Spinal conditions in children

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While back pain is something many of us live with daily, it’s uncommon for children to experience it. If your child has symptoms of back or pediatric spine disorders, the spine experts at Advocate Children’s Hospital can help.

We offer the latest treatments, including nonsurgical and surgical options for even the most complex spinal conditions. From congenital conditions present at birth to sports injuries, our team can help your child feel better.

What are spinal conditions?

The spine includes the spinal cord, which connects the brain to the rest of the body through nerves. Vertebrae (back bones) make up the spinal column, surrounding and protecting the spinal cord. Spongy discs made of cartilage serve as shock absorbers between the vertebrae.

Spinal conditions can affect any of these parts and include congenital disorders, conditions that develop later in life and injuries.

Types of spinal conditions in children

Back and spine conditions in children are rare, and the problems children can have are different than those in adults. In younger children especially, back pain can indicate a more serious condition. Back pain in older children and teens often results from sports injuries.

Chiari malformation
Spina bifida
Spinal disorders related to cerebral palsy
Tethered spinal cord
Other defects of the neural tube, which develops into the brain and spine in the womb

Scoliosis, including congenital scoliosis, early onset scoliosis, idiopathic scoliosis and neuromuscular scoliosis
Kyphosis
Lordosis

Spinal cord injuries
Spinal trauma and fracture
Spine and back pain
Sports-related spine and back injuries
Spondylolysis and spondylolisthesis

What causes spinal conditions in children?

The causes of spinal conditions in children vary depending on the condition or injury. Often, the causes are unknown. Some common causes include:

Diseases such as infections and tumors
Injury or trauma from sports or vehicle accidents
Problems during development in the womb

Symptoms of spinal conditions in children

Signs and symptoms of pediatric spinal conditions vary widely and depend on the underlying cause. You may notice some of these signs in your child, or your child might tell you what they’re feeling.

Some symptoms that occur with many spinal conditions include:

Abnormal gait (walking pattern)
Bowel and bladder problems
Difficulty with balance, walking or other movement
Pain that feels sharp or dull, constant or shooting
Pain in parts of the body connected to a specific area of the spinal cord
Tremor (shaking) or spasticity (uncontrollable muscle contractions)
Weakness, numbness or tingling in legs or arms

Spinal conditions diagnosis in children

A neurosurgeon or a specialist from our neurology program asks about your child’s symptoms and personal and family medical history. The doctor then completes exams – a physical exam and possibly also a neurological exam, depending on symptoms. Find out more about what to expect during your visit, including the details of a neurological exam.

Our specialists often order imaging and tests to help confirm a diagnosis. We offer leading-edge diagnostic imaging, including:

Computed tomography (CT): A CT scan takes X-rays from multiple angles to create 3D images of the spine and spinal cord.
Magnetic resonance imaging (MRI): MRI uses powerful magnets and radio waves to create detailed images of the spine and spinal cord. We offer fast MRI, with technology that corrects for movement so your child doesn’t need anesthesia.
Myleogram: We take X-rays or CT scans of the spinal canal after injecting a contrast material into the spinal column. The contrast highlights issues in the spinal cord or nerves.
Ultrasound: We produce images of the spine and brain using sound waves (transcranial Doppler).
X-ray: Small doses of targeted radiation produce images of bones and some tissues.
EOS™ imaging system: Detailed 3D images are created using ultra-low doses of radiation.

Some painless tests and procedures we use include:

Evoked potential (EP) tests: These tests measure electrical activity in the brain and spinal cord to show how fast signals move through nerves. EP tests can find damage along nerve pathways that a neurological exam or MRI can’t detect.
Nerve conduction velocity (NCV) study: We place electrodes on your child’s arm or leg to send a mild electrical current through the nerves in a muscle. (The current is similar to a static electricity charge.) Doing so shows how fast the electrical signal traveled through nerves.

Sometimes, we need to use slightly more invasive tests, such as:

Biopsy: The doctor takes a small sample of tissue through an incision or a needle. We examine the tissue under a microscope for signs of disease or infection.
Blood tests: We use a thin needle in your child’s arm to take a small sample of blood. Blood tests can show blood cell counts, signs of infection and disease, and levels of enzymes and other substances.
Electromyogram (EMG): We insert a thin needle electrode, about the size of those used in acupuncture, into one of your child’s muscles. The doctor asks your child to move and then relax the muscle while the needle records its electrical activity. The needle only measures and does not send electrical current.
Genetic testing: Many conditions, such as muscular dystrophy and neurofibromatosis, involve genetic factors. We refer you to a genetic counselor for testing that can identify gene mutations related to specific diseases. Read more about our genetics program.
Lumbar puncture: We take a small sample of cerebrospinal fluid surrounding the brain and spinal cord. We look for signs of disease, infection and other issues.

Customized plans for spinal conditions in children

Once we confirm a diagnosis, our neurology and neurosurgery teams develop a treatment plan tailored to your child’s needs. Our pediatric specialists bring expertise from several fields of medicine, providing a wide range of nonsurgical and surgical treatments.

Nonsurgical treatments for spinal conditions

Medications, assistive devices and physical rehabilitation may provide all the help your child needs to treat a spinal condition. We may also prescribe these treatments in combination with surgery, depending on the particular condition and your child’s symptoms. Options include:

Monitoring: If symptoms are mild, your child may not need active treatment. We can see them regularly for imaging and other tests to check their health.
Medications: Corticosteroids and pain medications are two of the many medications that can help children with spinal conditions.
Assistive devices: Mobility aids such as canes and walkers provide support and help with flexibility and mobility.
Inpatient and outpatient rehabilitation: We may refer your child to our rehabilitation and development team for physical and occupational therapy. Our skilled therapists guide your child through exercises to improve strength, flexibility and skills needed for everyday life. We also offer specialized physical therapy for scoliosis using the Schroth method.
Orthotics: Dedicated team members create custom braces and use serial casting to manage spine curves in scoliosis and other conditions. For infants, we offer the Mehta technique for serial casts to successfully treat scoliosis and delay the need for surgery.

Surgery for spinal conditions

If your child needs additional treatment for a spinal condition, board-certified specialists in our neurosurgery program offer expertise in the latest techniques. As needed, we work with board-certified surgeons in our orthopedics program to coordinate your child’s care.

Our approach focuses on your child’s age and level of physical development, with treatment plans that support their growth. Using techniques that minimize the need for anesthesia or radiation in imaging, we’re dedicated to helping your child thrive.

Our neurosurgeons have exceptional experience using minimally invasive and open surgical techniques in procedures such as:

Decompression: Surgeons remove bone, a blood clot, a disc or other soft tissues that are pressing on spinal nerves or the spinal cord.
Detethering: We cut away connective tissue that is holding a tethered spinal cord in place against the spinal column. Detethering allows the spinal cord to move freely inside the spinal canal as the child grows.
Endoscopy: Our surgeons are experts in techniques that require only a few small incisions to access the spine. The surgeon uses a scope (thin tube with a camera and light) and miniaturized instruments to treat the affected area.
Fusion: Our surgeons stabilize vertebrae damaged by injury or disease using implanted titanium rods or screws to hold them together.
Repair: We offer many procedures to repair a wide range of spinal conditions, including scoliosis, spina bifida and tethered spinal cord. Our neurosurgeons have expertise repairing severe spina bifida (myelomeningocele) in the womb, a treatment not many programs offer. We partner with the Center for Fetal Care at Advocate Children’s Hospital for these surgeries.

We offer some of the newest procedures to treat spine curvature disorders. These treatments can delay or even avoid the need for spinal fusion surgery as your child gets older. They include:

Remotely adjustable growth rods: Our surgeons implant growth rods that they can adjust without repeated surgeries. As your child gets bigger, we use magnetic devices to adjust the growth rods through the skin.
Vertebral tethering: This technique, federally approved in 2019, helps straighten a curved spine while allowing for movement and growth. In an endoscopic procedure, we use screws to attach a flexible cord to vertebrae. Pressure from the cord slows growth on the outside of the curve while allowing the other side to develop. Tethering allows your child more flexibility and mobility for sports and play than spinal fusion.
Vertebral stapling: Similar to the tethering technique, staples hold the outside curve of vertebrae in place. As the child grows, the inside curve grows, gradually straightening the curve. Stapling also allows the child more movement.