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Advanced Pediatric Specialty Care: A Focus on Brain and Spine Surgery

The AMITA Health Neurosciences Institute is at the leading-edge of pediatric brain and spine surgery, offering a full spectrum of pediatric neurosurgical capabilities and expertise in the community setting. Patients and their families can stay closer to home, without the need to travel long distances for multiple evaluations and meetings. Surgical interventions are performed effectively by board-certified surgeons who are experts in their fields. The physicians at the AMITA Health Neurosciences Institute take a multidisciplinary approach to pediatric neurosurgery, with each patient benefiting from a close collaboration between pediatric neurosurgeons, orthopaedic spine surgeons, neurologists, nurses, child life specialists, neuropsychologists and reconstructive surgeons, if needed.

Pediatric Brain Surgery

In the area of pediatric brain surgery, the AMITA Health Neurosciences Institute’s Center for Pediatric Brain offers evidence-based approaches shown to improve patient experience and outcomes. For example, the highly trained pediatric surgical team emphasizes earlier diagnosis and the use of less-invasive procedures for endoscopic craniosynostosis. We recommend that patients be referred as early as possible (2-3 months of age) for any perceived abnormalities in head shape or growth. Earlier intervention, done while the skull is still thin, makes it possible to use small incisions that can help prevent secondary abnormalities.1 This minimally invasive approach differentiates the AMITA Health Neurosciences Institute from other in-community providers.

The pediatric neurosurgical team at the Center for Pediatric Brain also offers neuroendoscopy for hydrocephalus, which helps to avoid the need for shunts that can alter skull growth and carry a risk of malfunction that may require further surgery. Our team also collaborates with plastic surgery experts at the University of Chicago for elective surgeries for craniofacial abnormalities.

AMITA Health Neurosciences Institute’s Center for Pediatric Brain also provides leading-edge care for patients with epilepsy, including surgical options such as vagal nerve stimulation. We invite neurologists and epileptologists to refer their patients with epilepsy and focal brain abnormalities, or patients who have long-standing epilepsy that has been managed medically but with no improvement,2,3 to be evaluated as potential candidates for vagal nerve stimulation. The AMITA Health Neurosciences Institute will work closely with the referring physician to determine the right treatment for each patient.

The Center for Pediatric Brain continues to offer expedited concussion evaluations as well as concussion management.

Pediatric patients and their families who are referred to the Center for Pediatric Brain in Hoffman Estates will meet personally with the surgical team and undergo a full medical review to determine if any other tests or collaborative evaluations are required. The care team includes pediatric neurologists and neuropsychologists who contribute to patient evaluation, as well as pediatric anesthesiologists if imaging is needed. Patients and their families will receive a pre-procedural tour of the Institute and will have close contact with the care team at all times.

The pediatric brain surgeons and the surgical team stay in close contact with the referring physician, making it a point to always be available. Clinic notes are freely shared with the referring physician to ensure seamless, coordinated care. Bryan Bertoglio, MD, is available for phone consultations prior to referral for any pediatric neurosurgical procedure — referring physicians are invited to contact him at 847-981-3630.

Pediatric Spine Surgery

The pediatric spine surgical team at the AMITA Health Center for Spine Care provides care to patients of any age, from neonates to older teenagers, with seamless transition into adult spine care.

Pediatric patients with a straight spine and chronic pain who have already been seen by a pediatrician for pain are typically referred after completing a course of physical therapy, usually at least 6 weeks. Referral of pediatric patients with any type of spinal deformity — typically scoliosis or hyperkyphosis — is based on an X-ray showing a 20 degree or higher curve or more than 6 or 7 degrees on a scoliometer. However, the team will see patients with any curvature. Scoliosis affects approximately 3 percent of children, but only approximately 1 in 500 requires active treatment (bracing), and only approximately 1 in 5,000 will require surgery. All patient treatment plans include follow-up for life.

After graduating from the University of Illinois College of Medicine, Anthony Rinella, MD, completed his residency at Northwestern University, and a fellowship at Washington University in adult and pediatric spinal surgery. Prior to joining the team at the AMITA Health Neurosciences Institute, Dr. Rinella was on faculty at Loyola University Medical Center for eight years in a complex quaternary center. Dr. Rinella also founded an international outreach program, Global Spine Outreach, for treating spinal deformities. Through this outreach program, he has gained extensive experience in treating extremely complex pediatric spinal issues; he has treated more than 1,000 children in Poland, Colombia, and two cities in Mexico. Some of the children had extremely severe spinal curvatures. Dr. Rinella continues to lead Global Spine Outreach, which drives his philanthropic work.

When pediatric patients are referred to AMITA Health for spinal surgery evaluation, they undergo an initial comprehensive work up, including family history, physical exam and a review of imaging. Additional imaging may be ordered if needed. The team then reviews the patient’s case and makes treatment recommendations. The proposed treatment plan is discussed directly with the referring physician, through clinic notes and by phone. If surgery is recommended, all X-rays with measurements are printed out, and the rationale for the surgical plan is discussed with the referring physician. Dr. Rinella is also available for consultations prior to a referral, and can be reached at 630-856-8640 (Hinsdale) or 877-694-7722.

Exciting plans for the new Center for Spine Care in Woodridge

AMITA Health is committed to advancing spine medicine as an interdisciplinary field, by bringing together spinal surgery with primary care, urgent care and the subspecialties of orthopaedics, neurology, rehabilitation, pain management, pain psychology and advanced imaging into one physical space, planned for the Spring of 2019. The new facility will be home to top-of-the-line technology, such as an EOS machine with TOS imaging that uses extremely low radiation (1/10th the radiation of a standard X-ray) to produce much higher quality whole-body images.4,5 For pediatric patients diagnosed with scoliosis, AMITA Health offers the leading-edge MAGEC X system, which uses a less-invasive magnet-driven adjustable growing rod that reduces the need for repeat surgeries.6 Spine-related disorders are complex, particularly if surgery is indicated, and pediatric patients and their families can become overwhelmed if several specialists are involved in their care. To help address patients’ and their families’ emotional well-being, dedicated patient navigators help patients move among the different specialties based on their individualized, comprehensive care plan.

Bryan Bertoglio, M.D.

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Anthony Rinella, MD

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