Our Pediatric Spine Services

It can be difficult to know where to start when your child has back pain or a spine-related condition that may require seeing several specialists. Our Pediatric Spine Center offers integrated, individualized care from multiple specialists through one point of entry. When you contact our center, we will direct you to the right starting point, which may be neurosurgery, orthopedic surgery, pain management, physical therapy, or a combination of all four specialists.

Imaging and diagnostic services

Our EOS low-dose imaging system—the only one of its kind exclusively for kids in the Bay Area—produces 3-D images to help with both diagnosis and treatment, with radiation exposure that is 1/50th that of a traditional x-ray. It’s especially effective in evaluating children with scoliosis.

Planning your child’s care from multiple angles

We designed our center with the purpose of enabling a collaborative approach to care among experts in different areas. This allows for a more holistic view of your child’s care, rather than using the lens of just one kind of specialist. Our neurosurgery, orthopedic surgery, and pain team members meet regularly to discuss patients’ care plans.

Nonsurgical treatment

Our spinal care approach centers on nonoperative treatment whenever possible, and avoiding surgery is our goal for most conditions. Nonsurgical approaches include:

Bracing. Our center partners with the Align Clinic for a fully customized approach to scoliosis bracing. This company is the only certified maker of Rigo-Cheneau braces in the Western United States. These braces help to de-rotate the spine, which allows for 3-D correction, as opposed to the traditional 2-D Boston brace. Having an on-site orthotist in our Palo Alto and Emeryville locations means better collaboration with our orthopedic surgeons to ensure that the bracing plan is as effective as possible.

We can use brace monitor technology that reports time wearing the bracing, and we use these measurements to follow how children are doing with compliance.

Physical therapy. We are the only children’s hospital in the Bay Area to offer the Schroth physical therapy method for children with scoliosis or kyphosis. Our Schroth therapists can work with your child during weekly sessions on postural training, back and abdomen strengthening, and breathing exercises.

Traditional physical therapy to help strengthen the core is also an important part of treatment for many children. It’s often the main treatment for children with back pain.

Surgical treatment

If surgical treatment is the right option for your child, you’ll be happy to know we have the expertise and technology to give your child the best possible outcome.

• We use minimally invasive surgery whenever possible.
• We are one of the few pediatric centers to use robotic neuronavigation with intraoperative CT scanning to help guide doctors in real time during surgical procedures.
• We also have an intraoperative MRI, which is especially important for spine tumor surgery.
• We have experienced operating room teams dedicated to caring just for spine patients.
• Lucile Packard Children’s Hospital Stanford is one of only six children’s hospitals in the world to use Surgical Theater Neurosurgeons use this 3-D virtual reality simulation platform to plan and practice a surgery, and our patients can even use it to better understand their treatment. We often use 3-D printing as well to simulate the surgery in advance to achieve the best possible outcomes.

Pain management

Many of our patients are dealing with significant pain when they come to see us, including children and teens with spine disease, spinal deformities, tumors, spine injuries, connective tissue diseases, spina bifida, syringomyelia, and tethered cord. Pain is also often a problem after surgery, and it can last days, weeks, or months. That’s why we have a comprehensive, proactive approach to addressing pain and symptoms.

Non-pharmacological pain management

With conditions such as scoliosis and back pain, we may begin treatment with osteopathy. The practice treats the body as a whole, including emotional, spiritual, and physical well-being. By manipulating the spine and the myofascial layers of the body, the osteopathic physician works to adjust the autonomic nervous system and release pain Stanford Medicine Children’s Health has the only osteopathic physician in the country who focuses on pediatric pain. They see patients before or after surgery, or if a child doesn’t need surgery but has chronic pain.

Whether or not your child needs surgery, we start with an assessment of their needs to uncover their concerns. This may include fear or anxiety about surgery or dealing with symptoms. We incorporate nonpharmacological methods into a plan for your child to follow that may include integrative techniques:

• Reducing stress. For many children, pain is worse when they’re stressed. Your child can learn ways to reduce stress, such as breathing techniques, imagery, progressive muscle relaxation, body scanning, mindfulness meditation, yoga, and clinical hypnosis.
• Biofeedback. This technique is used to control the body’s response and to gain better awareness of its functions.

Pharmacological and surgical pain management

If pharmacological pain management is the best option for your child, or if your child needs surgery, we offer several pain management options:

• Our team has the skill to provide nerve blocks in the spine, nerve root blocks, and epidural injections.
• We perform minimally invasive spine procedures by injecting steroids to address pain.
• We believe that opioids are valuable for treatment of severe pain in some children. But we also know that pain in most children can be managed well without opioids, using several nonopioid medications together.