By JOHN WOLFSON, Tufts Medical Center Staff
On the outside, Mason Bunker looked like a healthy little boy, but on the inside he was battling multiple medical challenges. He underwent surgeries for two unrelated conditions by the time he was nine months old. And then, before he even celebrated his first birthday, his mother noticed an unusual hump on his back while giving him a bath.
“If there’s a one percent chance of something happening, my son will be the one percent,” Nicole Bunker says with a weary laugh.
Mason was diagnosed with Early Onset Scoliosis. Scoliosis is a curvature of the spine that affects about three percent of Americans. It is more common in girls and typically reveals itself between the ages of 10 and 14, as children experience rapid growth. For children Mason’s age it is far less common and Early Onset Scoliosis accounts for only about 1% of all those with scoliosis.
“While we know it can run in families, we don’t know what causes scoliosis in most cases,” explains Stuart Braun, MD, Chief of Pediatric Orthopaedics and Director of the Scoliosis and Spinal Deformity Program at the Floating Hospital. “In Mason’s case, though, his muscles were underdeveloped from the time he was an infant, leaving his spine to be slowly pulled to the right.”
The treatments for scoliosis typically start with physical therapy and bracing to guide growth and keep the spine from curving further. If that is unsuccessful, surgery can be done. Doctors implant metal rods and other devices that fasten to the spine to keep it straight. In older patients this is performed in conjunction with a spinal fusion, halting growth and making the spine strong and stable. In young children we want to preserve growth so a “growing rod” is often used instead of a fusion. As the child grows, the rod must be frequently lengthened. Up until recently this has required a return trip to the operating room.
“The rods function sort of like a three-dimensional car tire jack,” Dr. Braun explains. “As the rods are adjusted, they slowly straighten the spine, sort of like the jack lifts the car.”
Doctors tried physical therapy, braces and casts on Mason but unfortunately the curve progressed. By the time he was four it was clear he would need surgery. Nicole was concerned about what the rods would mean for Mason.
“All those surgeries, and Mason would have to be put under every time, and he’d have to miss a lot of school,” she recalls thinking.
That’s when Dr. Braun mentioned a new, innovative option – what he calls “magic rods.” Once implanted, the Magec Rods could be lengthened as he grows, using external magnets during a routine office visit. This would avoid the many return visits to the operating room and the brief hospitalizations that would follow. The new technique had been gaining popularity in Europe, but only a few centers were offering it in the United States.
“I felt like Mason was the perfect candidate for this procedure,” says Dr. Braun. “Children need to be under 10, have a severe enough curve that’s not responding to bracing or casting and be in overall good health. It’s also important that the child’s parents have the schedule flexibility to make the required follow-up visits.”
Mason had the Magec Rods implanted in June of 2015. He spent less than a week in the hospital and at home, had a physical therapist help him gain his strength and independence. After that, “he was up and ready to go,” Nicole says. “He kept asking, ‘Can I walk more? I want to walk more!”
Mason returns to Dr. Braun’s office every three months to lengthen the rods. He lies on the examination table while a small magnetic machine passes over his spine for about one minute. The magnets lengthen the rods and a follow-up X-rays confirm that the rods had been properly extended. With each lengthening Mason gains about three millimeters in height. “It’s absolutely amazing,” Nicole says.
Mason’s curvature is already “significantly improved” and his scoliosis is diminishing. Dr. Braun has used the rods on a number of other young patients with success.
“This new technique not only eliminates the risk that comes with multiple surgeries, it cuts down on the amount of anxiety experienced by the entire family,” says Dr. Braun.
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Posted May 2017.