Traditional Growing Rods (TGR) vs Magnetically Controlled Growing Rods (MCGR) for Early-onset Scoliosis (EOS): A Systematic Review

ABSTRACT Background : Early-onset scoliosis (EOS) is a complex spinal deformity requiring growth-preserving surgical strategies [1]. Traditional Growing Rods (TGR) and Magnetically Controlled Growing Rods (MCGR) are widely used, differing in their lengthening approach and long-term management [1]. This systematic review and meta-analysis compares radiographic, clinical, patient-centred, and economic outcomes between MCGR and TGR in management of EOS. Methods A systematic search of PubMed, Embase, CINAHL, and Cochrane libraries was conducted for studies published between 2005-2025 following PRISMA guidelines. Eligible studies directly compared MCGR with TGR in children with EOS. Three reviewers independently screened and extracted data. Outcomes included radiographic correction (Cobb angle and T1-S1 spinal length), complications, procedural burden, patient-centred outcomes, and economic measures. Results Twenty-three studies met inclusion criteria. Nineteen studies reported Cobb angle correction, with seven included for meta-analysis which demonstrated a modest but statistically significant advantage favouring MCGR. Seventeen studies assessed T1-S1 length, with five included in meta-analysis, showing no significant difference in final spinal length between constructs. Annual spinal growth rates were comparable. MCGR was associated with a significantly lower risk of infection compared with TGR, while rates of unplanned revision were similar. Pooled analyses for proximal junctional kyphosis and rod breakage did not demonstrate statistically significant differences, although numerical trends favoured TGR for proximal junctional kyphosis and MCGR for rod breakage. MCGR reduced the frequency of invasive procedures and hospitalisations, while patient-centred and economic outcomes were heterogenous across studies. Conclusions MCGR reduced the frequency of invasive procedures and hospitalisations, which may contribute to favourable patient-centred and economic outcomes. TGR MCGR Paper Key Concepts 1.Magnetically controlled growing rods and traditional growing rods provide broadly comparable final spinal growth outcomes in early-onset scoliosis, with no significant difference in final T1–S1 spinal length. 2.MCGR demonstrated a modest advantage in coronal plane correction, with pooled Cobb angle percentage correction favouring MCGR over TGR. 3.MCGR was associated with a lower risk of infection compared with TGR, potentially reflecting the reduced need for repeated open surgical lengthening procedures. 4.Rates of unplanned revision, proximal junctional kyphosis, and rod breakage remain uncertain with no definitive construct superiority demonstrated for these outcomes.