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Wednesday, April 12, 2017

Ahead of the Curve

Posted By: Advancing Care

A revolutionary, new, non-invasive procedure for children with scoliosis is nothing short of MAGEC.

By Sheryl Kraft

If you were to catch a glimpse of 11-year old Miguel Ramos today, you’d see a normal, active and happy sixth-grader. But it wasn’t always that way.

Miguel was born with scoliosis, a musculoskeletal disorder resulting in an S- or C-shaped curvature of the spine. The condition is typically identified in adolescence, but Miguel was way ahead of the curve in more ways than one: His scoliosis was diagnosed before he was born.

Following a routine sonogram during week 23 of her pregnancy, Miguel’s mom, Grace Perez-Ramos, was shocked to learn of the problem. “It was sad and scary when the doctor told me I had to see a specialist right away,” said Perez-Ramos. “We didn’t know much about scoliosis — let alone what it meant for an unborn baby.” They learned that at the onset of adolescence, Miguel would require spinal fusion surgery to permanently correct and stabilize his spine with a titanium rod.

Miguel’s condition, infantile scoliosis, has no known cause, and is usually diagnosed prior to age 4. “Early diagnosis and treatment, if needed, allows for the deformity to be kept to a minimum and for the patient to lead a normal life,” explains Miguel’s doctor, Damon DelBello, MD, an orthopedic surgeon at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth).

At just two months old, Miguel was fitted for a lightweight, custom-molded plastic brace, which, according to Dr. DelBello, can stop or slow the progression of the curve, and in some cases, improve it. “The goal is to keep the scoliosis under control until the spinal fusion can be performed.”

But as Miguel grew and continued to be re-fitted for new braces, his curve grew, as well. This became concerning to Dr. DelBello, as advancing scoliosis can adversely impact overall health, by placing pressure on the rib cage and compromising lung function.

As Miguel’s condition worsened, so did his tolerance for the brace. Although he was accustomed to it since birth, according to Perez-Ramos, “when he got older, it got harder. Sometimes, when I went to adjust it in the middle of the night, I would find that he had taken his brace off.”

“It was hard for me to move around and to sleep,” remembers Miguel. “It was hard to go on rides in the car or on roller coasters.” With the brace no longer adequate, Miguel’s curve had to be brought under control. But at age 10, his skeleton had not matured enough, according to Dr. DelBello.

A stopgap measure was needed.

Enter growing rods. This treatment, in which rods are surgically attached to the spine above and below the curve, allows the spine to continue growing until the child is old enough for a spinal fusion. But traditional growing rods don’t come without their challenges. They require multiple surgeries that must be repeated approximately every six months to lengthen the rods, to keep pace with the child’s growth. “With all those operations comes anesthesia, painkillers, infection risk, missed days of school, recovery — the works,” recalls Perez-Ramos.

As it is said, timing can be everything. Just as preparations for the initial surgery were being finalized, the FDA approved a revolutionary, new, non-invasive procedure. MAGEC (MAGnetic Expansion Control) Spinal Growing Rods would save Miguel from the daunting series of multiple surgeries and hospital stays in the years ahead.

For his 10th birthday, Miguel’s parents surprised him with a trip he’d never been able to take before — a visit to Disney World. With Dr. DelBello’s okay, he abandoned his brace and enjoyed all the rides and activities he had long dreamed about. “We waited to tell him about the surgery until we got home, then took him in for surgery two days later,” recalls Perez-Ramos. “Dr. DelBello was wonderful, patiently explaining everything in detail. And everyone — the nurses, the anesthesiologist — was so comforting. When it was time for the surgery, on my way out of the room, I turned around and made eye contact with the doctor. He gave me a look that said, ‘I got this.’”

Following the initial, one-time surgical procedure to implant the adjustable rods, (which are fitted with tiny motorized magnets), rather than return to the operating room every six months to lengthen the rods, Miguel now visits Dr. DelBello’s office once every three months. Instead of enduring another invasive procedure, he simply hops onto the treatment table and has his rods lengthened about one-eighth of an inch via external magnetic remote control. About five minutes later, barely enough time for a catch-up conversation with the doctor he’s known since birth, he’s done and walks out of the office, pain-free, ready to resume his normal routine.

“Other than [playing] contact sports, like tackle football, kids with the MAGEC Rods can be outside playing normally, like any other child,” says DelBello of this innovative surgical procedure. “It’s now my go-to method, proving to be safe and effective with low complication rates. What used to be a trip to the operating room is now a few minutes in the office.”

Today, Miguel continues to walk tall, but without the bulkiness of a brace. “Now, it’s a lot easier to sleep and to move around,” he says. “It feels a lot better. I can play more sports and do more things with my friends.”

“It’s mind-boggling,” says Perez-Ramos. “Miguel has had to endure so much but is now the best he’s been.”

Pictured above: Every three months Miguel (here with his mom, Grace) visits Dr. DelBello’s office to have his rods lengthened via external magnetic remote control. 

Orthopedic Services at WMCHealth

Westchester Medical Center: 914.493.7000

MidHudson Regional Hospital: 845.483.5000

Good Samaritan Hospital: 845.368.5000

HealthAlliance of the Hudson Valley: 845.334.3130