Starship Paediatric Spine Service
Public Service Orthopaedics Paediatrics
The Starship Hospital Spine Clinic is nationally recognised for its patient care, education and research capabilities in the field of scoliosis, kyphosis, spondylolisthesis, trauma and other spine conditions. The orthopaedic surgeons of the Spine Clinic also provide care for children with a variety of neuromuscular conditions, which are frequently associated with spinal deformity, including cerebral palsy, spina bifida, and muscular dystrophy. The Spine Clinic is committed to providing patients with the most advanced and up-to-date treatment options available.
The Spine Clinic comprises three orthopaedic surgeons and a nurse specialist who provide assessment, treatment and follow-up for children and adolescents with spinal disorders. Families are invited to participate in research, which is ongoing and an integral part of this Department. The Spine Service is based at Starship Children’s Hospital but conducts outreach clinics in Waikato Hospital.
Because the Starship Hospital has the only paediatric dedicated Intensive Care Unit, it is the national referral centre for children with complex health needs who may require spinal surgery. Our orthopaedic services work closely with specialists in other departments such as neurosurgery, neurology, cardiology, respiratory and anaesthesia in order to ensure the best outcome for patients.
Congenital spinal disorders
Neuromuscular spinal disorders
Cervical instability - congenital and traumatic
You must have a referral from your GP or a specialist and you have to have been allocated an appointment before you can attend these clinics.
Tuesday 9am to 12.00pm
Thursday 8.30am to 12pm
Friday 8.30am to 12.00 pm
Emergency cases such as injuries must be referred via the Starship Paediatric Emergency Department.
Your child must be assessed by your GP or a specialist before they can be referred to the Spine Service at the Starship Hospital. If the referral is accepted, an appointment will be sent directly to you. If you do receive an appointment, please turn up on the day because, if you do not turn up, you will deprive another patient of this valuable appointment.
When the Spine Service receives a referral there are two options:
- The referral will be returned to the GP and they will be asked to manage the condition based on expert advice given to him / her from a Starship doctor.
- An appointment will be sent to you with advice that there will be a waiting time before your child can be seen.
If you receive an appointment you will need to go to the Outpatient Department on Level 3 of Starship Children’s Hospital where your child will be assessed by specialised doctors. This usually takes several hours and may involve additional tests.
Recommendations and options regarding your child’s future treatment plan will be discussed with you.
Please bring to the appointment:
- Any letters or reports from your doctor or another hospital
- Any x-rays, CT or MRI films and reports.
If you have a condition that was caused by an accident, you will receive faster attention and treatment by seeing an orthopaedic surgeon outside the hospital under the cover of the Accident Compensation Corporation (ACC).
Who Will My Child See When They Come To The Spine Clinic?
Each clinic is headed by a specialist spine surgeon. However, due to the large number of children seen in each clinic, your child may be seen initially by a registrar (a registered doctor who is undertaking further specialised training). The registrar will discuss your child’s condition with the specialist who will decide on the plan of treatment. Starship Children’s Hospital is a teaching hospital. There may be medical or nursing students attached to a clinic. Please let the clinic staff know if you or your child do not feel comfortable having a student present.
What Happens At The Spine Clinic?
X-rays of the spine are required at nearly every visit. X-rays assist the doctor to diagnose your child’s spine disorder and allow him to see the changes that may have taken place between visits. Modern x-ray machines ensure minimal exposure to radiation. You are welcome to discuss any concerns with the Radiology Department staff.
2. Medical and Family History
A complete medical history of your child and family will be taken. Your orthopaedic surgeon is looking for underlying medical conditions because some spinal problems can be associated with other disorders.
3. Physical Examination
The doctor will observe your child standing (front and back) and look for any asymmetry in the shoulders, rib cage, waist, and pelvis. Your child may be asked to put on a hospital gown because your doctor will need to view all of your child’s spine and hips as well as assess the skin for the presence of dimples, sinuses, hairy patches and pigmentation changes.
4. Neurological Examination
Sometimes neurological problems are the underlying cause of a spine disorder. A neurological examination includes evaluation of the function of the muscles and nerves of the upper and lower limbs. The following symptoms are assessed: pain, numbness, parasthesia (e.g. tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes.
When your doctor has made a full assessment he will be able to discuss diagnosis and treatment options with you.
Due to the complex nature of spine disorders and the need for x-rays, please come prepared to spend several hours at the Spine Clinic.
Other Diagnostic Tests
In order to help your doctor make a diagnosis your child may require more specialised tests such as:
CT Scan: Computerised Tomography uses a combination of x-rays and computer technology to produce more detailed images of bones and internal organs. It creates cross-sectional images (like slices) of the inside of the body.
MRI Scan: A Magnetic Resonance Imaging Scan uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. It is used to evaluate the spinal cord and spinal nerves which can not be seen on an ordinary x-ray.
Bone Scan: Useful for diagnosing subtle or hidden bone fractures that may not show up on a routine x-ray, such as a stress fracture. Bone scans can also help detect causes of unexplained back pain.
These tests are not usually available on the same day as your initial clinic appointment. A separate appointment will be necessary. Your child will then have a follow-up appointment made with the Spine Clinic to discuss the results.
Common Conditions / Procedures / Treatments
The most common condition seen in the Spine Clinic is scoliosis (a lateral/ sideways curvature of the spine).… More
The term neuromuscular scoliosis is used to describe curvature of the spine in children with any disorder of the neurological system.… More
Congenital scoliosis is defined as a lateral curvature of the spine that is the result of malformations of one or more vertebra.… More
Kyphosis (Postural, Scheuermann's, Congenital)
Kyphosis is the term used to describe the forward curvature of the thoracic spine.… More
Spondylolisthesis (Dysplastic, Isthmic)
Spondylolisthesis is the term used to describe when one vertebra slips forward on the one below it.… More
Back pain in children is abnormal and should be investigated thoroughly.… More
About 1 in 200 babies have torticollis, a shortening of a muscle in the neck causing their head to tilt to one side.… More
Spine Trauma / Injuries
The Starship Hospital Spine Service also treats children with fractures of the bones in the spine or injuries to the spinal cord. Usually, children are admitted acutely through the Emergency Department or are transferred from another hospital. Children with ongoing disability will require extensive rehabilitation. The Spine Service work closely… More
There are no charges for New Zealand citizens or those with permanent New Zealand residency when they are treated in the public hospital. All non-residents and visitors to New Zealand will be billed for the full cost of the consultations and treatment.
The only exception to this is for the treatment of accidents where the cost of treatment can be paid for by the Accident Compensation Corporation (ACC).
www.iscoliosis.com Very informative patient education website designed for families and young people with scoliosis.
www.srs.org The Scoliosis Research Society is an organization dedicated to education, research and treatment of spinal deformity. This site contains a very informative patient education section.
(09) 367 0000 ext 22492
Surgical booking enquiries:
(09) 367 0000 ext 22494
Nurse Specialist - Paediatric Spine
GP/External Specialist Help Desk: (09) 3072800
All referrals to Starship Paediatric Spine must be done through your family doctor or specialist. If you live outside the Auckland region, referrals must come via your local hospital.
Starship Children's Health
2 Park Road
Starship Children's Health
2 Park Road
Department of Orthopaedics
Private Bag 92024
Auckland Mail Centre
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This page was last updated at 2:38PM on September 14, 2020. This information is reviewed and edited by Starship Paediatric Spine Service.