MAGEC® Questions

Are you considering the MAGEC system as a treatment for your child's Early Onset Scoliosis (EOS)? Here are some suggested topics to discuss with your doctor, with some helpful information included.

Questions to Ask Your Doctor about MAGEC Treatment

What is the initial surgery like? How long will my child have to stay in the hospital?

Will my child need a brace? If so, for how long?

How active can my child be once MAGEC rods are implanted?

Suggested activity levels range from surgeon to surgeon and patient to patient. While some surgeons may recommend a return to normal activities, others may caution against high impact activities.

What exactly does the postoperative treatment entail? What else is done during the clinic visit (e.g. X-ray or ultrasound imaging)?

Postoperative treatment protocols vary by clinic and surgeon preference, as each clinic has different protocols and resources available to them.

How often will my child be lengthened?

Children are growing little by little every day, so MAGEC rods are lengthened every so often to keep up with a child’s growth. Lengthening intervals vary by clinic and patient–typical lengthening intervals span anywhere from every 6 weeks to every 3 months and may change depending on your child’s growth.

What is the likelihood my child will have to undergo an unplanned reoperation?

Generally, in growing rod surgeries (not just MAGEC surgeries), there is a risk of implant related complications.1 Implant related failures can include hooks or screws pulling out of place or rod fractures.

The child’s weight, type of deformity, spinal flexibility, degree of mobility, surgical technique, and/or activity level may also be contributing factors to implant complications.

In non-fusion constructs, like MAGEC constructs, the length of time the rods have been implanted the higher the risk of rod fracture.2

How about planned surgeries? Is there ever a chance my child’s MAGEC rod will have to be exchanged?

It is possible that the MAGEC rod will be maximally lengthened–the smaller version of the rod expands up to 28mm, and the larger version expands up to 48mm). If the rod reaches its max length, and your child still has growth left, you and your surgeon may elect to swap out the rods and continue MAGEC treatment.

What is metallosis, titanium wear debris, and tissue discoloration, and do I need to be concerned?

There is documented evidence that spinal fixation systems that stabilize non-fused spinal segments are known to generate particles, which can result in tissue discoloration near the implants.3,4 Because MAGEC rod constructs fall into this category and stabilize non-fused segments of the spine, the constructs can generate titanium wear debris particles over time, sometimes referred to as metallosis. Metallosis simply refers to an accumulation of metal debris in soft tissue, and does not necessarily pose a risk to a patient.5

Tissue discoloration can occur when the tissue interacts with the metal wear debris particles; the wear debris found near MAGEC implants has been identified as primarily titanium alloy particles. Although discoloration can be unsightly, titanium particles are not uncommon near titanium alloy spinal implants.3,6,7,8 To date, there have not been any reports of serious complications or clinical symptoms associated with titanium wear debris in MAGEC patients.

Other circumstances may contribute to increased wear and release of particulate to adjacent tissues. Contributing factors may include: patient - specific variables (e.g.–weight, spinal flexibility, degree of mobility), surgical technique, patient activity level, and worn or compromised internal components.

Although tissue discoloration cases have been generally asymptomatic and rare, NuVasive® is actively exploring opportunities to reduce these occurrences. Current iterations of the MAGEC rod include features to help reduce the creation and release of titanium alloy particles.

I have heard there were serious complications from metal-on-metal hip implants. Is this the same thing?

No. The metal-on-metal hip issues (and subsequent lawsuits) revolved around wear debris from a metal called cobalt-chrome. Titanium wear debris has not been shown to have the same systemic effects on patients that result in serious complications.

Will MAGEC rods fix my child’s scoliosis?

MAGEC rods are used to brace the spine during growth to minimize the progression of scoliosis. While some correction might be achieved in the initial implantation surgery and subsequent distractions, it is most likely a child diagnosed with EOS will need a final fusion at the end of MAGEC treatment to further straighten out the child’s spine.

Do you have further questions about MAGEC?

Please contact [email protected].

1. Johari A, Nemade A. Growing spine deformities: Are magnetic rods the final answer? World J Orthop 2017;8(4):295-300. 2. Liang J, Li S, Zhuang Q, et al. Risk factors for predicting complications associated with growing rod surgery for earlyonset scoliosis. Journal of Clinical Neurology and Neurosurgery 2015;136:15-9. 3. Wang JC, Yu WD, Sandhu HS, et al. Metal debris from titanium spinal implants. Spine 1999;24(9):899-903. 4. McCarthy RE, Sucato D, Turn JL, et al. Shilla growing rods in a caprine animal model. Clinical Orthopedics and Related Research 2010;468:705-10. 5. Romesburg JW, Wasserman PL, Schoppe, CH. Metallosis and metal-induced synovitis following total knee arthroplasty: Review of radiographic and CT findings. Journal of Radiology Case Reports 2010;4(9):7-17. 6. Kim H-D, Kim K-S, Ki S-C, et al. Electron microprobe analysis and tissue reaction around titanium alloy spinal implants. Asian Spine J 2007;1(1):1-7. 7. Yamaguchi K, Konishi H, Hara S, et al. Biocompatibility studies of titanium-based alloy pedicle screw and rod system: histological aspects. The Spine J 2001;1:260-8. 8. Villaraga ML, Cripton PA, Teti SC, et al. Wear and corrosion in retrieved thoracolumbar posterior internal fixation. Spine 2006;31(21):2454-62.