Like every medical procedure, any form of pediatric spinal cord surgery carries an inherent risk of complications. But while post-op issues are sometimes unavoidable, all too often, paralysis and other serious injuries occur because a surgeon, anesthesiologist, neuromonitor, or other medical professional acted negligently and failed to meet accepted standards of treatment or care.
Our Child Injury Lawyers have extensive experience representing infants, toddlers, kids, and teens harmed due to preventable medical errors and medical malpractice, earning national recognition for their aggressive pursuit of justice on behalf of injured children and their families. If your son or daughter experienced paralysis following spinal fusion or other pediatric spinal cord surgery, and you suspect medical malpractice, please call our law firm toll-free at 877-875-2927 to speak with an attorney and learn more about your legal rights.
When is Pediatric Spinal Cord Surgery Necessary?
Although spinal disorders are thankfully rare in children, there are a number of conditions that may require pediatric spinal cord surgery. Some of the most common include:
- Scoliosis: Scoliosis is characterized by an abnormal curvature of the spine, which can be either “C”-shaped or “S”-shaped when viewed from the front or back. In children, the condition may be present at birth (congenital), develop in adolescence (idiopathic), or be associated with disorders like cerebral palsy (neuromuscular).
- Kyphosis: Kyphosis describes an abnormal curvature in which the spine bends forward more than usual in the upper back, resulting in a rounded or hunched posture. Congenital kyphosis is present at birth and results from abnormal vertebral development during fetal growth. Scheuermann’s Kyphosis begins during adolescence and is caused by wedged or misshapen vertebrae in the thoracic (upper back) region, leading to an exaggerated forward curvature.
- Dysplastic Spondylolisthesis: Spondylolisthesis is characterized by the forward displacement of one vertebra over the vertebra below it. Dysplastic Spondylolisthesis occurs due to a congenital defect in the formation of the vertebra and is often present from birth.
- Chiari Malformation: Chiari Malformation is a congenital abnormality in which the cerebellum extends or herniates into the upper spinal canal through the opening at the base of the skull that connects the brain to the spinal cord. Depending on the severity, the displacement of the cerebellum tissue can cause a wide range of neurological issues, including speech problems, muscle weakness or spasticity, and vision loss.
- Spina Bifida: One of the most common abnormalities affecting the central nervous system, Spina Bifida is a congenital abnormality that occurs when the spinal column does not fully close during early fetal development. Myelomeningocele is the most severe and common form of spina bifida and is often associated with Chiari Malformation.
- Split Cord Malformation: Also known as Diastematomyelia, Split Cord Malformation is a congenital anomaly that involves the division or splitting of the spinal cord into two separate and often partially enclosed segments. Some patients with Split Cord Malformation may also experience Tethered Cord Syndrome.
- Syringomyelia: Syringomyelia is a neurological disorder often associated with Chiari Malformation. The condition is characterized by the formation of fluid-filled cavities or cysts, known as syrinxes or syringes, within the spinal cord that disrupt its normal function, potentially causing neurological symptoms that range from pain and muscle weakness to sensory disturbances, loss of coordination, and bladder and bowel dysfunction.
- Tethered Cord Syndrome: Tethered Cord Syndrome describes a disorder in which the spinal cord is abnormally attached or “tethered” to the surrounding tissues. Over time, the cord gets stretched, causing chronic injury to the cord. Tethered Cord Syndrome can be present at birth or acquired later in life due to factors such as injury, surgery, or scarring. Congenital forms are often associated with Spinal Cord Malformation (Diastematomyela), Syringomyelia, and Spina Bifida, especially Myelomeningocele.
- Thoracic Insufficiency Syndrome: TIS is a medical condition that affects the chest and spine, particularly in pediatric patients. It’s characterized by inadequate growth of the chest and ribcage, which can lead to restricted lung development and respiratory problems. TIS can occur as a result of various congenital or acquired factors, including certain types of Scoliosis.
Common Pediatric Spinal Cord Surgeries
Depending on a child’s specific diagnosis, treatment for spinal disorders may include bracing, casting, physical therapy, or surgery. The most common pediatric spinal cord surgeries include:
Spinal Fusion Surgery
Spinal fusion generally involves using screws, rods, or plates to stabilize the spine and hold the vertebrae in the desired position, as well as placing bone graft material between the affected vertebrae to promote bone fusion. The procedure can be approached in one of three ways:
- Anterior Spinal Fusion: Performed on the front of the spine through an incision in the child’s side.
- Posterior Spinal Fusion: The most common approach, this fusion procedure is performed on the back of the spine through an incision in the child’s back.
- Anterior-Posterior Spinal Fusion: This type of spinal fusion is performed on the front and back part of the spine through two incisions.
Spinal fusion surgery is frequently recommended to correct curvature and prevent further progression in kids with Scoliosis and Kyphosis when more conservative treatments have failed. However, fusion procedures may also be used to treat other conditions, including Dysplastic Spondylolisthesis and Syringomyelia.
The Shilla Technique
The Shilla Technique describes a specific type of spinal fusion involving specialized devices and implants, such as adjustable rods and screws, designed to allow for spinal growth. These growth-friendly implants can be lengthened or adjusted as the child grows, accommodating the natural growth of the spine.
A laminectomy is a surgical procedure performed to remove a portion of the lamina, the bony arch at the back of a vertebra in the spine. The procedure treats spinal conditions that cause compression or pressure on the spinal cord or nerve roots, including spinal stenosis, herniated discs, bone spurs, tumors, and certain congenital conditions after more conservative treatments have failed.
Vertical Expandable Prosthetic Titanium Rib (VEPTR)
VEPTR surgery is a specialized surgical procedure used to treat certain congenital or acquired chest and spine deformities, particularly in pediatric patients with Scoliosis and TIS. The VEPTR device is a specialized implant made of titanium. It consists of expandable rods, hooks, and other components that can be adjusted to accommodate the child’s growth.
Traditional Growing Rods
Used to treat Scoliosis, growing rods are temporarily attached to the spine via special screws to help correct curvature as the spine grows. The child must return to the operating room every six months for a mechanical lengthening procedure.
MAGEC Growing Rods
Like traditional growing rods, MAGEC rods are surgically attached to the spine to treat Scoliosis. However, they can be painlessly lengthened in a physician’s office via a magnetic controller, eliminating the need for further surgery.
Vertebral Body Tethering
VBT is an advanced surgical procedure in which screws or other devices are placed into the vertebral bodies along the curved section of the spine. A flexible cord or tether is then attached to these devices and tightened, pulling on the curved spine to partially straighten it. The tether restricts further growth on the convex side of the curve, allowing for correction as the patient continues to grow. VBT is considered a growth-friendly treatment for Scoliosis because the tethering system allows for ongoing correction and improved spine alignment as a child or teenager continues to grow.
Decompression surgery is the most common surgical treatment for Chiari Malformation. The procedure involves the removal of a small portion of the occipital bone (the back of the skull) and sometimes the first cervical vertebra to make room for the brainstem and cerebellum. This allows for improved cerebrospinal fluid flow and reduced compression of neural structures.
In some cases of Chiari Malformation, duraplasty is performed with decompression surgery. This involves opening the dura mater (the protective membrane covering the brain and spinal cord) and placing a patch or graft to expand the dural space, helping to maintain adequate cerebrospinal fluid flow and relieve pressure on the brainstem and spinal cord.
Spinal Cord Detethering
Surgical treatment of Tethered Cord Syndrome involves releasing adhesions and correcting abnormalities in the spinal cord to allow for the normal flow of cerebrospinal fluid and improved neural function. During the surgery, an incision is made in the back to access the spinal cord and surrounding tissues. Any adhesions, scar tissue, or structural abnormalities tethering the cord are carefully removed or released. The dura mater (the protective membrane surrounding the spinal cord) may be reconstructed to ensure the cord has enough space to move freely.
Paralysis from Pediatric Spinal Surgery: The Consequences
Paralysis describes a severe injury to the central nervous system that partially or completely inhibits a child’s ability to move their extremities. Forms of paralysis include:
- Monoplegia: Affects only one limb or region of the body.
- Diplegia: Affects corresponding parts on both sides of the body, including arms or legs.
- Hemiplegia: Affects only one side of the body; is usually caused by a stroke.
- Quadriplegia: Affects all four limbs, along with certain organs.
- Paraplegia: Affects all body parts from the waist down.
Paralysis from pediatric spinal cord surgery, whether partial or complete, can have profound consequences for kids and their families:
- Loss of Biological Functions: Children left paralyzed by pediatric spinal cord surgery often experience permanent bowel and bladder control loss. Some also have respiratory difficulties and require ventilation for the rest of their lives.
- Medical Expenses: Permanent paralysis means a lifetime of extensive and costly medical care, including hospitalization, surgeries, rehabilitation, and ongoing medical treatments.
- Assistive Devices: Children with paralysis may require assistive devices, such as wheelchairs, braces, and communication aids, for the rest of their lives. These devices can be expensive, and their maintenance and replacement costs add up over time.
- Home Modifications: Expensive home modifications may be required to make a child’s home safe and accessible, including ramps, widened doorways, and accessible bathrooms.
- Personal Care: Many people with paralysis require personal care assistance for the activities of daily living, including bathing, dressing, and feeding. The cost of hiring caregivers or nursing services can be significant.
- Lost Income: Paralysis can negatively impact a child’s future ability to work and significantly reduce their earning capacity as an adult.
- Reduced Quality of Life: Paralysis can limit a child’s ability to participate in activities kids typically enjoy, impacting their overall quality of life and social interactions.
- Psychological and Emotional Impact: Paralysis can lead to psychological and emotional challenges, including depression, anxiety, and adjustment disorders.
- Impact on Family. The family of a child who has been paralyzed is likely to experience emotional and financial strain. Mothers and fathers often leave their jobs to provide their son or daughter with 24/7 care, which can negatively impact the family’s financial well-being and quality of life.
When is Paralysis the Result of Medical Malpractice?
Avoidable medical errors that may result in paralysis after pediatric spinal cord surgery include:
- Negligent Neuromonitoring: During any type of high-risk spinal cord surgery, neurologists and other healthcare professionals are tasked with running intraoperative remote neuromonitoring technology to ensure the integrity of the spinal cord, including the signal being sent to the extremities, throughout the procedure. If the signal becomes weak or is lost, neuromonitoring tools should provide the OR team an opportunity to correct the issue and prevent permanent spinal cord injury. Unfortunately, there have been several cases where neuromonitoring tools were not being run regularly, or the healthcare professionals tasked with monitoring were texting or otherwise distracted during procedures, resulting in children becoming permanently paralyzed.
- Surgical Errors: Because the spinal cord is particularly delicate, any surgical error has the potential to cause grave injury, including full or partial paralysis. For example, a surgeon may inadvertently nick the spinal cord, use surgical instruments incorrectly or with excessive force, or use the wrong technique. If the surgeon cuts a blood vessel, insufficient blood flow to the spinal cord could result in paralysis, as could the misuse or misplacement of rods, screws and other hardware during the procedure. Paralysis may also occur if an anesthesiologist administering an epidural inserts the needle incorrectly.
- Improperly Placed Pedicle Screw: When not placed correctly, these screws can intrude into the spinal canal, leading to spinal cord and nerve damage. Unfortunately, a misplaced pedicle screw may not be immediately apparent, resulting in greater damage over time.
- Misadministration of Epidural Injection: Administering an epidural injection too close to the spine can cause significant nerve damage. This can result in sensory disturbances, weakness, or loss of motor function in the affected area, including full or partial paralysis.
- Inadequate Sterilization of the Skin Before Lumbar Puncture: While paralysis is generally not a direct consequence of inadequate skin sterilization during a lumbar puncture, a resulting infection, such as meningitis or an epidural abscess, could potentially lead to neurological deficits, including paralysis.
- Poor Patient Monitoring: Pediatric spinal cord surgery is typically lengthy and arduous. Insufficient monitoring of a patient’s vital signs, blood loss and oxygenation during and after a procedure can allow serious complications to go undetected, resulting in paralysis and other neurological injuries.
Paralysis associated with pediatric spinal cord surgery is not always the result of medical malpractice. From a legal standpoint, malpractice only occurs when a negligent doctor, hospital, or another healthcare provider, such as a nurse or physician, violates the standard of care and causes harm to a patient that would not have occurred otherwise. Without qualified legal counsel, parents and caregivers may have difficulty discerning whether their child’s paralysis was caused by a negligent healthcare provider who breached their duty of care, especially when a medical error isn’t immediately apparent.
No child should ever be left paralyzed due to a healthcare provider’s negligence.
If your son or daughter experienced paralysis after pediatric spinal cord surgery, nationally recognized child injury and pediatric malpractice lawyer Jeff Killino is ready to leverage his extensive experience to ensure all responsible parties are held accountable. Contact us toll-free at 877-875-2927 to get the legal help you need today.