Complex spinal surgeries on children with spina bifida paused after rise in complications

External review by US experts commissioned into Temple Street surgeries over the past three years

Urgently-needed, complex spinal surgeries at Temple Street children’s hospital have been paused since last year after an increase in complications was identified by staff.

An external clinical review of all complex surgeries carried out in the hospital over the past three years on children with spina bifida has been commissioned.

The review is being carried out by experts from Boston Children’s hospital and is expected to be presented to Children’s Health Ireland (CHI) in mid-July.

CHI says it decided to pause kyphectomy surgery on children with spinal bifida, which corrects rounding of the upper back, as this is the most complex type of spinal surgery in this group.


Asked whether it will publish the review, CHI said it intends to share the recommendations with key stakeholders.

CHI says the pause affects “a small number” of patients awaiting a particular type of fusion surgery and that spinal fusions “are continuing otherwise”.

Because of the pause, the number of complex surgeries carried out in Temple Street has plummeted – at a time when extra investment was expected to lead to an increase in the number of procedures carried out.

Just five spinal fusions have been completed in Temple Street so far this year, compared to 15 in the same period in 2022.

A spokeswoman said parents have been kept apprised of the status of the review.

“Spina bifida is a complex condition which affects multiple systems in the body. Children born with spina bifida have extremely complex needs and those needing spinal surgery are the most complex. As can be seen internationally, these complex cases do unfortunately have a high rate of complications,” according to CHI.

Sixteen families have been contacted by the review team, according to Amanda Coughlan-Santry, co-lead of the Spina Bifida and Hydrocephalus Paediatric Advocacy group. Most have children who urgently need surgery to prevent their spine curving further and are in “dire circumstances”.

She said her group noted a sharp increase in post-operative complications and readmissions last June and highlighted this to Minister for Health, Stephen Donnelly.

Initially, their “words fell on deaf ears” before services were “shut down” later last year. “The staff are doing what they can for our children. I have no issue with the quality of the work. The issue is the time it takes for children with deteriorating health to access services.”

Families were told the review was under way but have not been able to get any further information, she said.

At the end of April, there were 154 children waiting for spinal fusion surgery – 111 at Crumlin children’s hospital, 34 at Temple Street and nine at Cappagh hospital. There were also 142 children waiting for other spinal procedures.

In 2022, the HSE approved a €19 million plan to increase capacity scoliosis and spina bifida operations, which aims for no child to wait longer than four months for surgery.

A fifth operating theatre in Temple Street promised as part of the initiative was supposed to be ready last year but is still under construction.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times