Radiological and surgical outcomes after graduation to posterior spinal fusion surgery following magnetically controlled growing rod treatment for early-onset scoliosis: a systematic review and single-arm meta-analysis

Clinical Snapshot

Key Findings

• P Value: p < 0.05 for all radiographic parameters

• Effect Size: Not specified in abstract

• Primary Outcome: Significant improvements in all radiographic parameters following PSF

• Nnt Or Sensitivity: 17.2% pooled postoperative complication rate

• Confidence Interval: Not reported in abstract

Clinical Application

PSF following MCGR appears technically feasible with acceptable complication rates, though requires specialised paediatric spinal surgery expertise Relevant to Australian paediatric orthopaedic practice, though MCGR availability may be limited by PBS funding and requires consideration within established spinal deformity centres Paediatric patients with early-onset scoliosis who have undergone MCGR treatment and are being considered for definitive spinal fusion

Abstract

PURPOSE: Early-onset scoliosis (EOS) is a challenging condition for spinal surgeons. Growing rods represent the standard treatment for patients requiring surgery, and magnetically controlled growing rods (MCGR) are increasingly adopted. Many patients ultimately transition to posterior spinal fusion (PSF), although the necessity of definitive fusion remains debated. This systematic review and single-arm meta-analysis aimed to evaluate radiographic and surgical outcomes of PSF following MCGR treatment. METHODS: A systematic literature search was conducted in PubMed, Google Scholar, Medline, Scopus, Embase, and the Cochrane Library up to April 2025, following PRISMA guidelines. Eligible studies were identified using a PIO (Population, Intervention, Outcome) framework. Extracted data included demographic, radiographic, and surgical outcomes, including complications. A single-arm meta-analysis compared pre- and post-PSF radiographic parameters (main curve magnitude, thoracic kyphosis (TK), T1-T12 and T1-S1 lengths). Risk of bias was assessed using the MINORS tool. RESULTS: Eight retrospective studies were included (370 patients), of which six were eligible for quantitative synthesis. The meta-analysis demonstrated significant improvements in all radiographic parameters (main curve magnitude, TK, T1-T12 and T1-S1 lengths, p < 0.05). The pooled overall postoperative complication rate after PSF was 17.2%. CONCLUSIONS: PSF appears to be a viable treatment option following MCGR, providing significant deformity correction with a relatively acceptable complication rate. Nevertheless, the current evidence is limited by small, retrospective cohorts. Larger, prospective studies with standardized reporting of surgical variables and clinical outcomes are needed to better define the role of final fusion and to optimize treatment protocols.

References

1. 1.Brigato, P., Oggiano, L., Ravaioli, C., De Salvatore, S., Sangiovanni, G. M., Palombi, D., Sessa, S., Costici, P. F., Saran, N., & Albert Ouellet, J. (2026). Radiological and surgical outcomes after graduation to posterior spinal fusion surgery following magnetically controlled growing rod treatment for early-onset scoliosis: a systematic review and single-arm meta-analysis. European Journal of Orthopaedic Surgery & Traumatology. https://doi.org/10.1007/s43390-023-00801-y