Infant’s Rare Spinal Defect Is Detected and Repaired by Mount Sinai Doctors

Philip Ferreira was born at The Mount Sinai Hospital on May 24, 2020, via an uneventful vaginal birth. His mother, Thaís Lopez Polo, describes him as always being “very active and loving.” It wasn't until Philip was about nine months old that a dimple and excessive hair were discovered on his lower back during a dermatology appointment to evaluate a hemangioma on his neck. Thaís never thought that something as small as a dimple would be linked to a neurological issue with her son's spinal development that would require surgical intervention.

In early 2021, thinking it was just a birthmark, Thaís brought Philip to a dermatologist. During the appointment, the doctor noticed a tuft of hair and a sacral dimple—a small indentation located just above the crease between the child’s buttocks. As a fetus matures, the skin, brain, and spine develop from the same embryonal tissue, and this excessive hair and indentation alerted the dermatologist that more detailed tests were required to investigate whether Philip had any abnormalities in the formation of his spinal canal. The dermatologist referred Philip to Walter Molofsky, MD, a pediatric neurologist at the Mount Sinai Kravis Children’s Hospital who is Associate Professor of Neurology and Pediatrics at the Icahn School of Medicine at Mount Sinai and Director of Pediatric Neurology for the Mount Sinai Health System.

Dr. Molofsky conducted imaging and tests that determined that Philip had tethered spinal cord syndrome, a neurologic disorder in which the spinal cord adheres to tissue within the spinal canal, causing the spinal cord to stretch as a child grows. The syndrome can lead to neurologic deficits and discomfort. Dr. Molofsky referred Philip to Peter F. Morgenstern, MD , Assistant Professor of Neurosurgery and Pediatrics at Icahn Mount Sinai, for further neurosurgical evaluation.

In his first appointment with Philip, on March 16, Dr. Morgenstern explained that for Philip to live a normal, healthy life and not develop serious problems in the future he would need surgery to correct the tethered spinal cord. Not all children need surgery for a tethered cord, but Dr. Morgenstern saw an early sign on Philip’s imaging of stretching of the spinal cord -  a fluid collection in the spinal cord. 

“My feeling as a mother was one of fear,” Thaís recalled. “After all, it is a surgery on a baby's back. But I prayed a lot, I asked God to calm me down and lead everything in the best possible way, so that Philip could face all this in a calm way.”

The surgery was scheduled for April 23. Although Thaís was scared that her 11-month-old son required neurosurgery, she said Dr. Morgenstern and physician assistant Christina Curnias, PA-C, made her feel at ease leading up to the procedure.

Philip underwent a successful lumbar laminotomy for release of the tethered cord and spent three days in the hospital after the operation for monitoring and to allow his back to begin healing. As with many infants, he needed mild sedation for these three days to keep him calm. Thaís described those three days as the hardest of her life, and she was worried about his future. But on April 26, the day Philip was discharged, Dr. Morgenstern assured her that he would be able to return to normal toddler life—walking, playing, rolling, and crawling.

Since the surgery, Thaís said Philip is continuing to develop well. He happily celebrated his first birthday a month after his discharge. On June 8, she brought Philip to Mount Sinai Kravis Children’s Hospital for his first follow up appointment with Dr. Morgenstern, who confirmed that his incision was healing perfectly.

“Since it all started, the most important thing in this whole process was the care of Dr. Morgenstern, Christina, and their entire team,” Thaís said. “He and his team are very professional and very caring. This is very important for parents who are going through this difficult time.”

“Anytime my husband and I thought we should seek another medical opinion, we thank God every day for bringing Dr. Morgenstern, Christina, and their team into our life.”