Minimally Invasive Placement of Pedicle Screws Using Robotic-Assisted Navigation and Magnetically Controlled Growing Rods in a Patient with Early-Onset Scoliosis: Technical Note and Case Report

Abstract

Introduction: Early-onset scoliosis (EOS) refers to spinal curvature exceeding ten degrees in the coronal plane in patients under 10 years old. When non-operative management fails to control the curvature, surgical intervention may be indicated. In younger patients, growth-friendly instrumentation may be necessary to allow for continued spinal growth while controlling the curve, which includes magnetically control growing rods (MCGR). This paper is the first description of robotic-assisted navigation in a patient with EOS undergoing MCGR insertion with the minimally invasive placement of pedicle screws. The benefits of a trans-muscular robotic-assisted technique include minimizing the risk of autofusion of the non-instrumented area. Case Report: The 7-year-old female patient with vertebral, anal, cardiac, tracheoesophageal, renal, esophageal, and limb anomalies and a complex medical history, presented with progressive, early-onset syndromic scoliosis. She underwent various surgeries in infancy for imperforate anus, colonic atresia, and malrotation, among other issues. Over time her curve worsened, reaching 71° by age seven. Insertion of MCGR was recommended and successfully performed using robotic-assisted navigation for placement of pedicle screws. Immediately post-operatively, the patients’ major curve improved to 15°. She was discharged home without complications on post-operative day 4. Conclusion: This case study exemplifies the success and safety of growth-friendly instrumentation using robotic-assisted navigation for the placement of pedicle screws. Keywords: Magnetically controlled growing rods, early-onset scoliosis, robotic-assisted navigation.