Complex Cervical Spine Program

Care for infants, children, and young adults with complex cervical spine disorders

The Complex Cervical Spine Program at Boston Children’s Hospital provides highly specialized care for infants, children, and young adults with rare and severe cervical spine disorders. These conditions can affect spinal alignment and stability, placing the spinal cord at risk. Many patients have uncommon or complex conditions that require individualized treatment, as no standardized care protocols exist.

Established in 1998, the program was the first of its kind and remains the largest in the United States. It is nationally recognized for caring for children with the most complex cervical spine disorders, including those associated with skeletal dysplasia and multisystem disease. Our team collaborates with pediatric spine centers nationwide on research and clinical innovation to advance care for these rare conditions.

Why choose Boston Children’s Complex Cervical Spine Program?

We have extensive experience treating cervical spine conditions caused by a wide range of congenital, genetic, and acquired disorders, including:

Many of these conditions affect how the bones of the neck form, move, and protect the spinal cord. Some children have complex anatomy, fragile bones, or pressure on the spinal cord, requiring especially careful evaluation and individualized treatment.

A fall from a swing uncovers a rare cervical spine condition: Charlotte’s story

If it were any other year, Charlotte Gillis would have celebrated her 10th birthday in mid-July with a big party. But in June 2024, a fall from a swing had left her temporarily paralyzed. Though her…

In cases of pediatric cervical spine instability, two attending surgeons are better than one

Cervical spine instability (caused by congenital deformity, trauma, or a tumor) can affect children in a number of ways: from chronic headaches to bowel dysfunction to severe mobility limitations. In…

Generations of excellence in surgical care: Dr. Emans and Dr. Hogue

Some surgeons follow their patients for years, even decades. This is true of Dr. John Emans, who has treated patients with complex spine conditions at Boston Children’s Hospital for more than 40…

View all

Team-based, coordinated spine care

The Complex Cervical Spine Program brings together experts from Boston Children’s Spine Division and Department of Neurosurgery to provide coordinated care from the very first visit. Each child is evaluated by both a pediatric orthopedic spine surgeon and a pediatric neurosurgeon. This team-based approach ensures thorough assessment, precise surgical planning, and continuity of care as a child grows, addressing spinal alignment, stability, and spinal cord protection.

A multidisciplinary team with expertise

Children with complex cervical spine disorders often have medical needs that extend beyond the spine. To address these needs, the Complex Cervical Spine Program is centered on a dedicated multidisciplinary team that includes:

Neurosurgeons specializing in disorders of the spine and spinal cord
Orthopedic surgeons specializing in the full range of spinal deformities
Complex care specialists who coordinate care before and after surgery and serve as a single point of contact for families
Neuroradiologists skilled in diagnosing disorders of the brain, skull, and spine
Radiologists specializing in advanced imaging technologies
Anesthesiologists trained to minimize pain and anxiety in children undergoing procedures
Physical medicine and rehabilitation specialists focused on function and independence

Because many patients also have conditions that also affect their heart, lungs, digestive tract, or other systems, we coordinate closely with specialists across Boston Children’s, including teams in genetics, cardiology, and pulmonology, and others to provide fully integrated care.

Personalized treatment planning

When developing a treatment plan, we meet with families to review appropriate options and discuss the potential risks and benefits of each approach. Care is tailored to each child’s needs and family preferences and may include close monitoring, non-surgical treatments, or surgery.

Surgical safety for complex cervical spine procedures

Spinal fusion can correct many cervical spine deformities, but it can be especially challenging in children with small anatomy or fragile bones. Our dual-surgeon approach pairs pediatric orthopedic and neurosurgery expertise to enhance surgical planning and maximize precision and safety.