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

STUDY DESIGN. Case report. OBJECTIVE. To 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 DATA. Although 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. METHODS. Original chart, radiographs and photographs were compared to the situation 36 years after surgery. Pulmonary function tests and blood gasses were obtained at follow-up. RESULTS. At 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. CONCLUSION. The 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.