A device that aims to straighten and lengthen the spine of children with scoliosis is supported in new NICE guidance.
Published today, the medical technology guidance from the National Institute for Health and Care Excellence (NICE) encourages the NHS to use the MAGEC system in children aged two years and over who need surgery to correct their scoliosis. This is specifically where standard methods to straighten the child’s spine, such as wearing a back brace, have not worked. Using the device means the child can avoid repeated surgery with the associated effects and risks – and could save the NHS an estimated £12,000 per child over six years.
Scoliosis is a condition where the spine curves abnormally to the side. In many cases, no interventional treatment is needed because the spine corrects itself as the child grows. If treatment is required, a back brace can help stop the spine from curving further. This brace is worn until the child stops growing. Other standard options include using an external plaster cast or growth rods that are surgically inserted around part of the spine. These standard rods are then extended twice a year via small incisions in the back; a procedure performed under general anaesthetic and which may require an overnight stay in hospital.
As the child grows, they will gain more height from having a straighter spine than from one that is curved. Fusing the spine is the final option, but this limits spinal growth so is normally avoided until the child has stopped growing.
By avoiding the need for the repeated surgical procedures, the committee accepted that the device can reduce the incidence of surgical complications and provide other physical and psychological benefits for affected children and their families
The MAGEC system, developed by Ellipse Technologies, includes one or two extendable titanium rods which are surgically inserted and attached to the spine or ribs above and below the curved section of spine. The procedure to implant the rods is similar to that used for conventional rods. However, the main difference is that the MAGEC system does not need periodic surgical procedures in order to lengthen the rods. Instead, using a magnet and screw system that sits within the rod, the length of the MAGEC system rod can be increased using a remote control device. This can be done in an outpatient clinic and does not require a general anaesthetic.
Jane Clarke, whose grandson is being treated with the MAGEC system, said: “Our child required spinal growth rods when he was eight to counter a worsening spinal curvature. MAGEC growth rods were inserted and for the past two years he's attended outpatients every three months to have these lengthened. The procedure is virtually painless, takes about 15 minutes, and he meets other children having the same treatment, which means he feels less isolated. He has an X-ray or ultrasound and is ready to go home after just an hour. Conventional growth rods would mean the pain and distress of surgery every six months, so that’s four operations he's avoided in the past two years thanks to the MAGEC system. I hope that this new NICE guidance will help more children to benefit from this device.”
Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, added: “We are delighted to publish this guidance which can help make a real difference to children who need surgery for a curved spine. The NICE guidance advises that the MAGEC system can benefit these children with scoliosis, and save the NHS money.
“Where standard treatment for scoliosis, such as a back brace, hasn’t worked, the guidance says that the MAGEC system offers a real improvement over the current surgical option involving conventional growth rods. Using standard growth rods requires repeated surgical procedures which are needed to extend the rods as the child grows. Having surgery sometimes twice a year to extend the rods can be difficult for the child and their family or carers and can cause distress.
The NICE guidance advises that the MAGEC system can benefit these children with scoliosis, and save the NHS money
“In this guidance, the independent Medical Technologies Advisory Committee concluded that there was evidence to support the use of the MAGEC system to help straighten and lengthen the spine in children aged two years and over. By avoiding the need for the repeated surgical procedures, the committee accepted that the device can reduce the incidence of surgical complications and provide other physical and psychological benefits for affected children and their families. These can include less time away from school, no need to be admitted as a hospital inpatient, and avoiding fear of repeated surgery.
“As well as these benefits for the child, using MAGEC is estimated to potentially save the NHS around £12,000 per patient after six years compared with using conventional growth rods. This guidance encourages the NHS to consider using the MAGEC system for children who need surgical treatment for scoliosis.”
