Remote control rod to lengthen girl's spine helps prevent multiple scoliosis surgeries

Eight-year-old Isabella Cuartas can't wait to run, play sports and ride horses again. Just a few years ago, her future didn't appear it would be nearly as much fun, and instead featured repeated surgeries for scoliosis.

Her dad, Ovidio Cuartas, said the family first noticed something was wrong with Isabella's back in 2017 while living in Colombia. 

"I felt really nervous and sad, and [it was] terrifying," said Isabella, who now lives in Burlington, Ont., with her parents and brother.

Scoliosis, a curvature of the spine that often sets in just ahead of puberty and can either correct itself or worsen, affects about three per cent of the population.

Isabella was transferred to the pediatric orthopedic clinic at the McMaster Children's Hospital in Hamilton in June 2020 as her curvature worsened, keeping her from many activities young children love.

After moving to Canada in 2019, Isabella's family continued to seek treatment.

In January, Isabella became the first patient at the hospital to use a technology called MAGEC — Magnetic Expansion Control System. The procedure was first completed in Canada in 2014 and has typically been used for early-onset scoliosis for children under 10.

The standard treatment for children with scoliosis would be to undergo surgery every six to eight months to lengthen rods used to strengthen their spines, according to the hospital.

The idea of the magnetic rod lengthening is that we bring patients to the clinic instead of the operating room.- Dr. Waleed Kishta, pediatric orthopedic surgeon, McMaster Children's Hospital

The MAGEC technology allows the rod to be lengthened using an electronic remote control in a less invasive procedure that can be done at a clinic in minutes, reducing the risks of infection, injury and death, according to the hospital.

A study published in Spine Surgery and Related Research in 2019 found the most frequent clinical problem associated with the MAGEC rod was the failure of the "non-invasive distraction mechanism" that can lead to revision surgeries to replace the device.

The study, based on adverse events reported in a U.S. Food and Drug Administration database, says while the MAGEC rod hasn't completely replaced the traditional growth-rod system, in part due to its cost, it also concludes the MAGEC is "much more advantageous than its predecessor."

Procedure comes with 'less stress'

"The idea of the magnetic rod lengthening is that we bring patients to the clinic instead of the operating room," stated Dr. Waleed Kishta, a pediatric orthopedic surgeon, in a media release.

"It's very easy for children to get the lengthening procedure done at the clinic. It's a very big change for families with less stress of complications."

Isabella said she was a bit nervous, but everyone at the hospital treated her "like a queen."

"She was very excited because everybody was so special at the hospital," said Ovidio. "Because she was the first one, everybody wanted to take care of her and make sure she was comfortable and happy."

Feeling 'like a normal person'

The surgery only involved two small cuts at the top and bottom of her back, and she was up and walking just a few days later, he said. 

"It's quite nice that you don't have to go through all those surgeries anymore."

Her brother, Jacob, agreed.

"Surgeries are a hard thing to do," he said, adding he's looking forward to playing with his sister again.

Ovidio said the recovery hasn't slowed Isabella down too much.

"She chases him anyway," he joked, pointing at Jacob.

Curvature improves

Isabella's curve has improved since the surgery. The hospital said it's gone from 70 degrees to 30 degrees, which she said made her feel "really good, like a normal person."

The rod will remain in place until the curve is corrected as much as possible. They're typically removed around age 14, and a more permanent surgery is carried out to fuse metal and bone to straighten the spine.

Ovidio said his daughter's first appointment to lengthen the rod is scheduled for July. She can't be too active right now, but come September should be able to get back to some of her favourite things.

"Now I can ride horses and run."