For children with complex spinal conditions, the Johns Hopkins Pediatric Spine Program provides multidisciplinary care that encompasses chronic condition management, surgery, and recovery and rehabilitation, with a variety of specialty and subspeciality experts. Patients with spinal disorders such as scoliosis, kyphosis and spondylolisthesis have access to the latest surgical approaches, including an active robotic spinal surgery platform and an innovative hybrid surgery for complex scoliosis that aims to preserve motion and function.

Amit Jain, an orthopaedic spine surgeon and chief of minimally invasive spine surgery in the Johns Hopkins Medicine Department of Orthopaedic Surgery, says what sets the program apart from others is the quality and diversity of its expertise.

“At Hopkins, everybody is at the top of their game,” he says. “We’re able to tackle a breadth and complexity that’s truly unmatched, and a big part of that is the amazing colleagues we have and the ecosystem we have.”

In addition to Jain and his colleagues in orthopaedic surgery, the pediatric spine program includes clinicians from the Pediatric Complex Care Collaborative Program, pediatric nursing, pediatric anesthesia, the pediatric intensive care unit (PICU), the pediatric pain service and pediatric hospitalists, as well as pediatric physical medicine rehabilitation at Johns Hopkins Medicine and Kennedy Krieger Institute.

The program is a high-volume quaternary/tertiary center for pediatric spine care that specializes in complex pediatric scoliosis surgery, including pediatric neuromuscular spinal fusion, as well as adolescent idiopathic scoliosis (AIS). Jain treats both adult and pediatric patients with complex spine conditions.

Because hundreds of these surgeries are performed there each year, and advances developed for complex cases have informed more routine procedures, the center boasts stellar outcomes: The average length of stay for an AIS patient is two days, compared with the national average of four to five days; blood loss on average is much lower than national averages.

Johns Hopkins Medicine, a pioneer in robotic spine surgery, was one of the first medical centers in the country with a first-generation robotic platform for adult spinal surgery. A second-generation active robot, acquired by JHM in 2026, is suitable for pediatric patients. It moves with the patient, allowing for open surgery, and enabling surgeons to treat the most complex pediatric neuromuscular and congenital spine cases. Jain points to examples of patients with spinal curvatures of over 130 degrees for whom the robot helped guide screw trajectories to straighten the spine. Few centers in the world have the capabilities to treat patients with such complex conditions, he says.

Jain, as director of the spine surgery fellowship, teaches fellows how to use the robot and blood-conserving spinal surgical techniques. He also has an R01 grant to develop a next-generation robot.

Johns Hopkins Medicine was also an early adopter of an innovative treatment for pediatric scoliosis with two curves — the hybrid technique of thoracic fusion with lumbar vertebral body tether, a minimally invasive procedure in which the thoracic spine is straightened and fused using rods and screws, and a polyethylene cord is attached to the lumbar spine to allow for motion and flexibility.

Jain says patients have great outcomes and recoveries with this approach, and many are able to return to full athletic activity.

Collaboration with pediatric anesthesia allows surgeons to perform certain high-risk surgeries in an efficient and bloodless manner using cell salvage machines, which wash and recycle a patient’s blood.

After surgery, the PICU team, pediatric hospitalist team and pediatric pain service follow patients, making sure children are comfortable, and recommend plans to get them off opioids quickly if they have used them for pain control. Physical medicine and rehabilitation teams help patients restore function and mobility.

Prior to surgery, a multidisciplinary pediatric neuromuscular group — with Johns Hopkins and Kennedy Krieger experts in genetics, neuromuscular disorders and neurodevelopmental disorders — meets weekly to discuss chronic condition management, to identify patients who will need surgery, and to help optimize those patients ahead of surgery.

In the research realm, Jain is a member of the Harms Study Group, a worldwide cohort of about 40 master pediatric spinal surgeons. Jain has published over 300 scientific papers, many in top-tier journals. A foundational 2016 article in the Journal of Bone and Joint Surgery that the Harms Study Group produced, for which Jain is first author, detailed a system that helps surgeons predict which patients with cerebral palsy will have higher rates of complications after surgery, allowing surgeons to better counsel families. A recent study published in Spine Deformity, for which Jain was principal investigator, examined the trade-offs between long and short spinal fusions and motion preservation, ultimately finding no significant differences in patient outcomes between short and long fusions.

For Jain, all of the complex care, innovation and research is possible because of the entire pediatric spine team and those it collaborates with.

“It’s the whole village, that’s the secret sauce,” he says. “It’s not just the surgeon, or the robot — it’s the Hopkins village. That’s the real Hopkins advantage.”

Medically reviewed by Amit Jain, M.D., M.B.A.