Surgeons at Seattle Children’s helped introduce a technology
that reduces surgeries for kids with severe scoliosis – and
improves their lives.
Published in Connection magazine, Winter 2017
Dr. Klane White (left) and ultrasonographer Jenny McBroom view an image of the MAGEC growing rods attached to Carmen Rhoton’s spine. The visual
enables White to confirm the position of the rods as he gently expands their length. Rods are typically expanded three to seven millimeters at a time,
and most children come twice a year for rod expansions while they are growing.
Life threw Carmen Rhoton a curveball
when she was born with severe
scoliosis, but she’s the one throwing
The 10-year-old pitches and plays
third base on a softball team in Everett.
“It’s fun and I really love it,” Carmen says.
Carmen’s scoliosis could have left
her unable to walk – and possibly
shortened her life – but she is free to
reach her full potential on the softball
field and beyond thanks to a pair of
surgically placed growing rods that are
straightening her spine as she grows.
“She moves a little differently
because her back isn’t as flexible, but
she has a normal life expectancy,” says
Carmen’s mom, Angie Howard. “The
growing rods make all the difference.”
There’s a catch, though. To do
their job, the rods must be regularly
lengthened to accommodate Carmen’s
growth. In the past, this required
surgeons to reopen the original incision
approximately every six months to
manually expand the rods.
Since first getting growing rods
when she was 2½ years old, Carmen
has had 14 surgeries – each bringing
a pile of worries about the possible
complications, effects of repeated
anesthesia and painful recovery periods
for a child who was barely out of diapers
when the daunting process began.
Surgery every six months is a thing of the past for Carmen and many other kids with severe early-onset scoliosis.
Home in an hour
Each click of the MAGEC remote control
(right) activates a magnet in the growing
rods that turns a screw and extends the rod
a third of a millimeter – about the width
of a grain of sand.
But surgery every six months is a thing
of the past for Carmen and many other
kids with severe early onset scoliosis
thanks to a new generation of growing
rods that work like MAGEC.
The MAGnetic Expansion Control
(MAGEC) system allows surgeons to
lengthen a child’s growing rods with
the push of a button on a remote
control. No incision. No anesthesia.
No painful recovery period.
“They used to come for an appointment
before surgery, return again for
the surgery itself, spend 12 to 24 hours
at the hospital and take several days
to recover from the pain,” says Seattle
Children’s surgeon Dr. Klane White.
“With the MAGEC system, they come
to the clinic and go home in an hour
with little or no discomfort.”
Seattle Children’s is the regional
center for early-onset scoliosis. Our
knowledge and experience helped us
be among the first to adopt the MAGEC
system after it was approved in 2014.
Carmen was one of the first patients at Seattle Children’s to get MAGEC growing rods
when White replaced her original
growing rods last year.
“As Dr. White explained them to
me, I thought, ‘You must be kidding.’
It sounded futuristic and out of this
world,” Carmen’s mom recalls. “We
were scared at first because it was
so new, but now it’s amazing to think
Carmen may not need any more
surgeries to lengthen her rods.”
Early onset ups risks
Scoliosis can occur at any age, but if
a child is born with it or develops it
early in life, the potential deformity is
magnified dramatically because of all
the growth yet to occur in a young
If left untreated, early-onset scoliosis
can prevent a child from gaining height
and weight and make their spine so
crooked they become unable to walk – let alone play a sport. It can also restrict
breathing by deforming the chest so
badly that the lungs and other organs
can’t develop and function normally,
which can shorten a child’s life.
As recently as 15 years ago, spinal
fusion was the standard treatment.
While the procedure prevented the
child’s spine from continuing to curve,
it also prevented the spine from
growing – an example of the cure
being almost as bad as the disease.
“They’d be 12 years old and stuck with
the chest and lungs of a 3-year-old,”
White says. “Imagine climbing 10 flights
of stairs with a belt cinched around
your chest. That’s how every breath
would feel to them.”
The development of the first generation
of growing rods launched a new
era of care beginning in the early 2000s.
Our spine program was among the first
to offer this game-changing solution
for addressing spinal curvature without
stopping spinal growth. We now have
one of the largest growing rod programs
in the country and are a leader in studying
the impact and effectiveness of
“Now we can focus on normal kid stuff and not worry about
the next surgery. It’s cool how medicine keeps making
Latest leap forward
Carmen Rhoton, 10, was born with a disorder that causes severe early-onset scoliosis, but a pair of MAGEC growing rods is correcting her spine as she
grows, allowing her to swing for the fences on the softball field and beyond. Without growing rods, Carmen might not be able to walk, let alone pitch
and play third base on the Sparks girls’ softball team in Everett.
MAGEC rods are the latest leap forward.
With few exceptions, they are the first
choice in treatment for children diagnosed
with severe early-onset scoliosis
at Seattle Children’s and most other
hospitals with growing rod programs.
And kids like Carmen, provided they
have at least two years of growth
remaining, are getting MAGEC rods
as replacements for conventional
rods they originally received.
Surgeons perform the same surgery
to attach MAGEC rods to the spine
with hooks and screws as they do with
conventional rods. However, with MAGEC
rods they may not need to pick up their
scalpel again until it’s time to remove
the rods when the child stops growing.
The spine is then typically fused to
keep it as straight as possible for the
rest of the child’s life.
To lengthen conventional rods,
surgeons open up the child’s back,
loosen a screw with a special screwdriver,
gently expand the telescoping
rod and then tighten the screw and
close the incision. With MAGEC rods,
a magnet in the rod does the trick.
The doctor holds the system’s remote
control against the child’s back. Each
click of the remote activates the magnet
and rotates the screw to expand the
rod one-third of a millimeter – about
the width of a grain of sand. Rods are
typically expanded three to seven
millimeters at a time.
“A few kids say they feel some pain
as we lengthen the rods, but many say
they don’t feel anything,” says Dr. Wally Krengel, who leads the spine team at
Seattle Children’s. The lengthening,
according to Carmen, “kind of feels
like a massage.”
Whatever it feels like, the MAGEC
rods are a welcome relief from repeated
surgeries – especially for kids with
conditions that impose heavy health
burdens on top of their scoliosis.
Joycelyn Mendoza, 7, was born with
severe developmental delays and
can’t walk or speak because of a
rare chromosomal disorder that also
Joycelyn – who lives in the Eastern
Washington town of Granger – is breathing
better after getting MAGEC rods when
she was 6 years old to help her chest
and lungs develop. “We’re very happy.
The rods are helping a lot,” says her
dad, Selso Mendoza.
Joycelyn’s dad can’t imagine his
challenged daughter facing the repeated
surgeries required by conventional
growing rods. “That would have been a
lot for her along with everything else she
has to deal with,” he says. “The MAGEC
rods are better for her and better for us.”
A focus on lung function
Since growing rods need to be adjusted as the child grows, the nurses in our Orthopedics Clinic,
including Shannon Kniestedt (left) and Jeananne Martin, develop ongoing relationships with the
children and their families that begin before the rods are implanted and continue until the child
stops growing and the rods are removed.Dr. Wally Krengel leads our spine team, which was one of the first to use MAGEC growing rods to treat severe early onset scoliosis.
Severe early-onset scoliosis is rare, so
no single hospital treats enough patients
to study the condition effectively on its
own. As part of the Children’s Spine Study Group, Seattle Children’s teams
with other top-tier children’s hospitals
around the country to find better ways
to meet the challenges faced by children
with severe early-onset scoliosis.
“Our research at Seattle Children’s
focuses on how scoliosis affects lung
function. Restrictive lung disease is
the primary threat to the health of a
child with severe scoliosis, but the
connection between the two needs
to be better understood,” White says.
White and Dr. Gregory Redding, who
leads the Seattle Children’s pulmonary
team, are leading a multi-site study to
help clarify the circumstances under
which growing rods provide the best
possible treatment for scoliosis patients
with lung disease. “We specifically want
to understand if the amount of lung
disease a child already has when they
get growing rods is related to how much
their breathing improves with rods,”
White says. “That will give us a better
sense of which children will derive
enough benefit from rods to warrant
putting them through the procedure.”
White notes that MAGEC rod technology
is still too new to document how
much it improves the quality of a child’s
life when compared to conventional
rods, but he only has to listen to the
families he works with to know they
appreciate the ease of treatment.
“They’re very happy,” White says.
“When I complete their first expansion,
they look at me and say, ‘You’re done?’”
Carmen’s mom is grateful her
daughter could switch to the MAGEC
system. “Now we can focus on normal
kid stuff and not worry about the next
surgery,” she says. “It’s cool how medicine
keeps making improvements.”
MAGEC rods are a welcome relief from