\"journal\":{\"name\":\"Spine deformity\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine deformity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s43390-025-01171-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01171-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Internal mechanism failure of magnetic controlled growing rods (MCGRs) for early-onset scoliosis: a systematic review of implant retrieval analysis studies.
Purpose: Magnetic controlled growing rods (MCGRs) are used to treat early-onset scoliosis when nonsurgical options fail, controlling curve progression and allowing for continued spinal growth. Recent reports of unplanned reoperations and mechanical failure of MCGRs have led to further research. This is a systematic review on the retrieval analysis of explanted MCGR rods. Understanding the failure mechanisms will shed light on the survivorship and complications associated with the implant.
Methods: A Medline and EMBASE database search was performed, looking at all variations in the terms "magnetic controlled growing rods" and the terms "retrieval/explant/metallosis" All published retrieval analysis studies of MCGR were included, and all clinical outcome studies, biomechanical testing studies, review articles, and case reports were excluded. Data were collected regarding the source, year, and aim of the study; number of patients and rods analysed; duration of implantation; and main findings and conclusions.
Results: Nine studies (454 rods) reported metallosis due to O-ring damage (67%), internal mechanism failure of locking pins (45%) and rod fracture (7%) in all MCGR generations. Actuator locking pin fractures reported in 174 rods (38.3%) continue to persist despite newer implant iterations. The pin fracture rates decreased from 52% in MAGEC 1.3 to 15% in MAGEC X.
Conclusions: MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC.
Levels of evidence: MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC. This systematic review provides Level III evidence on failure mechanisms in MCGR, as the results were obtained from Level III studies. The levels of evidence for all relevant references can be found in the reference section.
期刊介绍：
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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