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Spine Surgery and Scoliosis Care

Spine Surgery and Scoliosis Care

patient on bicycle

The orthopaedists and orthopaedic surgeons at Shriners Hospitals for Children — Northern California treat spine conditions of all degrees – from common idiopathic adolescent scoliosis to the most complex spine deformities, spinal fractures and tumors.

We believe each child deserves an individualized treatment plan using the most advanced spine care techniques. Our focus is on early detection and fusionless treatments for the growing spine, as well as minimally invasive to advanced surgical techniques in children who require spinal fusions.

Our medical team responds to the individual needs of each patient and works to achieve the best possible outcomes through leading-edge clinical care, therapy and research. Our EOS imaging system helps us to provide high-quality care while reducing exposure to radiation for our patients.

Conditions treated

    • Idiopathic scoliosis, including infantile, juvenile and adolescent
    • Congenital scoliosis
    • Scoliosis with syndromes including:
      • VACTERL
      • Marfan
      • Neurofibromatosis
      • Klippel-Feil syndrome
      • Thoracic insufficiency syndrome and other rib cage impairments
    • Torticollis
    • Cervical instability
    • Abnormal posture
    • Neuromuscular scoliosis associated with:
      • Spinal cord injury
      • Cerebral palsy
      • Spina bifida
      • Tethered spinal cord
    • Kyphosis, including Scheuermann’s
    • Spondylosis and spondylolisthesis
    • Curve progression after spine surgery
    • Hemivertebrae with fused or absent ribs
    • Scoliosis after thoracotomy

Schedule an Appointment

Shriners Hospitals for Children — Northern California

Phone: 916-453-2191
Email: referrals.ncal@shrinenet.org

All care is provided regardless of a
family’s ability to pay.

Nonsurgical treatment options

Shriners Hospitals for Children — Northern California offers a multidisciplinary team that specializes in the diagnosis, management and treatment of all pediatric and adolescent spine conditions. We treat newborn patients through 17 years of age. Our team seeks to reduce the need for surgical intervention and offers the following non-surgical options for qualified patients.

Bracing

Non-operative treatment for idiopathic scoliosis:

  • May be combined with prescribed scoliosis specific exercise
  • Can be effective in stopping the progression of the curve
  • Schedule and type of brace will depend on the location and degree of curve
  • Compliance with wearing the brace is vital to the success of bracing treatment
Serial casting

For infantile scoliosis when the curve is progressive:

  • Requires cast changes under anesthesia every two to three months
  • Casting straightens the spine through the continuous application of external force
  • Casting is an option versus bracing for improved compliance

Surgical treatment options

Not every child will need surgical intervention. When surgery is the best option, our renowned orthopaedic specialists are on the forefront of the latest research and have a wealth of experience. Our physicians are accomplished in the following surgical treatments:

Fusionless surgery

Innovative treatment options for children with scoliosis:

  • Anterior vertebral body tethering (AVBT) – AVBT is a minimally invasive procedure that produces stabilization for the anterior thoracic and lumbar spine and avoids spinal fusion. Using bone screws and a flexible cord, the spine curve is gently straightened during surgery. Additional correction occurs as the spine is allowed to grow. This device is currently FDA approved for this indication but long-term data is lacking. Our results to date appear promising.
Growing systems

Expandable devices used in growing children with scoliosis:

  • Vertical expandable prosthetic titanium rib (VEPTR or titanium rib) – This is a titanium rod curved to fit the back of the chest and spine, and is designed to primarily be used for growing children with a chest wall deformity and thoracic insufficiency, helping to correct spinal deformity and allow for the development of the chest and lungs.
  • Growing rods – Growing rods allow for continued and controlled spine growth. This is performed as a surgical procedure through the back where the rods are attached to the spine both above and below the curves with screws. The growing rods will need to be lengthened under anesthesia every four to six months, depending on the advancement of the curvature of the spine.
  • MAGnetic expansion control (MAGEC) spinal bracing and distraction system – MAGEC rods are for younger children with curves less than 50 degrees. With MAGEC rods, a surgical procedure for implantation is required, but the noninvasive lengthening procedure eliminates the need for repeated lengthening surgeries. The MAGEC System is composed of two magnetic, telescoping rods that can be gradually lengthened from outside the skin after initial implantation. This procedure uses an external remote controller in the outpatient department.
Spinal fusion surgery

Spinal fusion surgery is recommended to correct a curve or stop it from progressing when the patient is still growing and has a curve that is greater than 50 degrees. Rods and screws are attached to the curved part of the backbone and the spine is straightened. Small pieces of bone graft are then put over the spine; this will grow together with the spinal bone, fusing it into the proper position. In addition to improved internal fixation, posterior spinal fusion allows earlier mobilization of the patient. A spinal fusion also helps prevent severe deformity and can avoid years of bracing.

Collaborative approach to care

Patients benefit from the expertise of a multidisciplinary team of professionals that includes:

  • Orthopaedists
  • Orthopaedic surgeons
  • Pediatric physiatrists
  • Pediatric anesthesiologists
  • Pediatric intensive care specialists
  • Nurses
  • Physical therapists
  • Respiratory therapists
  • Orthotists

Throughout Shriners Hospitals for Children — Northern California, professionals work collaboratively to provide patients and parents with easy access to care. Orthotists custom design and fabricate braces on-site. Physical therapists work side by side with doctors. The entire team embraces a family-centered approach to care that distinguishes the Pediatric Spine Center at Shriners Hospitals for Children — Northern California from any other hospital system.

Advancing care with spine research

Shriners Hospital for Children — Northern California has a multidisciplinary team on our orthopaedic clinical research program. Our pediatric spine surgeons are the principal investigators on several studies, focused on improving pediatric spine care. The multidisciplinary team works in concert to conduct orthopaedic clinical research. The team includes:

  • Physicians
  • Psychologists
  • Nurses
  • Therapists
  • Bio-mechanical engineers
  • Clinical research professionals

The medical team

Medical staff
Rolando F. Roberto, M.D., Orthopaedic Spine Surgeon
Eric O. Klineberg, M.D., Orthopaedic Spine Surgeon
Yashar Javidan, M.D., Pediatric Orthopaedic Surgeon
Joel Lerman, M.D., Pediatric Orthopaedic Surgeon
Debra Templeton, M.D., Pediatric Orthopaedic Surgeon

Physician assistants
Prarthana Mysore, PA
Melina McCahon, PA

Nursing staff
Leanne Wong, RN, BSN, Case Manager
Tessy Awa, PNP
Kou Her, LVN
Erica Macias, LVN

Social worker
Janis Tokunaga, LCSW

Outpatient clinic scheduler
Monika Wilde, MA

Physical therapists
Sandy Reina-Guerra, PT, D.P.T., PCS

Pediatric orthotics and prosthetics (POPS) department
Michael Wadekamper