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Neurological Surgery
Complex spinal deformity
Recent advances in spinal surgery have revolutionized care for children with spinal disorders and scoliosis. Many children, for example, can develop instability at the upper part of the spine (called the craniovertebral junction) either after trauma or secondary to genetic disorders like Down syndrome. It is critical to stabilize the spine in these children or devastating injury to the spinal cord can occur.
Traditional approaches have been to perform surgery using bone and wires and then bracing children in a halo for three to six months. A halo involves placing a ring around the child's head, which is secured with six to 10 screws directly into the skull, and then connecting it with four metal rods to a plastic shell around the chest. Even in the most experienced centers, the success rate for this surgery was only about 80 percent, there were many complications using the halo, and many children required repeated surgery.
Using newer, innovative techniques, we can now safely use rigid instrumentation to directly stabilize the spine without the need for a halo or other cumbersome postoperative bracing. Placing different types of screws into the bone and directly across the joint immediately stabilizes the damaged region of the spine. Children are able to resume normal activities much earlier than with traditional approaches, and without the discomfort and complications of invasive bracing. Studies have shown that these techniques can be used even in very young children without halting growth of the spine. Our pediatric neurosurgeons have more experience with these techniques than any other center in the Northeast. They have played a major role in advancing the field of spinal instrumentation at the craniovertebral junction in children, with success rates for the surgery approaching 100 percent.
