The Pediatric Neurosurgery Division at UPMC Children’s Hospital of Pittsburgh (CHP) is led by Taylor Abel, MD, and also includes Robert Kellogg, MD, Michael McDowell, MD, Martin Piazza, MD, and Ian Pollack, MD. The division provides care for children with tumors, spinal and cranial deformities, vascular malformations, spasticity, epilepsy and peripheral nerve disorders. The division has gained international recognition for the treatment of pediatric brain tumors, epilepsy, neurovascular surgery, cerebral palsy and movement disorders, traumatic brain injury, and disorders of the skull base and cranio-cervical junction.
The center’s neurosurgeons work closely with specialists in pediatrics, surgery, radiation therapy, pediatric neuro-oncology, physical therapy, orthopedics, plastic surgery, otolaryngology, critical care, pediatric neurology and social services. Through its neuro-oncology program, the center provides comprehensive, multi-disciplinary care for patients with brain and spinal cord tumors, in collaboration with the oncology and radiation therapy programs. Patients may be eligible for treatment in one of many innovative research protocols at CHP. These protocols—several of which are unique to CHP or available at only a few centers throughout the country—provide CHP patients access to new treatments and promising studies.
The pediatric neurosurgery program is supported by five full-time advanced practice providers, which—along with an extensive telemedicine presence—has enabled expansion of the division’s outreach program to multiple communities beyond our immediate geographic area. Our research initiatives are also supported by four full-time research coordinators, allowing us to maintain a broad array of clinical studies to place our site on the cutting edge of pediatric neurosurgery patient care, while advancing the field in general.
Pediatric Brain Tumor Program
Dr. Pollack is the institutional principal investigator and chair of the neurosurgery committee in the Pediatric Brain Tumor Consortium, supported by the National Cancer Institute to perform cutting-edge clinical trials in children with brain tumors, and serves as the principal investigator on several studies involving vaccine-based immunotherapy for children with challenging brain tumors. The clinical program at CHP has been enhanced by the completion of an intraoperative MRI suite, which facilitates the goal of achieving safer and more extensive resections in challenging childhood brain tumors and allowing immediate postoperative imaging without the need for a second anesthetic.
These clinical advances are coupled with a robust and rapidly growing research enterprise, encompassing a state-of-the-art pediatric brain tumor bank, as well as a series of eight NIH R01, P01, and R21-funded research projects, and a cadre of rising-star investigators, including Sameer Agnihotri, PhD, Gary Kohanbash, PhD, Baoli Hu, PhD, and Antony MichealRaj, PhD. These activities build upon the division’s existing strength in experimental therapeutics and immunobiology, with a goal of developing the next generations of precision-medicine-based clinical trials.
Pediatric Epilepsy Surgery Program
The Pediatric Epilepsy Surgery Program, led by Dr. Abel and William Pequignot Welch, MD, of the University of Pittsburgh Department of Pediatrics, is the only center in the region able to provide comprehensive epilepsy surgery evaluation and performs more than 120 epilepsy surgeries each year. A comprehensive pre-surgical evaluation, using state-of-the-art neuroimaging and electrophysiology resources, is performed to identify the specific site in the brain causing seizures and to determine its relationship to important functional areas of the brain. Patients with focal epilepsy can be treated with the full range of treatment options including lesionectomy, cortical resection, lobar resection, or hemispheric disconnection—with or without a period of direct cortical recordings (i.e., SEEG or subdural grid electrodes) to elucidate epileptic cortex. The surgical epilepsy program is equipped with both a ROSA robot and O-Arm intraoperative CT scanner, which enables frameless robot-assisted SEEG implantation. Approaches are tailored to minimize the use of craniotomies when possible. The program is one of the highest volume centers for both pediatric MR-guided laser ablation and pediatric responsive neural stimulation (RNS) in North America. For children with drug-resistant multi-focal or generalized epilepsy, all available treatment procedures are available, including MR-guided laser callosotomy, traditional callosotomy, vagus nerve stimulation, centromedian RNS, and deep brain stimulation. A multidisciplinary epilepsy surgery clinic provides streamlined, comprehensive evaluation of children with drug-resistant epilepsy for surgery.
Dr. Abel’s basic research program focuses on understanding the neural basis of complex natural sound perception. This effort is funded by multiple federal grants, including funding from NINDS, NIDCD, and NSF. The epilepsy surgery program’s clinical research efforts, also directed by Dr. Abel, focus on comparative effectiveness of different epilepsy surgery strategies, and is funded by both PCORI and industry.
Pediatric Spasticity and Movement Disorder Program
The Pediatric Spasticity and Movement Disorder Program is involved in cutting edge clinical and basic research focused on developing and applying new and improved treatments for children with movement disorders. Dr. Kellogg manages this aspect of the practice and participates in The Spasticity and Movement Disorders Clinic that is held weekly. This clinic is made up of a team of pediatric medical professionals who specialize in the comprehensive, multidisciplinary evaluation and treatment of children and young adults with spasticity and other movement disorders, such as cerebral palsy, spasticity, dystonia, chorea, athetosis and tremor. The purpose of the clinic is to determine whether a patient would benefit from treatment with oral medications, intrathecal baclofen, selective dorsal rhizotomy, intramuscular botox injection, deep brain stimulation, orthopedic procedures, or other therapies. Additionally, the division offers intraventricular baclofen pumps, which is a therapy pioneered at UPMC Children’s Hospital of Pittsburgh by A. Leland Albright, MD, that has been revived with the addition of Dr. Kellogg. With the ROSA robot and O-Arm, asleep frameless stereotactic deep brain stimulation is available for children with dystonia and other movement disorders requiring neuromodulation.
Craniofacial Program
The division is an integral collaborator in the Cleft-Palate and Craniofacial Center in the management of children with craniofacial disorders. Because children with complex craniosynostosis often require a staged approach to the treatment of their cranial, midfacial and lower facial deformities, close multidisciplinary follow-up is maintained throughout childhood to adolescence in order to optimize long-term functional and cosmetic outcome. The center offers a panoply of surgical options, ranging from innovative endoscopic techniques that have been refined at CHP, as well as a broad range of open approaches carefully tailored to the child’s anatomy.
Congenital Neurosurgery Program
In conjunction with a team of specialists at UPMC Magee-Womens Hospital, the division has established a program to treat babies with myelomeningocele, or open spina bifida, with in utero surgery here in Pittsburgh. Babies who are not candidates for in utero surgery undergo conventional closure of the defect within several days of birth. These children are seen throughout childhood by a multidisciplinary team of medical professionals in the Spina Bifida Clinic at Children’s Hospital of Pittsburgh, one of the largest such clinics in the country. Expectant mothers are referred by the Fetal Diagnosis and Treatment Center at UPMC Magee-Womens Hospital for counseling in the pediatric neurosurgery clinic if prenatal imaging reveals a potential neurosurgical abnormality. The division collaborates with maternal-fetal medicine experts at UPMC Magee-Womens Hospital as co-PI on multiple grants to study in utero treatment of congenital aqueductal stenosis, a common cause of hydrocephalus.
The Brachial Plexus Birth Injury Clinic—run through the division of pediatric plastic surgery—manages infants with birth injuries to the brachial plexus in a collaborative fashion with specialists from neurosurgery, plastic surgery, orthopedic surgery, and physical and occupational therapy. UPMC Children’s Hospital of Pittsburgh is one of a handful of centers in the country that have a dedicated multidisciplinary clinic for these patients and is the only such program in the region. Older patients with peripheral nerve tumors or injuries are seen outside of the Brachial Plexus program.
UPMC Children’s Hospital of Pittsburgh is a member of the Hydrocephalus Clinical Research Network, a group of 11 premier pediatric neurosurgical departments in North America that are dedicated to designing and undertaking field-changing prospective research into pediatric hydrocephalus. In addition, CHP is also a member institution in the Park-Reeves Syringomyelia Research Consortium, a group dedicated to solving important clinical problems within the realm of Chiari malformation and syringomyelia. These efforts have led to dozens of publications that have helped to advance the field in collaboration with other consortium sites.
Skull Base Surgery Program
More recently, the division has added Dr. McDowell to our team, who brings particular expertise in the management of cranial base anomalies, after completing both endoscopic cranial base and pediatric neurosurgical fellowships. With this unique combination of skill sets, he is joined by the other members of the internationally acclaimed UPMC Center for Cranial Base Surgery in proving unmatchable care for disorders of the pituitary gland, skull base, and cranio-cervical junction. Dr. McDowell also brings research expertise in near infrared spectroscopy (NIRS) as a noninvasive way of monitoring brain function and intracranial pressure. He recently received the 2021 Hydrocephalus Association Award for his groundbreaking work that may soon have wide-reaching applications for disorders of intracranial pressure include trauma, Chiari malformation, craniosynostosis, and hydrocephalus. A large-scale clinical trial is underway to validate this technology in children and adults with neurosurgical conditions.
National and International Leadership in Pediatric Neuroscience
Finally, our division members maintain an active role in organized neurosurgery and allied fields. In addition to his consortium involvement, Dr. Pollack serves as chair of the American Board of Pediatric Neurosurgery, a director on the Accreditation Council for Pediatric Neurosurgical Fellowships, and a principal investigator with the Children’s Brain Tumor Network. Dr. Abel serves on the board of directors for the Pediatric Epilepsy Alliance. Dr. Abel also serves on board of directors of the American Epilepsy Society where he is chair of the American Epilepsy Society membership council. Dr. Abel serves on multiple committees in the American Epilepsy Society and AANS/CNS Section on Pediatric Neurosurgery, including the AES Membership Council, the AES Neurosurgery Task Force, and is the founding chair of the AES Early Career Committee. Dr. Abel also serves on the AANS/CNS Joint Guidelines Committee. Dr. McDowell is the chair of the Young Neurosurgeons Committee of the AANS/CNS Section on Pediatric Neurosurgery and the course director of the acclaimed “Brain and Blade” course for pre-clinical medical students, for which he was awarded the 2021 University of Pittsburgh Dean’s Distinguished Teaching Award.