What are MAGEC Growing Rods?
MAGnetic Expansion Control (MAGEC) rods are an FDA-approved treatment for
use in children with severe progressive spinal deformities such as
The procedure allows children to grow without the need for repeat surgeries.
The system is used to brace the spine as the child grows and minimize the progression of spinal deformities like scoliosis.
MAGEC growing rods are innovative surgical devices only available at a few select pediatric hospitals in the United States. Robert Wood Johnson University Hospital and Bristol-Myers Squibb Children’s Hospital New Brunswick, RWJBarnabas Health facilities, offer this advanced surgery to qualified candidates as an alternative to other scoliosis treatments such as:
- Traditional growing rods, which require multiple surgeries over time
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Although traditional growing rods were the standard of care for growing children with spinal deformities, these methods are limited in their usefulness. For example, traditional growing rods cannot be controlled externally. While traditional growing rods can be effective in managing a child’s scoliosis, they are much more invasive because they require repeated expansion surgeries in order to keep up with the pace of the child’s growth. That could mean as many as 10+ surgeries before the child reaches skeletal maturity.
MAGEC rods differ in how they expand compared to traditional growing rods. MAGEC rods are lengthened using powerful magnets in 3- to 6-month intervals using a short, non-invasive procedure in a doctor’s office.
Most children who need MAGEC rods have two — one on the left and one on the right side of the spine — and each rod is adjusted independently.
Is My Child a Good Candidate for MAGEC Growing Rods?
Not all children with severe spinal deformities are good candidates for MAGEC rods, such as very young children or those who have gone through puberty and have finished growing.
MAGEC rods are not always strong enough to lengthen very stiff curves, either. Treatment depends on the child’s age, size, spinal condition, and separate factors.
If your child has been diagnosed with early-onset scoliosis or a related condition, you will be able to discuss treatment options with your child’s doctor.
To be considered for MAGEC growing rods, a child would:
- Have significant, progressive scoliosis or another severe spinal deformity
- Have had preventative bracing without significant success
- Have significant bone growth remaining (they must be skeletally immature, which is determined through an X-ray to check on the growth plates)
- Not need periodic MRIs as part of their medical care; MAGEC growing rods are not approved for use in MRI scans, because both the MRI machine and MAGEC growing rods use magnets
Evaluation
To determine whether to proceed with MAGEC rod surgery, a pediatric orthopedic surgeon may:
- Review a child’s medical history
- Conduct a physical examination
- Do imaging tests such as an X-ray or EOS imaging of the spine to measure the precise degree of spinal curvature and which part of the spine is affected
- Do a magnetic resonance imaging (MRI) test to evaluate the spine and spinal cord nerves, as they may be abnormal in younger children with scoliosis
Older children may undergo additional X-rays of their hands and hips to determine whether they need a growth-friendly solution to manage their spinal deformity until they reach skeletal maturity.
Benefits of MAGEC Growing Rods
Any type of growing rod, but especially MAGEC growing rods, greatly benefit growing children with early-onset or idiopathic scoliosis. Both MAGEC and traditional growing rods straighten and stabilize the spine as the child continues to grow. MAGEC rods are more beneficial than traditional growing rods, because fewer surgeries are necessary, and thus, they will not need frequent general anesthesia, which carries its own risks. Children with MAGEC rods generally recover more quickly after lengthening the rods, meaning they are able to return to regular childhood activities like playing and athletic pursuits more quickly.
Risks Involved in MAGEC Growing Rod Surgery
All surgeries carry inherent risks of infection or bleeding, as well as adverse reactions to anesthesia. However, our experience of infection or excessive bleeding and other potentially serious complications are unlikely with MAGEC growing rod surgery. Children may be at higher risk if they are very physically active and thus damage or weaken the MAGEC rods, hooks or screws, but this is rare.
After surgery, the child has titanium rods and metal instruments in their body. You must alert any of your child’s other doctors to the presence of this metal instrumentation. For example, they cannot undergo MRI scans with implanted MAGEC growing rods.
Preparing for the MAGEC Growing Rod Surgery
Before MAGEC growing rod surgery, your child must be medically cleared for surgery by an anesthesiologist, which may require additional tests.
On the morning of MAGEC growing rod surgery, the child will arrive at the hospital with their parent(s) to be admitted. Parents are allowed to stay with their child in the pre-op area before surgery begins, and the child is taken to the operating room with one of our Child Life specialists.
Visitation may be subject to change; check with the hospital as the date of surgery nears.
What to Expect During MAGEC Growing Rod Surgery
Children are under general anesthesia during surgery, so they are unconscious and unable to detect pain during the operation.
The surgeon will access the spine from the back. Usually, children require two MAGEC rods – one on either side of the spine. The rods are secured to the spine by surgical hooks and pedicle screws.
Rods are attached both above and below the curve to act as a brace for the spine as the child continues to grow so it minimizes the progression of scoliosis.
Surgery generally takes 3-4 hours to complete, depending on your child’s age, size, overall health, and condition.
What Happens After MAGEC Growing Rod Surgery
The variable-length titanium MAGEC rods are magnetic. During follow-up appointments, the magnet is activated by an external remote control which expands the MAGEC rods without any need for an additional operation, as would be standard with traditional growing rods.
What to Expect After Surgery
After surgery, your child will be taken to the Pediatric Intensive Care Unit (PICU). Parents will be able to visit their children as soon as possible, usually within a few hours of surgery. Shortly afterwards, your child will get out of bed to walk with a nurse or rehabilitation therapist’s assistance. Your child will get intravenous (IV) pain medicine until they are able to eat and drink again, and then pain medicine will be given orally. Most patients do well with non-narcotic pain medicine plus a muscle relaxant.
During recovery in the hospital, your child’s incision will be checked and redressed, and imaging studies such as an X-ray will ensure their implants are stable.
Most patients are allowed to go home 2 to 3 days after the procedure.
Recovery from MAGEC Growing Rod Surgery
Your child will go home with the ability to walk, climb stairs, and do most normal activities. Depending on your child’s recovery and pain, they can return to school 4-6 weeks after surgery. Arrangements can be made with your child’s school so they can keep up with their lessons.
Your child’s incisions will have small surgical strips or a liquid dressing covering them. In most cases, these dressings will eventually curl up and fall off. In some cases, a parent may be instructed to remove these after several weeks. There will be NO stitches or staples to remove.
Normally no bracing or physical therapy is needed after surgery. Your child will be restricted from bending and twisting excessively, as well as gym class and sports, until your surgeon clears them, typically by 3-6 months.
Follow-Up Care
For their post-operative visits, your child will return for an evaluation by your pediatric spine surgeon at approximately 2 weeks and 6 weeks after their surgery
During this appointment, clinicians will:
- Examine your child’s incision to ensure it is healing properly
- Review new X-rays or ultrasounds to ensure the MAGEC implants are positioned correctly and properly bracing your child’s spine for future growth
- Plan and schedule your child’s first lengthening procedure
Most children can return to routine daily activities after these visits. There are no major restrictions on routine activities, but patients are encouraged to avoid activities that carry a greater risk of injury such as using trampolines or bungee jumping.
Expansion Procedures
Your child’s first expansion procedure will occur about 4 months after the MAGEC rods are implanted.
In most cases, your child will lay on their belly on the exam table. Younger children may sit on a parent’s lap — with their back facing outward — and hug the parent during the procedure.
A clinician will locate the magnetic component of each rod in your child’s back, and make a small mark on the skin to note the correct placement. Next, the clinician will determine how much to lengthen each rod to match your child’s recent growth (generally 3 to 6 millimeters) and program the external remote controller with the measurement.
The external remote control is then placed on your child’s back — over the small mark — and activated. Once in position, the external remote controller is turned on and magnetically expands the rod to the pre-determined length. The process is then repeated for the second rod.
Though the procedure is completely painless and can be completed in less than 10 minutes, some children become anxious when they hear the loud rumbling noise — similar to a washing machine — that the external machine produces. Sedation is not used during the expansion procedure, but if needed, medication can be given to relax your child.
After the lengthening procedure, your child will undergo imaging to ensure the MAGEC rods have been properly expanded and recheck all instrumentation. EOS imaging allows clinicians to see your child’s spine in a weight-bearing position and plan for future expansions.
Your child can return home after the appointment. There are no activity restrictions, and your child can return to school the next day.
Your child will continue to be examined — and the MAGEC rods expanded — every 3 to 6 months until they finish growing.
When your child has reached skeletal maturity, a final surgery will be performed to remove the instrumentation and fuse the spine in place.
Rod Replacement
Depending on your child’s age and size when the MAGEC growing rods were first implanted, they may need to have the rods replaced before reaching skeletal maturity. If your child is particularly active, rod repair may be needed if a connection between the rods and bones are damaged.
Surgical replacement of MAGEC rods is similar to the initial implant surgery, with the same recovery time and activity restrictions for six weeks after surgery.
