• Spine · Dec 2007

    Case Reports

    Congenital thoracic scoliosis with unilateral unsegmented bar and concave fused ribs: rib osteotomy and posterior fusion at 1 year old, anterior and posterior fusion at 5 years old with a 36-year follow-up.

    • Robert B Winter and John E Lonstein.
    • Twin Cities Spine Center, Minneapolis, Minnesota 55404, USA. jwinhaven@aol.com
    • Spine. 2007 Dec 15; 32 (26): E841-4.

    Study DesignCase report.ObjectiveTo document the 36-year follow-up of a patient with a fusion at age 1 year for congenital scoliosis with a unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs.Summary And Background DataAlthough early spine fusion has been recommended as a life-saving measure for this problem, very little information exists as to the long-term effect of such treatment.MethodsOriginal chart, radiographs and photographs were compared to the situation 36 years after surgery. Pulmonary function tests and blood gasses were obtained at follow-up.ResultsAt age 37, the patient is free of any respiratory complaints, is an avid golfer, is married with 2 children, and the manager of a large factory. His pulmonary volumes are about half of normal, but his blood gasses are normal.ConclusionThe early fusion prevented the customary severe progression of this condition and early death due to cor pulmonale. He is a fully functioning member of society. Will more modern treatments with lengthening of the hemithorax provide a better outcome? Only time will tell.

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