Pediatric Spine Specialists

Children’s Healthcare of Atlanta is a leader in pediatric spine care. More kids, teens and young adults come to us for spinal fusion surgery than any other pediatric hospital in the country.* We not only rank among the best pediatric hospitals in the country for orthopedics, but we are also the only nationally ranked pediatric orthopedics program in Georgia.**

What Causes Spine Problems in Kids and Teens?

The spine withstands a lot of stress each day, making it a common site for an overuse injury, especially in growing children. It is composed of seven cervical vertebrae, 12 thoracic vertebrae, five lumbar vertebrae, five sacral vertebrae and four fused coccyx vertebrae. Our team of pediatric spine specialists at Children’s Healthcare of Atlanta understands how each of those vertebrae can change as your child or teen grows or if your child or teen is injured.

Spine problems in children can present at birth (known as congenital spine problems), develop over time as your child or teen grows or be caused by an injury, such as a muscle strain from physical activity or improper weight lifting. Curvature of the spine (scoliosis) can occur in otherwise healthy children for no apparent reason, although the tendency can run in the family. Heavy backpacks can also be a source of back pain, as suggested weight limits are no more than 15% of a child or teen's body weight.

If an issue arises or back pain continues in your child or teen, we recommend they be treated by someone who is specially trained in caring for the pediatric spine. At Children’s, our experts help care for, diagnose and treat spine problems in children of all ages, from 0 to 21.

Common pediatric spine conditions and injuries may include:

  • Scoliosis, a lateral, or sideways curvature of the spine greater than 10 degrees. Scoliosis can occur in otherwise healthy children of all ages. It can also be associated with neuromuscular conditions such as spina bifida, cerebral palsy, spinal muscular atrophy and muscular dystrophy. In addition, some curves are caused by syndromes such as Down’s syndrome and congenital malformations of the spine.
  • Kyphosis, rounding of the upper back, or a hunched back
  • Spondyloysis, stress fractures
  • Spondylolisthesis, slipped vertebrae
  • Trauma, including spinal fractures and post-traumatic spine problems
  • Tumors and infections in the bone, such as aneurysmal bone cysts, osteoblastoma, histiocytosis, malignant tumors and osteomyelitis
  • Vertebrae (disk) problems, including degenerated disc disease, herniated discs or disc disorders
  • Deformities of the spine and chest associated with other conditions, such as Prader-Willi syndrome, Jeune syndrome, congenital rib fusions, Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Rett syndrome, Freidrich’s ataxia, osteogenesis imperfecta, and achondroplasia

How Do Doctors Diagnose Spine Problems?

Our spine specialists treats thousands of growing spines each year, so we understand what symptoms to look for and how to diagnose babies, kids and teens.

We work closely with other pediatric specialists to review diagnostic tests that may include:

Our pediatric radiologists receive advanced training, as well as follow guidelines and protocols like dose-reducing technology that allows us to cut CT and X-ray radiation exposure by more than 50% compared to adult facilities.


What Are Treatments for Spine Problems?

Our spine team is specially trained to develop treatment plans for children and teens of all ages, and monitor patients over time so they have better results as they continue growing.

Treatment options for pediatric spine conditions and injuries may include:

Spine bracing

Spine bracing is used to help prevent curves in the spine from getting larger as your child grows. Generally, curves less than 20 degrees don’t require treatment, since most do not worsen, but children whose curve is larger than 20 degrees are candidates for either part-time bracing (approximately 16 hours a day), or night bracing. Braces do not make curves go away, but may prevent the curve in your child’s spine from worsening.

For some children, bracing may not be the best treatment. This may be because of your child’s spine curve type, stiffness, remaining growth, other medical problems or previous surgeries. These are each considered to help our specialists determine which treatment is best for your child’s spine.

Spine surgery

If your child, teen or young adult needs surgery, our doctors are on the forefront of spine surgery innovations. We treat more spine patients than any other program of its kind in the country. Our dedicated surgical team sets the standard for quality and safety in pediatric spine surgery. To coordinate care, we utilize clinical practice guidelines that dictate a high standard of care and help our patients get back to being kids more quickly. Our surgical team includes surgeons, anesthesiologists, nurses and operating room techs, each with a dedicated role to safeguarding the patient journey.

Children’s has some of the best spine surgery results in the nation. Our team continuously refines the surgical processes, including before, during and after surgery. Compared to other pediatric hospitals, our patients:

  • Are in great company: Children’s performs more spine surgeries than any other pediatric hospital in the U.S.*
  • Recover more quickly: Our team works diligently to help make sure patients can go home as soon as possible after surgery. In fact, Children’s has a shorter average length of stay for spine procedures than most children’s hospitals in the country.*
  • Experience fewer complications: Children’s spine patients report fewer problems following surgery and fewer emergency department visits while recovering from surgery.*

What types of spine surgery are there?

The type of spine surgery recommended for your child or teen depends on several things, including their unique condition, previous treatments and whether they have a lot of growth still remaining. Larger curves (greater than 40 degrees) in younger children can be challenging to manage.

For pre-adolescent children (generally under 10 years old), surgical treatment options may include:

  • Serial casting: A special technique that does not require an incision but does require anesthesia to apply a cast called EDF is used to slowly reduce the size of the curve in your child’s spine over several months. This is usually an outpatient procedure. EDF casting can result in complete correction of the curve, or at least allow for bracing of a smaller curve.
  • Growing rods: Magnetically controlled rods (MAGEC rods) are mechanical lengthening rods help correct the curve and control worsening of a curved spine in children who have significant growth remaining.
  • Vertical expandable prosthetic titanium rib (VEPTR): This is for children with severe chest deformities and spinal curves, and helps expand and support the chest wall so that a child can breathe. Children’s is one of only a handful of pediatric hospitals in the U.S. with extended experience using this device.

For adolescent children (generally older than 10 and up to 21), surgical treatment options may include:

  • Spinal fusion surgery: A spine specialist fuses, or joins, some of the bones in the spine together using spinal rods to permanently correct and prevent a spinal curve from getting worse. This procedure may be recommended for children with curves larger than 45 degrees.
  • Vertebral body tethering: This evolving technique is designed to correct the curvature in a child’s spine by performing a procedure that helps direct the remaining growth of their spine without having to fuse the vertebrae. This procedure is typically reserved for children with significant growth remaining. 

The spine specialists at Children’s are leaders in using several types of computer-assisted spine devices. These technologies can help add precision to a child or teen’s surgery, and include 3D navigation and spinal robotics that allow for pre-operative views of the spine so that our team can be aware of any potential challenges before surgery. The surgeon also uses a robotic arm to guide them during the procedure. In addition, Children’s was the first pediatric facility in the U.S. to clinically advance the Mazor robotic system for children and teens, and with significant experience, we continue to remain at the forefront of this advanced technology.

Meet Our Spine Specialists

The Spine Program at Children’s is led by Dennis P. Devito, MD, Medical Director, and Nicholas D. Fletcher, MD, Medical Director of Quality and Outcomes.

Children's Physician Group–Orthopaedics and Sports Medicine

Orthopedic surgeons:

Our orthotics and prosthetics specialists apply the latest advances in technology for children and teens who need an orthosis, or brace, to support or correct a condition of the bones or muscles like scoliosis.

Members of the Children’s Orthopedics Program, which is consistently ranked among the best children’s hospitals in the country by U.S. News & World Report,** collaborate on patient care. We work closely with specialists from across the country and around the world to help establish best practices for pediatric spine care, and we are on the forefront of advanced technologies.

Our orthopedic surgeons are actively involved in more than 35 research studies to help further pediatric spine care. These projects include several that are looking at the results of our post-operative care pathways in both children with idiopathic scoliosis and those with special needs, such as cerebral palsy. These pathways have been shown to help decrease how long patients are staying in the hospital, while also improving post-operative pain management and when your child or teen can return to school.

We are also looking at how to continue to improve safety, outcomes and patient satisfaction during a patient’s stay in our hospitals for scoliosis surgery. Other projects focus on nonsurgical ways to manage scoliosis, such as bracing, newer technologies like Vertebral Body Tethering (VBT) and maximizing safety during spine surgery.

Make an appointm​ent with Children’s Physician Group–Orthopedics and Sports Medicine

Support for Spine Patients and Parents

We want our patients and families to have the best possible experience during their spine surgery journey.

Concierge services

Our dedicated concierge team includes a spine liaison who helps coordinate a patient’s experience by providing complete follow-up care and helping make sure families have the information and resources they need before, during and after care. The spine liaison also serves as a single point of contact for your child and their primary care provider.

The spine liaison will help coordinate care by:

  • Providing information about lodging and key contacts for those who live outside metro Atlanta, as well as travel accommodations to Atlanta and transportation while in Atlanta.
  • Helping families navigate the hospitals and escorting them as needed.
  • Assisting with the hospital intake process and clinic visits.
  • Writing treatment plans for your child or teen’s referring provider.
  • Assisting in arranging the use of durable medical equipment after your child or teen is released from the hospital.
  • Coordinating interpretation services.
  • Coordinating financial planning with insurance companies.
  • Following up with you after your child or teen’s procedure or visit.
  • Communicating and coordinating requests for your child or teen’s referring provider.

Contact concierge services at 404-785-1849 or spineconciergeservices@choa.org.

Is there a Facebook group for scoliosis families?

Children's created a private Facebook group so our scoliosis families can better communicate with each other—and us. This page offers forums for asking questions, sharing tips and celebrating milestones with other spine patient families.

Learn more about our private Facebook group

*Pediatric Health Information System (2018), as prepared by the Children’s Hospital Association. This report compares clinical data annually for more than 52 pediatric hospitals in the U.S.

**No. 10 on the U.S. News & World Report "Best Children's Hospitals" list for 2020-21