STUDY DESIGN: Retrospective case report. PURPOSE: To provide true outcome analysis by a 63-year follow-up. MATERIAL AND METHODS: A 16-year-old girl had a posterior spine fusion for adolescent idiopathic scoliosis in 1939 and has been followed ever since. Both original photographs and radiographs as well as current material are available. BACKGROUND INFORMATION: A follow-up of this duration has not previously been reported. RESULTS: She had a solid T9-L3 arthrodesis and had no problems until age 50 when degenerative changes at L3-L4 required extension of the fusion to L4. When seen in 2002 at age 79, she had problems with degenerative disc disease at L4-S1 with spinal stenosis symptoms. CONCLUSIONS: The original fusion area remained solid and without symptoms for 63 years. Distal degenerative changes began 34 years after her original surgery and are still present at the 63-year follow-up. These degenerative changes at L4-L5 and L5-S1 are often thought to be secondary to the arthrodesis to L4, but because they are extremely common in persons of this age who do not have scoliosis or a fusion mass to L4, it is not possible to imply a cause and effect relationship. True outcome results cannot be ascertained at a 2-year or even 10-year follow-up.
STUDY DESIGN: Retrospective case report. PURPOSE: To provide true outcome analysis by a 63-year follow-up. MATERIAL AND METHODS: A 16-year-old girl had a posterior spine fusion for adolescent idiopathic scoliosis in 1939 and has been followed ever since. Both original photographs and radiographs as well as current material are available. BACKGROUND INFORMATION: A follow-up of this duration has not previously been reported. RESULTS: She had a solid T9-L3 arthrodesis and had no problems until age 50 when degenerative changes at L3-L4 required extension of the fusion to L4. When seen in 2002 at age 79, she had problems with degenerative disc disease at L4-S1 with spinal stenosis symptoms. CONCLUSIONS: The original fusion area remained solid and without symptoms for 63 years. Distal degenerative changes began 34 years after her original surgery and are still present at the 63-year follow-up. These degenerative changes at L4-L5 and L5-S1 are often thought to be secondary to the arthrodesis to L4, but because they are extremely common in persons of this age who do not have scoliosis or a fusion mass to L4, it is not possible to imply a cause and effect relationship. True outcome results cannot be ascertained at a 2-year or even 10-year follow-up.