A World-First By A Turkish Physician

Kyphosis, commonly known as a hunchback, is a condition characterized by an excessive forward curvature of the spine. Adolescent kyphosis, which typically manifests during puberty, can significantly impede normal growth and development in children, necessitating early therapeutic intervention. In recent years, tethering (band-tensioning) surgery—a minimally invasive, motion-preserving procedure that offers complete recovery—has emerged as a leading option for patients requiring surgical intervention. The “Posterior Vertebral Tethering” technique, developed by Prof. Dr. Mehmet Aydoğan, the Head of the Advanced Spine Center at Memorial Şişli Hospital, and recognized in medical literature worldwide, allows patients to resume their school and social lives in a short time without any loss of movement, and even to continue engaging in sports and dance at a professional level.

A treatment that supports healthy growth in pediatric patients

Adolescent kyphosis is a progressive spinal disorder that manifests as increasing hunchback in children aged 10 to 19 years. The prevalence of the condition ranges between 4-8%. Although genetic factors are thought to play a role in its onset, the exact cause remains unclear. The pathophysiology of kyphosis involves a slowed growth in the anterior aspect of the vertebral column while growth in the posterior aspect continues, resulting in the formation of a spinal curvature. As the condition progresses, an increase in curvatures in the lumbar and cervical regions may also occur simultaneously, disrupting the body’s overall balance and significantly diminishing quality of life, causing back and neck pain. In advanced cases, kyphosis may necessitate lumbar-cervical surgeries and potentially lead to shortness of breath and respiratory difficulties. Particularly in children and adolescents, the aesthetic concerns caused by kyphosis can also lead to various psychological and behavioral issues. 

It is crucial for children with noticeable spinal curvature to be examined by a physician at an early stage. The degrees of kyphosis are determined by calculating the curvature of the spine. While the upper limit for spinal curvature is 50 degrees, surgical intervention is considered for kyphosis patients when the curvature exceeds 70 degrees, as the condition can increasingly impair quality of life. The goal of kyphosis surgery is to correct the spinal deformity, achieving a functional, pain-free, and aesthetically pleasing spine. This allows the child to continue living a healthy life. 

A revolutionary treatment approach for adolescent kyphosis

The conventional surgical management of kyphosis involves the correction of spinal curvature through the application of pedicle screws and rods, culminating in the fusion of the involved vertebrae. Although this approach restores physiological spinal alignment, it inevitably results in the loss of 

movement between the vertebrae, which adversely affects not only the patients’ range of motion but their overall quality of life. This has led to the development of new treatment approaches aimed at supporting a more comfortable growth process for patients. 

Prof. Dr. Mehmet Aydoğan, the Head of the Advanced Spine Center at Memorial Şişli Hospital, has developed a method for treating kyphosis inspired by his experience with scoliosis surgeries. The technique, known as “Posterior Vertebral Tethering,” allows for the treatment of kyphosis without fusing the vertebrae, thereby preserving intervertebral movement. As a result, children who undergo kyphosis treatment using this method can continue their lives without loss of mobility. Furthermore, those who wish to pursue careers as professional athletes or dancers are not adversely affected by having undergone kyphosis surgery.

Advantages of the tethering surgery

• Tethering surgery supports the child’s growth process and does not hinder it.
• It preserves the mobility of the spine, allowing children to continue engaging in professional sports and dance activities. 
• The operation is performed using a minimally invasive technique with small incisions, leaving no visible scars. 
• The risk of bleeding and infection is minimal.
• The recovery time is significantly reduced, enabling children to return to school and their daily activities quickly.

A significant contribution for spine surgeons and children worldwide

Prof. Dr. Mehmet Aydoğan has been conducting scientific research in the field of spine surgery for over 20 years at prestigious hospitals in Turkey as well as UCLA (the University of California, Los Angeles). 

He meticulously followed the clinical and radiological outcomes of the first 10 patients treated with the “Posterior Vertebral Tethering” method over an average of three years. The results of his work were published in the European Spine Journal, one of the most respected journals in orthopedics and traumatology, and the official publication of the European Spine Society, announcing the outcomes of his method to the scientific community.

This groundbreaking technique, which has been recognized as a major advancement in the field of spine surgery, has been well-received in the literature and has garnered substantial interest from specialists worldwide. The possibility for children with kyphosis in other regions to be treated with the “posterior vertebral tethering” method, preserving spinal flexibility and restoring their health, is both a source of pride and joy for us.