Whether a congenital birth defect, scoliosis or tumor, spine conditions are complex and require nuanced expertise to ensure healthy growth throughout childhood and beyond. For more than 35 years, pediatric orthopedic spine surgeons at Nicklaus Children’s Center for Spinal Disorders, part of the Orthopedic, Sports Medicine and Spine Institute, have pioneered new treatments and surgical techniques and developed best-practice guidelines to help children with these unique disorders.

“Our surgeons specialize exclusively in pediatric spine procedures,” says Subaraman Ramchandran, MD, attending pediatric orthopedic spine surgeon and Director of Spine Research at Nicklaus Children’s. “We have a history of developing leading-edge surgical techniques, equipping us to treat even the rarest conditions.”

Offering Multidisciplinary Depth and Breadth

Physicians at the Center for Spinal Disorders treat a wide range of conditions and injuries.

“I think our depth and breadth of treatment set us apart,” says Stephen G. George, MD, Medical Director of Spinal Surgery at Nicklaus Children’s. “In addition to having a high-volume program treating common conditions, we also manage extremely rare problems due to our large catchment area, serving not only South Florida but regional and international patients as well.”

Multidisciplinary care is a core aspect of the program and a key contributor to its ongoing success, especially considering the complex, and individualized needs that these patients may require, according to Dr. George.
The spinal team frequently teams up with physicians in other departments, including:

• Cardiology
• Gastroenterology
• General orthopedics
• Hematology
• Neurosurgery
• Neurology
• General pediatric surgery
• Oncology
• Plastic surgery
• Pulmonology

Advanced Imaging With Less Radiation

The Center for Spinal Disorders offers EOS imaging, which produces two- and three-dimensional stereoradiographic images that provide a whole-body picture with about a tenth of the radiation of a conventional X-ray.

“Children with spinal deformities routinely undergo numerous X-rays throughout their lives,” Dr. Ramchandran says. “It’s significant to be able to reduce their radiation exposure.”

However, EOS imaging provides more than enhanced quality at lower radiation doses.

“Because of the way the EOS system acquires the image, it also allows us to create 3D models of the spine, which has revolutionized the way we’re able to understand scoliosis,” Dr. George says. “Furthermore, it helps us to stratify the types of deformities and better tailor treatment in a more sophisticated and evidence-based manner.”

Going Beyond Standard Treatments

Scoliosis in children is not uncommon. Most children with the condition will not need surgery, but for those who do, the resources at the Center for Spinal Disorders provide options other hospitals cannot.

“I had a patient who, by age 5, had such a severe debilitating scoliotic curve that other hospitals had declined to treat her,” Dr. George says. “When I met with her parents to discuss treatment options, it was the first time they heard there was a possibility that their daughter could eventually have a normal life.”

The Center for Spinal Disorders uses both growth-friendly techniques and fusion techniques to treat scoliosis and other conditions.

“We offer a wide array of treatment options,” Dr. Ramchandran says. “Beyond spinal fusion, we offer magnetically controlled growing rod instrumentation that helps us to let the spine grow in a very young child but at the same time control its growth over time.”

In addition to scoliosis procedures, the pediatric orthopedic team routinely treat conditions such as:

• Disc herniations
• Spinal trauma
• Spinal tumors
• Spondylolysis and spondylolisthesis

Advancing Research

The Center for Spinal Disorders team participates in wide-ranging research efforts to improve knowledge about and care for pediatric spinal conditions.

“We are currently enrolling patients for multiple international and national spine study registries, including the Harms Study Group, the Fox Study Group and Pediatric Spine Study Group,” Dr. Ramchandran says. “We also involve interested students and research fellows from the University of Miami and Florida International University to conduct high-quality, investigator-initiated studies.”

One ongoing trial involves the use of a long-acting local anesthetic, bupivacaine, for optimizing postoperative pain control and lowering the length of hospital stays. Another involves understanding the 3D anatomy of spinal deformity to help tailor and personalize surgical intervention.

“Research is something we pride ourselves on,” Dr. George says. “We are fortunate to be able to collaborate with other experts in the field.”

Comprehensive Care for All

In addition to delivering expertise and high volume of care, the Center for Spinal Disorders team works to ensure a child’s needs are met throughout their care journey.

“Beyond surgical care, we have excellent nursing care, inpatient care and an experienced support staff,” Dr. Ramchandran says. “We also have a very qualified neuromonitoring team that monitors the spinal cord and the nerve roots during every spinal fusion procedure to help detect and minimize any risk of spinal cord changes during spinal manipulation.”

Compassionate, personalized care extends beyond surgery and aftercare to other treatment modalities.
“We refuse to settle for conventional treatments — we continue to innovate and are part of industry-changing research,” Dr. George says. “We know our job is not only to offer the best treatments today, but also to be part of and create the best treatments of tomorrow, because we believe that is what all of our patients deserve.”

Learn more and contact the Nicklaus Children’s Center for Spinal Disorders by emailing our physician liaison.