Doctor Munish Gupta is Dedicated to Children with Severe Spine Deformities

Munish Gupta, M.D., is a compassionate physician on the Shriners Children's St. Louis team. He specializes in spinal deformities and treats many children who have severe scoliosis and kyphosis. Gupta hopes his patients and their families feel supported as they take on years-long treatment plans to ensure a healthy future for the patient. Recently, we spoke with Dr. Gupta about how patients and families benefit from care at Shriners Children's. Here is what he shared.

Which area of pediatric orthopedic care do you specialize in?

I specialize in spinal deformity of all kinds, especially severe deformity. Anything over 90 degrees is considered severe. I’ve been treating spinal deformities for 30 years and over time have developed strong skills in this sub-specialty. I served 18 years at Shriners Children’s Northern California. Then, I came to Shriners Children’s St. Louis. Overall, I’ve served 28 years within the Shriners Children’s system.

What makes Shriners Children’s unique?

The Shriners Children’s healthcare system is like a dream for a spine surgeon. You see the patient. You can take care of them. You don’t have to worry about insurance coverage. You don’t have to worry about who’s going to pay for the brace, for example. You can do what is needed for the patient without worrying about finances. It really helps the family be at ease because I think that’s one of the main things that the family worries about.

Do all your patients require surgery?

We see patients who can be treated with a brace successfully, but they have to be growing quickly and the curvature of the spine cannot be severe. If the curve is severe, then the only real option is surgery. The threat of a severe curve is that the lack of space in the torso can then pinch on their lungs and eventually affect their heart. It is best to straighten out the spine so the child doesn’t develop respiratory and heart problems.

What causes severe spinal deformities?

It’s called idiopathic scoliosis because we don’t know the driving force behind it. There has been a lot of research on this question. Researchers have found several genes related to the diagnoses of spinal deformities – but a lot of factors are either positive or negative. There are more than 300 such factors being researched.

Can you share an example of a treatment plan for a patient with a severe curve?

A girl with a spine curve of 120 degrees would require a treatment plan that is multifold. First, the patient will be put in traction. This will stretch the spine and open up the curve, to hopefully make it less severe. Then, we would surgically add growing rods. Those rods stay in as long as the child is still developing. Then, once the child reaches maturity, we would likely do a final spinal fusion.

What should I do if my child has a spine curve?

If your child has a small curve, especially if they have a lot of growth left, you should seek an opinion. What is the extent of the curve? What are the options in terms of treatment? For some, treatment will start with observation. If the curve starts growing in severity, then we may start with a brace. If the curve doesn’t respond to bracing and still continues to get worse, then you can do a fusion instrumentation. Adversely, if the child is very young and has developed a severe curve, then you have to use some sort of growing systems to straighten while still allowing the spine to grow. You want to avoid fusing the spine of a child who is very small because that will limit their ultimate height.

We thank Dr. Gupta for taking time out of his busy clinic schedule to share his commitment to compassionate pediatric spine care.