Q&A with Blake K. Montgomery, MD

Meet Blake K. Montgomery, MD, a board-certified pediatric spine surgeon and the newest orthopedic physician to join the Orthopedic Center at Children’s Hospital of Philadelphia. A native of St. Louis, Missouri, Dr. Montgomery grew up playing sports and fishing, cultivating his early fascination with science and medicine. When injuries derailed a potential baseball career, Dr. Montgomery decided to become a physician.

Here, Dr. Montgomery shares details about his background, his clinical and research interests, his role models, and the type of care he plans to deliver to patients and families at CHOP.

Question: Can you share a bit about your background and training?

Answer: I come from a large family and grew up focusing primarily on academics and sports. Throughout my youth, I played baseball, football and basketball. I received a scholarship to play baseball in college, but after two injuries and four surgeries, my athletic career ended. I have wanted to be a doctor since reading a biography about a surgeon in third grade, but these experiences solidified my interest in orthopedic surgery.

Following my recovery, I entered a combined undergraduate and medical school program at the University of Missouri-Kansas City. After completing medical school, I attended Stanford University for my orthopedic surgery residency. Subsequently, I completed a pediatric orthopedic surgery fellowship at Harvard Medical School/Boston Children’s Hospital. Afterward, I pursued a second fellowship in complex pediatric spine surgery at Starship Hospital in Auckland, New Zealand.

Q: What inspired your interest in pediatric orthopedic surgery?

A: I chose to specialize in pediatric orthopedic surgery, particularly in spine conditions, because of the impact we can have on our patients’ lives and the complexity of the procedures we perform. I am passionate about helping a diverse range of children and adolescents with varying goals. For example, I enjoy assisting an adolescent athlete in returning to their sport, and the next day, helping a child with scoliosis sit more comfortably in their wheelchair.

Being a trusted part of my patients’ lives during their journey brings me immense joy and fulfillment. As for the procedures, I am drawn to the complexity of spine surgery. The intricate nature of these surgeries captivated me. Spending hours in the operating room to improve someone’s quality of life is incredibly rewarding, and I love being able to help people in this way.

Q: What’s something you want parents and patients to know when coming to meet with you?

A: I want parents and patients to know that my goal is always to do what’s best for their child. I understand how much trust it takes to come see a spine specialist – especially when decisions can feel high-stakes – and I never take that trust for granted.

Q: How have your fellowship experiences in Boston, New Zealand and the National Institutes of Health impacted the quality of care you deliver to patients today?

A: Training in several different settings – medical school in the Midwest, residency on the West Coast, clinical and research fellowships in the Northeast, and an international clinical fellowship in New Zealand – has broadened how I care for patients today.

Each place offered a different mix of patient needs, surgical approaches and care team styles. That variety helped me learn multiple safe, effective ways to treat the same problem, and to choose the approach that best fits each child and family. My time in research, including work at the NIH, also strengthened my commitment to evidence-based care – using the best available data, measuring outcomes and continually improving.

Together, these experiences shaped a care philosophy focused on thoughtful decision-making, clear communication, and individualized treatment – always aiming for the safest plan and the best long-term function and quality of life for my patient.

Q: Describe your experience caring for children and adolescents with spine conditions.

A: Children and adolescents with spine conditions are like any other individual, but their spine condition may hold them back from reaching their full potential or threaten their future. For example, we specialize in caring for adolescents with idiopathic scoliosis. Patients with idiopathic scoliosis may experience pain or discomfort, but another significant concern is that severe scoliosis can continue to worsen as they age into adulthood. My goal is to catch scoliosis early when it is still mild and prevent it from becoming severe, thereby avoiding the need for surgery. However, if the curvature of their spine has progressed too much, we sometimes recommend surgery to prevent severe scoliosis from worsening throughout the young person’s life.

Q: Describe the range of treatments you offer to patients and families.

A: I offer a broad range of non-operative and operative treatment options (including those listed below), and I tailor the treatment plan to the child’s diagnosis, age and growth remaining, symptoms, function and goals.

Non-operative treatments

• Observation/monitoring with scheduled exams and imaging, when appropriate
• Physical therapy and guided home exercise programs for strength, flexibility, posture and conditioning
• Bracing for scoliosis and other alignment conditions when it can help guide growth or prevent disease progression
• Activity guidance and return-to-sport planning when relevant
• Coordination with multidisciplinary partners (such as neurology, pulmonology, rehab, anesthesia/pain management, orthotics) for complex neuromuscular and syndromic conditions

Operative/procedural treatments

• Growth-friendly scoliosis surgery, with techniques designed to help control the deformity, while preserving growth
• Growing rod surgery, including magnetic expansion controlled growing rods
• Spinal fusion surgery, including complex deformity correction
• Complex spine bone removal procedures (osteotomies) for severe or rigid deformity when required
• Cervical (neck) surgery for pediatric neck/spine conditions requiring stabilization or decompression
• Disc herniation surgery for spine decompression
• Spine casting including Mehta casting and/or Risser casting for early-onset scoliosis
• Pars fracture repair and treatment of stress injuries
• Spondylolisthesis surgery for stabilization or reduction of the spine
• Bertolotti syndrome surgery to address symptomatic lumbosacral transitional vertebrae
• Treatment for thoracic insufficiency syndrome, including growth-friendly chest and spine approaches
• Halo gravity traction in select complex cases for gradual preoperative or staged spinal correction support

Q: How do you approach working with families, explaining their child’s condition and the treatment you suggest?

A: I aim to approach every family the way I would want my own family to be treated – with respect, honesty and compassion. My first goal is to listen and understand what matters most to the child and their family, including their concerns, goals and day-to-day impact.

When I explain a diagnosis, I aim to use clear, non-technical language and check for understanding along the way. I review what we know about the condition and what to expect over time. I also make space for questions and encourage families to take notes or bring a support person if helpful.

For treatment, I walk through the full range of options: starting with non-operative pathways when appropriate (such as observation, therapy, activity changes or bracing) and discussing surgery when it’s the best choice. For each option, I outline the benefits and risks, and what recovery would look like in real life situations like school, sports, pain control and follow-up.

Finally, I emphasize that we’re a team. My role is to guide families with expertise and recommendations and then work together to choose the plan that best fits their child’s needs as well as the family’s goals and expectations.

Q: What are the rewards of caring for children with complex spine and neuromuscular conditions?

A: Caring for children with complex spine and neuromuscular conditions is deeply rewarding because the work can make a meaningful difference in a child’s comfort, function and long-term quality of life. These cases require especially detailed planning and thoughtful decision-making, often with a multidisciplinary team, but that complexity is also what makes the impact so significant.

Many of these children have a great deal to gain and to preserve such as sitting balance, breathing and endurance, mobility, ease of daily care, and the ability to participate more fully at home and school. It’s also rewarding to partner closely with families over time – earning their trust, guiding them through difficult choices, and celebrating progress that may be incremental, but is truly life-changing.

Q: Why did you choose to come to CHOP and what are you most looking forward to in your new role?

A: I chose to join CHOP because of its long-standing reputation for delivering exceptional pediatric care to children from around the world. CHOP’s commitment to advancing outcomes through collaboration, innovation and family-centered care strongly aligns with how I practice.

In this new role, I’m most looking forward to joining a team dedicated to caring for children and adolescents with complex spine conditions and supporting families through challenging decisions and long care journeys. I’m also excited to help push the field forward by continuing to refine techniques and approaches that can make spine surgery safer, more effective and better for the next generation of patients.

Q: Are there any common misconceptions you hear from families when they first come to see you as it relates to their treatment options or outlook?

A: One of the most common misconceptions I hear is that families feel they “should have noticed sooner,” and they often carry a lot of guilt about that. I reassure parents that many spine conditions – especially scoliosis – can be present for quite a while before they’re obvious. Changes can be subtle; kids may not have pain, and growth spurts can make things appear to “suddenly” show up.

Another myth is that a spine diagnosis automatically means surgery, or that the outlook is inevitably poor. In reality, many children do very well with monitoring, therapy or bracing when appropriate. When surgery is needed, we spend a lot of time matching the treatment plan to the child’s condition, growth, function and the family’s goals. The path forward is thoughtful and individualized.

Q: Are there specific conditions that interest you from a research perspective?

A: I’m most interested in caring for children and teens with spine problems because the spine affects how they move, sit, sleep, play and feel every day. I see many conditions — like scoliosis (a curved spine), kyphosis (a rounded back), slipped or herniated discs, and stress fractures that can lead to spondylolisthesis (a small “slip” in the spine). These issues can cause pain, limit activities and affect confidence. I’m passionate about helping kids feel better, move more easily, and get back to the things they love.

Research is one of the best ways to help children – not just in our own clinics, but around the world – and to improve care for future generations. I’m interested in many areas of pediatric spine research, but I’m especially focused on young children with early-onset scoliosis. This group has limited treatment choices, and many of the options we rely on today still have important drawbacks. I’m motivated to study better, safer treatments that can correct the curve while protecting a child’s growth, function and long-term quality of life.

Q: Who are your role models, and how have they inspired you in your work?

A: I’m fortunate to have many role models, both personal and professional. Through many of my family members – especially my mother – I learned what it means to genuinely care for others, to show up consistently, and to keep working to be the best version of myself. Those lessons shaped my values long before medicine became my career.

Professionally, I’ve been inspired by mentors who listen carefully to patients and families, communicate clearly, and treat every decision with humility and purpose. They set the standard for dedication to excellent care – doing things safely, thoughtfully and with strong attention to detail – while also pushing the field forward through research, quality improvement and better systems of care. Their example drives me to provide the best care possible today and to keep working to make care even safer and better for the next generation.