SURGICAL TECHNIQUECombining Bilateral Magnetically Controlled Implants Inserted Parallel to the Spine With Rib to Pelvis Fixation Surgical Technique and Early ResultsHell, Anna K. MD; Groenefeld, Katharina DDS; Tsaknakis, Konstantinos MD; Braunschweig, Lena PhD; Lorenz, Heiko M. MDAuthor Information Department of Trauma, Orthopaedic and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany Partly funded by a research grant for 10 SMA patients and the professional videotaping by NuVasive Specialized Orthopedics, Aliso Viejo, CA (formerly known as Ellipse Technology Inc., Irvine, CA). The authors declare no conflict of interest. Reprints: Anna K. Hell, MD, Department of Trauma, Orthopaedic and Plastic Surgery, University Medical Center Goettingen, Goettingen 37075, Germany (e-mail: email@example.com). Received May 24, 2017 Accepted November 20, 2017 Clinical Spine Surgery: July 2018 - Volume 31 - Issue 6 - p 239-246 doi: 10.1097/BSD.0000000000000614 Buy SDC Metrics Abstract Spine-based fixation of magnetically controlled lengthening devices has been successfully performed for children with early-onset scoliosis. However, spinal manipulation may lead to ossifications, stiffness, and autofusion as previously described. To avoid these problems, a surgical technique combining bilateral externally controlled magnetic device implantation with a rib cradle and pelvic hook fixation was introduced by us in 2011. By using a bilateral single-rib or double-rib cradle fixation and a pelvic hook, the magnetic device is percutaneously inserted. The spine corrects indirectly without further manipulation. In small rib diameter or severe osteoporosis, double-rib cradles are used. Our introduced technique enables modification of the rib vertebral angle, which may be beneficial in children with spinal muscular atrophy and rib-cage deformity. This nonrandomized prospective study describes 18 children with neuromuscular scoliosis treated first by this method. All patients followed the same protocol, with expansion procedures being performed 5 months after surgery and every 3 months thereafter. Clinical, radiologic, and complication data were analyzed, showing a significant reduction in scoliosis and pelvic obliquity and an increase in spinal length, which could be maintained over a follow-up period of 1.2 years. The overall complication rate was lower than previously described, with 8%, 2 of them requiring surgery. © 2018 by Lippincott Williams & Wilkins, Inc.