Magnet technology corrects spinal disorders

Before and after: On the left, Kora Olivo’s spine in 2014 before her magnetic growing rods were implanted. On the right, Kora’s spine today after four magnetic lengthening procedures.

For 7-year-old Kora Olivo, getting to ride the rollercoasters at Great America for the first time this summer marked a major milestone. Kora has early onset scoliosis (EOS), a severe spinal curvature that occurs when vertebrae develop incorrectly in utero. For the past year, she has been benefitting from a new technology that uses a magnet to straighten and lengthen her spine so that it can keep up with the rest of her body’s growth. It’s not only making Kora tall enough to ride rides now, but it’s also easing the pain and lung issues that are caused by her scoliosis.

When Kora was born, nurses noticed she had a slight breathing abnormality, and an x-ray led doctors to diagnose her with EOS. Despite no family history of the condition, Kora had multiple vertebrae deformities. She was also missing the upper lobe of her left lung, which is common among patients with EOS. When a spinal deformity crowds the space in the chest cavity, as in Kora’s case, lung growth can be impaired. If left untreated, this impairment can lead to life-threatening cardiac and pulmonary conditions. Kora’s pediatrician, Christine Halaburka, MD, referred her to the Spine Program at Stanford Medicine Children’s Health.

Lawrence Rinsky, MD, chief emeritus of pediatric orthopedic surgery at Lucile Packard Children’s Hospital Stanford, began treating Kora from the time she was three months old, taking x-rays twice a year and evaluating her growth to determine appropriate treatment. When she was five years old, Kora underwent a surgery in which standard growing rods were placed in her spine to begin correcting the curve. She would need to return the hospital for surgery every six months to surgically lengthen the rods, and she would require between 10 and 20 more surgeries throughout her childhood before she reached skeletal maturity.

But in 2016, a new technology changed all of that for Kora. Her standard rods were replaced with MAGEC titanium rods, which are lengthened magnetically through a non-invasive, non-surgical procedure called a distraction, which is conducted every three months in a doctor’s office. During a distraction, clinicians drag a magnet across the patient’s back to find the magnetic component of the MAGEC rod. An external remote controller is then placed on top of the magnet and turned on to expand the growing rod by three to four millimeters, depending on the patient’s growth between appointments. The entire procedure takes about 10 minutes.

Kora mimics the distraction procedure on a stuffed animal during her quarterly appointment.

“It feels weird and kind of tickles,” Kora says of her procedure — with a smile. Compared to the surgical alternative, she is quite happy.

“I can’t help but think about all the surgeries Kora would have gone through without this technology, and the toll that would have taken on her,” says her mother, Ali Olivo. “Now, she comes in, lays down for what feels like 30 seconds and then gets to go home. Last time, she went straight to swim practice. Today, she’s headed back to an ice cream social at school.”

Rinsky currently treats about 10 patients with the magnetic growing rods. He explains that the benefits of this technology include less time under anesthesia, less risk of complication and much less time spent in the hospital. Currently, Packard Children’s is one of the only children’s hospitals in Northern California using magnetic growing rods technology, but Rinsky believes this will soon change. “This technology is rapidly becoming the standard of care for EOS because it’s so much easier on the patients than coming in for surgery every six months,” he says.

Because the technology is so new, Rinsky explains that doctors cannot yet predict the total number of distraction procedures each patient will receive before they reach skeletal maturity, and there is a likelihood that young patients, like Kora, will need to exchange their growing rods for longer ones as they grow bigger and the rods run out of length. But the MAGEC rods can be lengthened by about four centimeters at a minimum, which lasts most patients about four years. In that time, with the previous standard rods, patients could have undergone as many as eight surgeries.

“Without surgery, Kora has grown 5 inches in a year and a half since receiving the magnetic rods,” Olivo says. “It is like her bones, her back and her body are saying ‘this is where we want to be.’”